Pubic hair falls out for many of the same reasons head hair does: hormonal shifts, nutritional gaps, medical conditions, or simply getting older. Some shedding is completely normal, since every hair follicle cycles through growth and rest phases. But if you’re noticing patchy spots, sudden thinning, or handfuls of hair coming loose, something more specific is likely going on.
Normal Shedding vs. Something More
Every hair on your body goes through a three-stage life cycle. The growth phase (anagen) is when the hair actively lengthens. Then comes a short transition phase (catagen) lasting about two weeks, followed by a resting phase (telogen) where the hair sits in the follicle doing nothing before eventually falling out. Pubic hair has a notably shorter growth phase and a longer resting phase compared to scalp hair, which is why it never grows very long. It also means pubic hairs shed and replace themselves on a regular basis.
Losing a few pubic hairs when you shower or change clothes is routine. What’s not routine is finding bald patches, noticing the hair becoming visibly sparse over weeks or months, or feeling itching or pain in the area before hair drops out.
Hormonal Changes Are the Most Common Cause
Pubic hair is uniquely sensitive to sex hormones, especially estrogen and testosterone. Any shift in these hormones can change how your pubic hair grows.
During menopause, declining estrogen levels directly affect hair follicles. Estrogen binds to receptors in the cells at the base of each follicle and influences how long the hair stays in its growth phase. As estrogen drops, follicles can shrink and produce thinner, sparser hair. This is one of the most common reasons women over 45 notice their pubic hair thinning. It’s gradual, affects the whole area evenly, and is a normal part of aging rather than a sign of disease.
Testosterone matters too. In pubic and underarm follicles specifically, testosterone acts directly on the hair without needing to be converted into a stronger form the way it does elsewhere on the body. Conditions that lower testosterone, certain medications, or hormonal therapies can all reduce pubic hair density. Polycystic ovary syndrome (PCOS), on the other hand, can cause excess body hair in some areas while thinning it in others, depending on how individual follicles respond.
Thyroid Problems
Your thyroid gland controls your metabolism, and that includes how fast your hair follicle cells divide. Both an underactive and overactive thyroid can trigger hair loss across the body, including the pubic area. About a third of people with hypothyroidism and half of those with hyperthyroidism experience noticeable hair shedding.
With an underactive thyroid, hair becomes coarse, dry, and brittle. The follicles get stuck in the resting phase and are slow to start growing again. With an overactive thyroid, hair becomes fine and silky but sheds more easily because the hair shafts are weaker. In either case, you’d typically notice thinning in other places too: the outer third of your eyebrows is a classic spot, along with general scalp thinning. If your pubic hair loss comes alongside fatigue, weight changes, or feeling unusually cold or warm, a thyroid issue is worth investigating.
Alopecia Areata
Alopecia areata is an autoimmune condition where your immune system mistakenly attacks hair follicles. It’s best known for causing round, smooth bald patches on the scalp, but it can strike anywhere, including the pubic area. The patches tend to be oval and well-defined, and the skin inside them feels unusually soft. If you tug gently on hairs at the edge of a patch, they come out easily.
One clue that points toward alopecia areata is your fingernails. Many people with this condition develop tiny pits or dents in the nail surface. If you’re seeing smooth bald patches on your pubis along with nail changes, that combination is distinctive.
Nutritional Deficiencies
The nutrients most commonly linked to hair loss are iron, zinc, vitamin D, and B vitamins. In studies comparing people with and without hair loss, those losing hair consistently had lower iron stores (measured as ferritin) and lower hemoglobin levels. The differences were modest but real. Zinc levels followed a similar pattern, with hair loss patients showing slightly lower levels than controls.
Iron deficiency is especially common in people who menstruate, vegetarians, and anyone with digestive conditions that impair nutrient absorption. If your pubic hair thinning coincides with feeling unusually tired, bruising easily, or having brittle nails, a simple blood test can check whether low iron or zinc is contributing.
Aging and Natural Thinning
Even without a hormonal disorder or nutritional gap, hair simply thins with age. After about 40 in women and even earlier in men, individual hair shafts start to shrink in diameter. The follicles themselves gradually produce finer, shorter hairs. By age 65, over half of men and more than a third of women have noticeable hair thinning somewhere on the body.
This age-related thinning, sometimes called senescent alopecia, involves a permanent decrease in both hair diameter and length. It appears to be a distinct process from hormone-driven hair loss, with different patterns of gene activity in the follicles. The hair doesn’t fall out in patches. Instead, it gradually becomes sparse and fine across the whole area over years. Other changes come along with it: the remaining hair may look duller, feel drier, and grow more slowly.
Skin Conditions and Infections
Fungal infections in the groin area (tinea cruris, commonly called jock itch) target keratin, the protein that makes up both your skin’s outer layer and your hair. When dermatophyte fungi invade the pubic area, they can damage hair shafts at the surface and cause temporary shedding alongside the classic red, itchy, ring-shaped rash. This type of hair loss reverses once the infection clears.
A less common but important condition is frontal fibrosing alopecia, a type of scarring hair loss that primarily affects the hairline on the scalp. In a study of 711 women with this condition, 67% also lost pubic or underarm hair. If you’re noticing your hairline receding along with pubic hair thinning, particularly if your eyebrows are also sparse, this connection is worth raising with a dermatologist. Unlike most other causes on this list, scarring hair loss is permanent because the follicles are destroyed.
Grooming, Friction, and Physical Damage
Repeated waxing, shaving, or epilating can damage hair follicles over time. Each session creates minor trauma, and over years, some follicles stop producing hair altogether. Tight clothing that constantly rubs against the pubic area can have a similar effect, weakening follicles through chronic friction. If you’ve been removing pubic hair regularly for years and notice it’s growing back thinner or patchier, cumulative follicle damage is the most likely explanation.
Stress and Sudden Shedding
A major physical or emotional shock can push large numbers of hair follicles into the resting phase all at once. This is called telogen effluvium, and it typically shows up two to three months after the triggering event: surgery, severe illness, childbirth, rapid weight loss, or intense emotional stress. The hair falls out diffusely rather than in patches, and it affects the whole body, not just one area. The good news is that this type of shedding is temporary. Once the underlying stressor resolves, hair typically regrows within six to twelve months.
What Patterns Tell You
The pattern of your hair loss offers real clues about the cause. Smooth, oval bald patches suggest alopecia areata. Gradual, even thinning across the whole area points toward hormones, aging, or nutritional issues. A red or scaly rash alongside the hair loss suggests infection. Hair that’s become coarse and brittle before falling out is a hallmark of thyroid problems.
If pubic hair is the only area affected and the loss is mild and gradual, it’s most likely hormonal or age-related. If you’re losing hair in multiple places on your body at the same time, that raises the likelihood of a systemic issue like thyroid disease, an autoimmune condition, or a nutritional deficiency that a blood test can usually identify.