Anagen formulation · 5 activesBFemale-pattern-targeted multi-mechanism stack

For The Ladies

Anagen's female-pattern combination protocol: topical spironolactone + microdosed T3 + estriol + minoxidil + levocetirizine. Designed to address the multiple drivers of female pattern hair loss in a single daily topical.

What's in it

Every active in For The Ladies

Each active in this formulation, scored against its own standalone evidence for AGA. Click any active for the full claim-by-claim breakdown.

Active	Grade	Why it's in this formula
Spironolactone0.25% Anti-androgen (topical)	B	Oral spironolactone is established standard-of-care for female pattern hair loss, particularly in combination with minoxidil. A 2025 comparative RCT (n=80 women, 6 months) found topical 1% spironolactone gel and topical 5% minoxidil gel both produced clinical improvement by Ludwig scale and trichoscopy. Anagen's 0.25% dose is lower than the studied 1% — the lower-dose efficacy floor is inferred rather than directly tested.
Liothyronine (T3)6.5 ng/mL→Anagen induction	C	Microdosed T3 for follicular activation. Particularly relevant in female pattern hair loss given the well-documented association between thyroid dysfunction and hair loss in women.
Estriol0.02% Estrogenic adjunct	C	Topical estrogens have published evidence for female pattern hair loss. The closest analog is 17α-estradiol 0.025% (Ell-Cranell® alpha), which in a phase IV trial (n=53 women, 8 months) significantly increased hair count and diameter. Estriol is a weaker estrogen than 17α-estradiol; whether this translates to comparable scalp efficacy at 0.02% is not directly studied.
Minoxidil5%→Follicular activator	A	5% topical minoxidil is FDA-approved for female pattern hair loss with extensive RCT evidence. Carries the primary efficacy load in this formulation.
Levocetirizine0.5%→Anti-inflammatory / anti-PGD2	C	PGD2-pathway adjunct.

The case for this stack

Why we paired these actives

Why a five-active female-pattern formula

Female pattern hair loss is mechanistically distinct from male AGA. While androgens (including DHT) play a role, the picture in women involves estrogen decline (particularly perimenopausal/postmenopausal), thyroid sensitivity, and individual variation in how aggressively scalp follicles respond to circulating androgens. The combination strategy targets these multiple drivers in parallel. The foundation pairing is minoxidil + topical spironolactone — analogous to fin+min in men. Oral spironolactone + minoxidil is the established standard-of-care female combination, and a 2025 comparative RCT (Hassan et al., n=80) demonstrated topical spironolactone 1% gel produces clinical and trichoscopic improvement comparable to topical minoxidil 5% gel. Anagen's protocol uses both — at a lower spironolactone concentration (0.25%) than the studied 1%. On top of that foundation, estriol provides the estrogenic axis (the closest published analog is 17α-estradiol 0.025%, which has phase IV trial data showing significant hair count improvement in female pattern loss). T3 and levocetirizine add their respective mechanisms. The lower estriol and spironolactone doses are calibrated to balance combination breadth against systemic exposure — a concern in women, particularly those of reproductive age.

Cited literature

Hassan GFR, Elsaftawy RE, Mady OY, Gheida SF (2025). Evaluation of the Efficacy and Safety of Topical Spironolactone versus Topical Minoxidil in the Treatment of Female Pattern Hair Loss: A Comparative, Clinical, and Trichoscopic Study. Int J Trichology PMID 40654550
Kim JH, Lee SY, Lee HJ, Yoon NY, Lee WS (2012). The Efficacy and Safety of 17α-Estradiol (Ell-Cranell® alpha 0.025%) Solution on Female Pattern Hair Loss: Single Center, Open-Label, Non-Comparative, Phase IV Study. Ann Dermatol PMID 22879713
Choe SJ, Lee S, Choi J, Lee WS (2017). Therapeutic Efficacy of a Combination Therapy of Topical 17α-Estradiol and Topical Minoxidil on Female Pattern Hair Loss: A Noncomparative, Retrospective Evaluation. Ann Dermatol PMID 28566902

What's been studied

The studies behind the combination

No published RCT of this exact five-active formulation. The evidence base is per-component and per-pairing — strongest for minoxidil, supportive for topical spironolactone and topical estrogens, mechanistic for T3.

