Testosterone Cypionate Hair Loss Severity Grading: A Clinical Rubric for Accelerated Male-Pattern Baldness

Does the Depo-Testosterone label grade hair loss?

The label lists 'male pattern of baldness' in its adverse reactions section, alongside hirsutism, seborrhea and acne [1]. That section gives no frequency, no staging and no timing, and attaches no dose or DHT level to the reaction [1].

What the Norwood classification measures

Norwood published the classification still used for male-pattern hair loss in 1975, in a paper that also estimated how often each pattern appears in 1,000 white adult men [2]. The classification describes the pattern of loss; it does not date the loss or assign a cause.

Does a stage tell you whether testosterone caused the loss?

No. Male-pattern hair loss is common without any drug: in a community sample of healthy men aged 18 to 49, 42% had type III or greater loss, ranging from 16% at ages 18 to 29 to 53% at ages 40 to 49 [3]. A stage recorded after starting testosterone cypionate has to be read against that background.

In many tissues testosterone acts through its reduction to dihydrotestosterone [1]. In a review of testosterone therapy in transgender men, alopecia is listed among the undesired effects and was still developing after the first year [4]. The label gives no Norwood-stage data or progression rate for men on testosterone cypionate [1], so a grade reflects the pattern of loss, not a measured rate of drug-related progression. Scalp dermoscopy allows staging of severity and monitoring of progress in androgenetic alopecia [5].