Female pattern alopecia is frequently referred to as androgenetic alopecia. It is most commonly noticed after menopause, although it may begin any time after puberty. The incidence of androgenetic alopecia in women is thought to be less than that in males, although some argue that differences in expression only make it seem that this is the case. Both frequency and severity increase with age.

Hereditary transmission of female pattern alopecia is consistent with a polygenic trait where many genes are involved in its susceptibility. In susceptible hair follicles, dihydrotestosterone (DHT) binds to the androgen receptor, and the hormone-receptor complex activates the genes responsible for the gradual transformation of large terminal follicles to miniaturized follicles. The role of DHT is less certain in pattern hair loss in women compared with men. In contrast to men, female pattern alopecia usually presents as diffuse thinning of the central portion of the scalp with sparing of the frontal hairline. Hair thinning is often more evident in the frontal portion of the scalp, resulting in "Christmas tree pattern" thinning of the central part.