October is World Menopause Month, and I could not let that go by without sharing some of the research I have collected on menopause and hair loss. Hair loss can be frustrating and distressing, if it is hormonally driven though, there are solutions. It is estimated that 20-60% of women will suffer from menopausal related hair loss before they reach the age of 60. My intention with the following information is to give you options. 

I have been researching hormones for the last 18 years, that does not mean I am an expert…far from it. After a painful battle with endometriosis, constant hormonal imbalances, and eventually a complete hysterectomy, I needed to learn because, at the time, it greatly affected my treatment plan and overall health. 

I needed to know what was at risk, what I needed, and what I would experience with or without these essentials of life. It was a highly confusing topic to navigate with the fearmongering that surrounded the now mostly refuted Women’s Health Initiative study. What I did was what I do, learn everything I could.

If you prefer my videos there is one for this blog on YouTube: Video on Hair Loss and Menopause What You Can Do About It

Medical Disclaimer: I am a research writer; I am not a medical doctor, dermatologist, or hair stylist. Please seek professional assistance should you feel I have found information you personally want to look into. This post is for informational purposes and all resources are hyperlinked throughout.

Hair Loss and Menopause

Hair loss is one symptom that can and often does get overlooked as a problematic symptom of menopause. Hair loss can be extremely distressing, when hair is so much a part of our personal identity and self-expression. While most people will experience a significant loss of hair at some point in their lives due to a myriad of reasons, it is estimated that half of women in menopause will experience hair loss. 

Hormones control more about your hair than you may have ever realized, including changes in your curl pattern, hair color, hair or no hair, hair loss, hair length, hair texture, and frizz on your temples.

At multiple points in your life, your hair will change due simply to hormonal changes. 

• Puberty
• Pregnancy, delivery, and post-partum
• Polycystic ovary syndrome
• Perimenopause
• Menopause
• Hormone treatment cessation (stopping HRT or the birth control pill)
• Hypothyroidism (not a sex hormone)
• Hormone related balding or hair loss (Androgenic alopecia)

Duration of Perimenopause and Menopause

Perimenopause can begin as early as your mid 30’s and last until your very last period. Menopause is actually defined as the day that marks 365 days since your last period, menopause lasts 24 hours, technically. Everything after that day is post-menopause. This total process can be half or more of our lives depending on when it all starts and how long you live. 

When the female organs slow or stop producing hormones it can cause a barrage of over 70 physical symptoms and many psychological symptoms. Many of which match chemical withdrawal symptoms because it is in fact a withdrawal. We often only hear about controlling hot flashes or night sweats, and if you are okay in that regard then you don’t need any other help with menopause… BUT over 70 symptoms go overlooked as treatable with Hormone Therapy, including those symptoms involving hair, skin, and nails.

Menopause Hormonal Deficiency 

Menopause IS a hormonal deficiency, it can be low estrogen, progesterone, and even testosterone. 

Menopause is literally withdrawal symptoms from this deficiency. Your body is used to this cascade of hormones that fill receptors and nourish your cells. When you yank them away it is much the same as yanking away a drug or alcohol. The body craves what it has lost and reacts by showing all these symptoms and eventually there are side-effects of the depletion. 

Perimenopausal & Menopausal Symptoms 

The symptoms of menopause can make you feel like you are falling apart. You can even find yourself in the care of multiple practitioners chasing different issues, and a little help to rebalance your hormones may be all you need. Too often this myriad of menopausal symptoms go misdiagnosed or mistreated with other medications that don’t treat the root cause.

Low estrogen causes around 25 symptoms on its own. Just with estrogen deficiency you can experience dry skin, thinning skin, thinning finer hair, and hair loss. Combine that with decreases in progesterone and testosterone the symptom list jumps up to 70 physical symptoms and many psychological symptoms. 

Of those 70+ symptoms 17 are hair, skin, and nails related:

1. Because hormones have an antioxidative property any chronic illness can be affected including psoriasis, eczema, and dermatitis. 
2. Dark circles under the eyes.
3. Increased hair loss or thinning anywhere on the body. 
4. Unusual body hair growth changes in different areas of the body.
5. Acne 
6. Dry ears, ringing, and tinnitus.
7. Decreases in sebum.
8. Changes in sweat production. 
9. Puffy eyes, this can also be due to sebum reduction.
10. Facial flushing.
11. Worsening rosacea.
12. Dry hair.
13. Skin creping due to changes in tone, integrity, and texture of skin.
14. Changes in fingernails, characterized by easy breakage, bending, cracking, and softening. 
15. Itchy, crawly skin with a pins and needles like sensation. 
16. Dry itchy eyes, this can also be related to sebum reduction.
17. Increase and worsening of allergies. 

The Relationship of Estrogen, Progesterone and Testosterone:

Most women don’t know they produce a substantial amount of testosterone. When the ovaries stop making estrogen and progesterone, this new imbalance increases the influence and effects of testosterone. Higher level of testosterone can cause increased shedding and thinning of the hair.

In addition, estrogen and progesterone are helpful in keeping the hair in the growing phase. When estrogen and progesterone fall it leads to slower hair growth rates. The hair also gets finer as the follicle gets smaller.

Menopausal Sebum Reduction and Hair Loss:

Sebum production is controlled by male hormones; consequently, men naturally produce more sebum than women. As women go through menopause and testosterone drops, our sebum production decreases. Because of our already limited supply of male hormones, this sebum reduction is even more pronounced than it is with men as they age.

