Shedding is a normal part of the hair growth cycle. While hair growth naturally slows down with age, hair loss can occur around the time of perimenopause and menopause. In fact, hair loss is a common problem for many older women. In a study of more than 170 postmenopausal women, over 52% had symptoms of female pattern hair loss (FPHL), medically referred to as androgenetic alopecia.(1)(2)(3)
Some menopausal women may experience mild hair changes during this phase of life. Other women may notice more pronounced changes, especially if influenced by genetics or lifestyle factors. Understanding how hormonal changes can affect hair health can help women determine whether they may be experiencing normal hair shedding or menopausal hair loss.
What is normal hair shedding?
The normal lifecycle of one strand of hair is between two and seven years.(2) Afterwards, the hair is shed, and new growth occurs in its place. This is known as the hair growth cycle, which happens in four phases:(1)(4)
Anagen phase: Hair growth
Catagen phase: A transitional phase where the hair follicle shrinks
Telogen phase: A resting phase during which the hair follicle is inactive
Exogen phase: Shedding of old hair
According to the American Academy of Dermatology Association (AAD), the body normally sheds anywhere from 50 to 100 hairs each day.(5) Losing more than this amount is considered excessive hair shedding, a condition known as telogen effluvium. Stress, illness, or weight loss can all contribute to increased shedding. However, hair shedding is not the same as hair loss. Hair loss occurs when something blocks the hair follicle’s ability to grow new hair.
Understanding Hair Loss During Menopause
FPHL often develops during a woman’s menopausal or postmenopausal years, typically in their 40s, 50s, or 60s. However, some women may begin to experience hair loss during perimenopause if they are genetically susceptible to the condition.(6)(7)
Menopausal hair loss is believed to be caused by hormonal changes that affect the hair follicles. Estrogen is the primary sex steroid hormone in women. It supports hair health by prolonging the growth phase of the hair cycle. It also promotes healthy blood flow and metabolic function, helping ensure that the hair follicles receive the energy and nutrients they need for hair growth. Progesterone, another key sex steroid hormone, also influences hair regrowth.(8)(9)
Androgens, including testosterone and dihydrotestosterone, play an important role in the hair growth cycle. As hormone levels fluctuate and decline during menopause, the balance between estrogen and androgens gets thrown off. The findings of one study showed that postmenopausal women with FPHL had reduced estrogen levels and increased androgen levels. This hormonal imbalance may contribute to hair loss, hair thinning, and changes in hair texture and volume that can occur during menopause.(7)(8)(9)
How can you tell the difference between normal shedding and menopause hair loss?
The following factors can help women tell the difference between normal hair shedding and menopausal hair loss:
Feature | Normal Hair Shedding | Excessive Hair Shedding | Menopause Hair Loss |
Signs | Sheds evenly from all over the scalp | Increased number of hairs on hairbrush or clothes | Diffuse thinning across the scalp and a wider part |
Volume | Lose between 50-100 hairs daily | Lose more than 50-100 hairs daily | Lose more than 50-100 hairs daily |
Triggers | Normal cycle of hair growth | Childbirth, stress, surgery | Hormonal changes |
Duration | Continuous | Usually temporary | May continue into postmenopause without treatment |
Age
Normal hair shedding takes place throughout life. However, hair loss that develops around the average age of menopause may be a sign that it's hormone-related. Most women enter perimenopause between the ages of 45 and 55 and reach menopause at an average age of 52.(10) A study found that women between the ages of 30 and 59 made up the majority of patient consultations for scalp-wide hair loss, also known as diffuse hair loss.(9)
Hair Loss Patterns
Menopausal hair loss typically presents as diffuse thinning across the scalp. Women may also notice a widening of their part. In cases of increased shedding, women may see more strands of hair in their hairbrush or stuck to the back of their clothing. However, diffuse thinning and widening of the hair part are not usually associated with normal hair shedding.(5)(8)
Hair Loss Triggers
If a woman has recently had surgery, experienced childbirth, stopped using oral contraceptives, or been under high levels of stress, these factors could be the cause of excessive shedding rather than menopause.(5) Increased shedding is usually temporary. In contrast, menopausal hair loss may continue into a woman’s postmenopausal years, although this is not always the case.
Signs of Hair Loss
Hair loss typically develops slowly over time. The following are signs of hair loss in women:(6)(11)
Widening hair part (usually the first noticeable sign)
Less full ponytail
Slowly thinning scalp hair
Receding hair around the temples
Women who are losing more than the normal 50 to 100 hair strands per day should consult with a doctor or dermatologist. Hair loss may be related to menopause, a health condition, or medication use. A healthcare provider can help determine the cause and recommend appropriate treatment.
Treatment & Management Options for Hair Loss
Treatment options are available for FPHL. It can also be managed with lifestyle changes.
Minoxidil Treatment
Minoxidil is a topical hair loss medication and the primary treatment method for FPHL. It activates hair regrowth by changing the hair growth cycle and boosting circulation around the hair follicles.(6)
The medication is available in different strengths. Formulations of 2% and 5% minoxidil are approved by the U.S. Food and Drug Administration (FDA) for over-the-counter use. A doctor may prescribe higher concentrations off-label, although some women may experience side effects with stronger products.
Shampoos for Hair Thinning
Shampoos can’t stimulate hair regrowth, but they can help hair retain moisture and reduce breakage and thinning. Some products contain ingredients such as biotin, caffeine, or adenosine, which research suggests may increase hair density and reduce hair loss.(6)(12)
Vitamins and Supplements
Hormonal changes may make menopausal women more susceptible to nutrient deficiencies, which may affect hair health.(13) In these cases, a doctor may recommend taking certain vitamins or supplements.(6) Vitamin D, vitamin E, and B vitamins, like biotin and folic acid, are among the many hair-friendly nutrients that are essential for overall health. However, women should always consult with a doctor before taking any supplements. Oversupplementation in healthy individuals may cause health problems and negatively impact the hair follicles.(1)
Stress Reduction Techniques
Many women experience increased stress and anxiety during menopause. Research suggests that the physiological effects of stress on the body may contribute to or worsen hair loss.(14) Managing stress through exercise, a healthy diet, meditation, or other forms of self-care may help reduce the impact of hair loss.
Low-Level Laser Treatment
The FDA has approved certain low-power laser devices for at-home treatment of hair loss. The treatment may increase hair density, although further studies are needed regarding long-term safety and efficacy.(6)(9)
Platelet-Rich Plasma Therapy
Platelet-rich plasma therapy involves the injection of the patient’s own blood into their scalp. It’s believed to promote hair growth, but more research is currently needed on this relatively new hair loss treatment approach.(6)
Hair Transplant Procedure
During a hair transplant, hair follicles are taken from one part of the body (typically another part of the scalp) and grafted onto areas affected by hair loss. The procedure may be recommended for some women if they have sufficient hair coverage elsewhere on the scalp that can be used.(6)
Hormone Replacement Therapy (HRT)
HRT is used to treat menopausal symptoms. While it’s not a direct treatment for hair loss, it may improve symptoms by increasing levels of hormones in the body that influence hair growth, primarily estrogen. One small study found that menopausal women with FPHL who were using HRT experienced improvements in hair thinning.(15)
Seeking Support for Menopausal Hair Loss
Hair loss can be a source of stress and anxiety during menopause. It may negatively impact women’s social life, self-image, or overall emotional well-being. For some women, psychological support can be an important part of treatment. Increased patient education about the hair growth cycle may also help reduce anxiety for those navigating hair loss during this phase of life. A healthcare provider can reassure patients that it may take time before they see treatment results.(16)
