Female pattern alopecia is frequently referred to as androgenetic alopecia. The onset generally occurs after puberty. However, rarely, androgenetic alopecia can occur in prepubertal children. Typically, female pattern alopecia starts prior to 40 years of age. Both frequency and severity increase with age, with an increase in incidence around menopause.

Hereditary transmission of female pattern alopecia is consistent with a polygenic trait, where many genes are involved in its susceptibility. In androgenetic alopecia, there is progressive shortening of the anagen growth phase with increased telogen and catagen hair transformation, which leads to follicular miniaturization. For men, this process is known to be due to dihydrotestosterone (DHT). However, the role of DHT is less certain in pattern hair loss in women. 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.