Hassan 2025 — Topical spironolactone vs minoxidil in FPHL

Int J Trichology · PMID 40654550

RCT

Design

Comparative RCT

Duration

6 months

Topical 1% spironolactone gel twice daily produced clinical improvement by Ludwig scale, Global Esthetic Improvement Scale, and trichoscopy — comparable to topical 5% minoxidil gel. Establishes topical spironolactone as a legitimate active for FPHL. Anagen's 0.25% concentration is lower than studied.

Kim 2012 — 17α-estradiol phase IV (closest topical estrogen analog)

Ann Dermatol · PMID 22879713

OPEN-LABEL

Design

Open-label, phase IV

Duration

8 months

17α-estradiol 0.025% solution applied daily produced statistically significant increases in hair count and hair diameter in Korean women with female pattern hair loss. Anagen uses estriol (not 17α-estradiol) at 0.02% — same approximate concentration, weaker estrogen.

Choe 2017 — Topical 17α-estradiol + minoxidil combination

Ann Dermatol · PMID 28566902

OBSERVATIONAL

Design

Retrospective

—

Duration

6 months

Combination of 0.025% topical 17α-estradiol + 3% topical minoxidil increased total hair count and hair caliber over 6 months in female pattern hair loss patients. Suggests topical estrogen + minoxidil pairing has additive benefit.

Oral spironolactone + minoxidil — established female AGA combination

Multiple

RCT

Design

Multiple RCTs and prospective trials

—

Duration

—

Oral spironolactone 100 mg/day + topical minoxidil produces synergistic hair density improvement in female pattern hair loss. Standard-of-care combination protocol; cited here as the analog Anagen's topical version is calibrated against.

Honest limits

What the science doesn't yet answer

Anagen's topical spironolactone is 0.25%, while the only direct comparative RCT used 1%. Whether the lower dose retains comparable efficacy is not directly studied.
Anagen uses estriol (a weaker estrogen) where most published topical-estrogen evidence is for 17α-estradiol. Estriol-specific RCT data in female pattern hair loss is limited.
No RCT has tested this exact five-active formulation. Combining anti-androgen + estrogenic + thyroid + vasodilator + anti-inflammatory mechanisms is mechanistically broad but not directly validated as a stack.
Whether female pattern hair loss patients with primarily non-androgenic etiology (perimenopausal, post-pregnancy, stress-driven) benefit equally from the spironolactone component is not directly tested.
Long-term (>1 year) outcomes of this protocol vs simpler female combinations (e.g., spironolactone + minoxidil only) are not characterized.

Bottom line

Our verdict on For The Ladies

Female-pattern maximalist

For The Ladies is Anagen's most ambitious female-pattern protocol. The foundation — minoxidil + topical spironolactone — has supportive RCT evidence, and the layered mechanisms (estrogenic, thyroid, anti-inflammatory) each carry independent human data. The honest evidentiary picture: minoxidil is Grade A in women, the topical-spironolactone-in-women evidence is meaningful but recent (2025 RCT), and the supporting actives carry the same per-component evidence quality as in Anagen's male combinations. No RCT has tested the five-active formulation as a whole — the case is mechanism-based plus per-component data. For women who want a single daily topical that addresses multiple female-AGA drivers at once, this is the maximalist option. For women who want the cleanest evidence base, a topical spironolactone + minoxidil combination — without the layered actives — sits one tier closer to directly-studied data.

Anti-androgen + estrogenic + thyroid + vasodilator + anti-inflammatory in one female-pattern topical. Strong on each component; the combined formulation is the editorial extrapolation.

Compare

How does For The Ladies compare to its closest Anagen siblings?

For The Ladies MaxB

For The Ladies, tuned for post-menopausal hair loss

Read the evidence →

Guys & GirlsB

Strong base regimen without androgen modulation

Read the evidence →

The BasicsA

The cleanest evidence in the catalog

Read the evidence →

← Back to all treatments & brands

Every active in For The Ladies

Each active in this formulation, scored against its own standalone evidence for AGA. Click any active for the full claim-by-claim breakdown.