Around the age of 40 and perimenopause, the production of sebum significantly drops for women and even further so after the age of 60, in post-menopause. Sebum provides lipids and nourishment to the skin and hair, as this nourishment is depleted, the hair becomes dry brittle and prone to breakage and shedding.

Menopausal Oxidative Stress and Hair Loss:

Antioxidant production in the human body gradually decreases with age, thereby increasing free radicals which damage the cells. Evidence points to oxidative stress as a major role in the aging process including pigment loss that leads to graying and also hair loss.

Hormones influence the oxidation process.

• Higher levels of estrogen have an antioxidant and beneficial effect throughout the body.
• Lower estrogen levels have a pro-oxidant and detrimental effect throughout the body.

Hair Loss Types with Specific Hormonal Issues:

• If you have thinning and frizzy hair around your temples and above your ears, it could be estrogen levels.
• If you notice your part is getting wider and thinning is around the crown of your head this could be androgenic alopecia, which is the hormonally driven type of hair loss, from too much testosterone and androgens.
• If you notice increased shedding that doesn’t seem to stop this could indicate higher than normal testosterone levels.
• If you notice your eyebrows thinning around the outside edges it could be hypothyroidism.

What to Do About These Symptoms:

Menopause may be a natural process unique only to humans and a few mammals, but that does not mean we have to suffer through it. Women are now living longer, and we can protect our entire body with a little help from nutrition, hormone replacement therapy (if it is right for you), and lifestyle.

Nutritional Support for Menopause & Hair Loss:

1. Antioxidants, like Vitamins A. C. & E.
2. 25-35 grams of fiber per day, include flax seed
3. Essential Fatty Acids i.e., Omega Oils or Fish Oil
4. Minimum of 1,000 IU of Vitamin D per day
5. Vitamin B-12
6. Collagen
7. Vitamin C
8. Iron
9. Zinc
10. Copper
11. Selenium
12. Saw Palmetto (if hair loss is related to DHT)
13. Blackcurrant Seed Oil (proven to help with hair loss)

You’ll notice there is no biotin on that list, biotin while it can be deficient and help with hair loss because of that deficiency, a true biotin deficiency is very rare. Shockingly the study on hair growth and biotin that is out there, was on children with uncombable hair syndrome, but you wouldn’t know that by the supplement industry. In addition, taking high doses of biotin can interfere with certain blood tests.

Medicinal Support for Menopause & Hair Loss:

Surprisingly few doctors were trained to help women cope with menopause in medical school, even gynecologists.

You will want to find a provider who has studied and specializes in hormone therapy. There is a hormone provider list on Dr. Mary Claire Haver’s website.

Once you find a provider, they will have your complete hormone panels done including thyroid levels. It may take several tests to get a clear picture of what is going on since our natural rhythm fluctuates.

After that you have several options to choose from, and you can mix-and-match based on what you need.

• Pharmaceutical choices include estrogen patches, creams, gels, or pills, and progesterone pills (topical progesterone is not well absorbed by the skin due to its larger molecular size).
• Bioidentical choices include compounded estrogen creams and pills, progesterone pills, and testosterone troches, creams, gels, and sublingual drops.
• Estrogen and testosterone pellet therapy can also be an option for many, but buyer beware, your body may absorb them faster or slower than it should, and they can be very expensive.

A Few Last Thoughts:

Unfortunately, there are still many practitioners who believe you should suck it up, I encourage you to walk away from a doctor who still holds that thought process.

My endocrinologist put it to me like this… “If any other organ fails in the body, we put you on life support or life supporting medications. If you lose the function of your thyroid, we will immediately medicate with thyroid hormone replacement, because without this hormone you will eventually die from the complications.

 

Thus far in medicine, when it is the ovaries failing, we have not treated them like the essential organs that they are. We have acted like they were just for making babies and once that job is done, c’est la vie. Sex hormones produced by the ovaries provide far more than just reproductive support, they help with sleep, weight control, breast health, heart health, brain health, bone and joint health, and so much more.”

There is solid evidence now that hormone replacement can help you for the rest of your life. In fact, studies indicate that it can significantly reduce cardiovascular disease (the number one cause of death for women) and reduces all-cause mortality rates (that means all other causes of death are mitigated with HRT).

My Choice and Your Choice:

Because I had a complete hysterectomy at the age of 40, I chose to go on a full hormone replacement regimen, since I do not have ovaries. I wanted to protect my heart, my bones and joints, and my brain. I use Bioidentical HRT because it can be catered to my needs and allergies, and I regularly revisit what is working or not with my provider. As we age our needs evolve and change so you may need different doses at different parts of your life.

Whatever you choose you have options to help you besides using just minoxidil, not that there is anything wrong with it, just that it is treating a symptom and not a cause. I hope you found this information helpful and that whatever you choose you now have more information to talk with your practitioner about.

If you need more information on the causes of hair loss head over to my Ultimate Guide on Hair Growth and Hair Loss.

I hope you found this post educational and helpful.

Thank you for reading. Please feel free to share.

As always it is about so much more than the hair.

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Works Cited:

1. Nutrition of women with hair loss problem during the period of menopause, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828511/pdf/MR-15-27186.pdf
2. Oxidative Stress in Ageing of Hair, Melatonin topically for hair loss, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929555/
3. The role of oxidative stress in menopause, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952404/
4. A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks, https://pubmed.ncbi.nlm.nih.gov/17217322/
5. Menopausal Hormone Replacement Therapy and Reduction of All-Cause Mortality and Cardiovascular Disease: It Is About Time and Timing, https://pubmed.ncbi.nlm.nih.gov/35594469/

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