Though the underlying causes for male and female pattern hair loss are same, there is some basic difference with regards to the physiology and genetics of the condition.
As already discussed, it is the altered metabolism of androgen in a genetically pre-disposed male and female which plays a major role in female and male pattern hair loss. 2 steroid-metabolizing enzymes (5a-reductase and aromatase), and androgen receptor proteins (ARPs) are the major metabolites of androgen metabolism.
Women have 3 to 3.5 times less 5α-reductase (types I and II) in their hair follicles as compared to men but the levels of enzyme aromatase in their bodies is significantly higher than those in males.
The aromatase enzyme is also part of normal androgen metabolism and has a protective effect on hair follicles. It brings about the conversion of androgen to estradiol and estrone, and therefore, there is less conversion of testosterone to DHT. It is also interesting to note that aromatase level in frontal hair follicles is 50% that of occipital hair follicles. This is the reason why women with androgenetic alopecia usually retain their frontal hairline and also explains the reason for difference in pattern of balding in men and women.
Changes in the levels of hormones also affect hair production in women. After menopause, estrogen level becomes low and they become prone to the destructive effect of DHT (Dihydro Testosterone) The hair on the head start becoming thinner and no new hair is produced. The gradual thinning of the hair is also associated with decrease in the diameter of the hair. The follicles remain alive but contain only miniaturized hair, and there is always a possibility of re-growth.
The typical pattern of female pattern baldness is different from that of male pattern baldness. Though the thinning of hair is seen all over the head, the frontal hairline is maintained. Widening of the natural part is also evident. There may be a moderate loss of hair on the crown, but this rarely progresses to total or near baldness as it may in men. The female pattern baldness is depicted on a Ludwig Scale.