Active	Grade	Why it's in this formula
Spironolactone0.25% Anti-androgen (topical)	B	Oral spironolactone is established standard-of-care for female pattern hair loss, particularly in combination with minoxidil. A 2025 comparative RCT (n=80 women, 6 months) found topical 1% spironolactone gel and topical 5% minoxidil gel both produced clinical improvement by Ludwig scale and trichoscopy. Anagen's 0.25% dose is lower than the studied 1% — the lower-dose efficacy floor is inferred rather than directly tested.
Liothyronine (T3)6.5 ng/mL→Anagen induction	C	Microdosed T3 for follicular activation. Particularly relevant in female pattern hair loss given the well-documented association between thyroid dysfunction and hair loss in women.
Estriol0.02% Estrogenic adjunct	C	Topical estrogens have published evidence for female pattern hair loss. The closest analog is 17α-estradiol 0.025% (Ell-Cranell® alpha), which in a phase IV trial (n=53 women, 8 months) significantly increased hair count and diameter. Estriol is a weaker estrogen than 17α-estradiol; whether this translates to comparable scalp efficacy at 0.02% is not directly studied.
Minoxidil5%→Follicular activator	A	5% topical minoxidil is FDA-approved for female pattern hair loss with extensive RCT evidence. Carries the primary efficacy load in this formulation.
Levocetirizine0.5%→Anti-inflammatory / anti-PGD2	C	PGD2-pathway adjunct.

Why we paired these actives

Why a five-active female-pattern formula

Cited literature

Hassan GFR, Elsaftawy RE, Mady OY, Gheida SF (2025). Evaluation of the Efficacy and Safety of Topical Spironolactone versus Topical Minoxidil in the Treatment of Female Pattern Hair Loss: A Comparative, Clinical, and Trichoscopic Study. Int J Trichology PMID 40654550
Kim JH, Lee SY, Lee HJ, Yoon NY, Lee WS (2012). The Efficacy and Safety of 17α-Estradiol (Ell-Cranell® alpha 0.025%) Solution on Female Pattern Hair Loss: Single Center, Open-Label, Non-Comparative, Phase IV Study. Ann Dermatol PMID 22879713
Choe SJ, Lee S, Choi J, Lee WS (2017). Therapeutic Efficacy of a Combination Therapy of Topical 17α-Estradiol and Topical Minoxidil on Female Pattern Hair Loss: A Noncomparative, Retrospective Evaluation. Ann Dermatol PMID 28566902

The studies behind the combination

Hassan 2025 — Topical spironolactone vs minoxidil in FPHL

Int J Trichology · PMID 40654550

RCT

Design

Comparative RCT

Duration

6 months

Kim 2012 — 17α-estradiol phase IV (closest topical estrogen analog)

Ann Dermatol · PMID 22879713

OPEN-LABEL

Design

Open-label, phase IV

Duration

8 months

Choe 2017 — Topical 17α-estradiol + minoxidil combination

Ann Dermatol · PMID 28566902

OBSERVATIONAL

Design

Retrospective

—

Duration

6 months

Oral spironolactone + minoxidil — established female AGA combination

Multiple

RCT

Design

Multiple RCTs and prospective trials

—

Duration

—

What the science doesn't yet answer

Anagen's topical spironolactone is 0.25%, while the only direct comparative RCT used 1%. Whether the lower dose retains comparable efficacy is not directly studied.
Anagen uses estriol (a weaker estrogen) where most published topical-estrogen evidence is for 17α-estradiol. Estriol-specific RCT data in female pattern hair loss is limited.
No RCT has tested this exact five-active formulation. Combining anti-androgen + estrogenic + thyroid + vasodilator + anti-inflammatory mechanisms is mechanistically broad but not directly validated as a stack.
Whether female pattern hair loss patients with primarily non-androgenic etiology (perimenopausal, post-pregnancy, stress-driven) benefit equally from the spironolactone component is not directly tested.
Long-term (>1 year) outcomes of this protocol vs simpler female combinations (e.g., spironolactone + minoxidil only) are not characterized.

Our verdict on For The Ladies

Female-pattern maximalist

Anti-androgen + estrogenic + thyroid + vasodilator + anti-inflammatory in one female-pattern topical. Strong on each component; the combined formulation is the editorial extrapolation.

For The Ladies

Every active in For The Ladies

Why we paired these actives

Why a five-active female-pattern formula

The studies behind the combination

What the science doesn't yet answer

Our verdict on For The Ladies

Related Anagen formulations

For The Ladies

Every active in For The Ladies

Why we paired these actives

Why a five-active female-pattern formula

The studies behind the combination

What the science doesn't yet answer

Our verdict on For The Ladies

Related Anagen formulations

For The Ladies