Menopause & Hair Loss: Understanding the Why & Finding Solutions

Hair changes during menopause may start with a few extra strands in the drain after a shower or on the hairbrush. Over time, this can lead to noticeable thinning, changes in hair texture, or loss of volume. Studies estimate that about 50% of women going through the menopause transition may experience hair changes.⁽¹⁾ 

Hair loss can be distressing for some women, as hair often plays a significant role in self-esteem and identity. Fortunately, various treatment options are available, and taking proactive steps can help improve hair health during menopause. 

When does menopause hair loss occur?

Menopause-related hair changes can occur at any phase of the menopausal transition. A common experience during menopause is hair loss with thinning at the crown or overall thinning, which is known as female pattern hair loss.⁽¹⁾

What causes menopause-related hair loss?

The hair growth cycle involves four stages: anagen (growth), catagen (transition), telogen (resting), and exogen (shedding). The following changes that occur during menopause may disrupt this cycle and cause hair loss:⁽¹⁾

Hormonal Changes

A balance of hormones, including estrogen, progesterone, and testosterone, is crucial for healthy hair growth. 

Androgens, like testosterone, promote hair growth on other parts of the body but may shrink hair follicles on the scalp, resulting in hair loss. Estrogen and progesterone help keep testosterone levels in check. Estrogen supports the activity of the enzyme responsible for converting excess androgens into estrogen. In contrast, progesterone inhibits the conversion of dihydrotestosterone (DHT), a precursor to testosterone.

Estrogen and progesterone bind to their receptors in the hair follicles to support the anagen phase of the hair growth cycle. They also augment the production of crucial growth factors that promote hair growth and thickness. 

As estrogen and progesterone levels decline during menopause, hair growth may be affected, leading to a loss of volume, thinning, and changes in hair texture. The disproportionate increase in androgens in relation to estrogen and progesterone may also contribute to hair loss.

Genetic Factors

Studies have shown that genes involved in the production of the enzyme that converts excess androgens into estrogen may contribute to female pattern hair loss during menopause. However, many other genes may also play a role in hair loss during the menopausal transition.

Increased Stress 

Women are more likely to experience stressful life events during menopause, such as children leaving home or failing to get a job, caring for aging parents, or marital problems. While it’s normal to feel stressed occasionally, persistent stress may affect hair growth.

Research suggests that high stress levels may cause more hair to enter the telogen or resting phase, which can result in significant hair loss. 

Altered Metabolism

Activation of hair follicles requires approximately 670 kilojoules of energy, which is equivalent to the energy expended during six minutes of intense exercise engaging both arms and legs. Experts believe menopause may cause a drop in energy at all levels of the body, including the hair follicles. 

Slowing metabolism during menopause, coupled with the aging process, may increase the risk of hair loss during the menopausal transition. 

Reduced Scalp Blood Flow

Estrogen is believed to have a dilatory effect on the blood vessels that maintain blood flow. Low estrogen levels during menopause may cause blood vessels to constrict, reducing blood flow to the scalp. When hair follicles don’t get adequate blood and oxygen supply, they may become more susceptible to weakening and hair loss.

Hair Changes During Menopause

As the body adapts to hormonal and other changes during menopause, it may affect the hair follicles, leading to the following changes:

• Hair thinning

• Loss of hair volume

• Finer or more brittle hair

• Widening of hair parting

• Graying of hair

Lifestyle Changes for Regaining Thicker Hair During Menopause

Hair loss during menopause involves a variety of contributing factors. To regain thicker hair during the menopausal transition, women should adopt lifestyle changes that support hair growth and avoid those that may cause hair loss. Some effective lifestyle changes include the following:^(2,3)

Taking Supplements

Nutrients like zinc, iron, biotin, and vitamin D are essential for hair growth, and deficiencies in these nutrients are common during menopause. Women deficient in these nutrients may consider taking supplements to support hair health. 

Orthosilicic acid supplements may also improve hair tensile strength and decrease brittleness. However, not all women may need supplements, and they should be taken only after consulting a physician. 

Eating a Healthy Diet

A balanced, low-fat diet may support healthy hair growth. Experts recommend including whole grains, fruits, vegetables, legumes, seeds, nuts, pulses, eggs, and milk in the diet. The nutrients in these foods can help support the growth and strength of hair follicles. 

Caring for the Scalp

Scalp health is one of the crucial factors that can contribute to hair loss. The following hair care routine may help support healthy hair growth:

• Using nourishing shampoos and conditioners and avoiding those with harsh chemicals

• Getting regular scalp massages to promote blood flow to the hair follicles

• Avoiding heat styling tools like hair straighteners and dryers, as they may damage hair

• Opting for all-natural hair color if dyeing is necessary

• Wearing a swimming cap to protect hair from chlorine exposure in swimming pools, which can cause damage

• Tying hair or wearing a hat to protect it from the sun and wind

Managing Stress

Relaxation techniques like yoga and meditation can help manage stress. Yoga may reduce stress hormones, improve circulation, and promote relaxation, which are beneficial for hair health. Meditation calms the mind, reduces anxiety, and creates a better environment for hair growth.

Counseling and cognitive behavioral therapy (CBT) may also support hair health by addressing stress and emotional challenges. CBT helps change negative thought patterns, reducing stress and its impact on the body.

Can hormone replacement therapy (HRT) prevent hair loss during menopause?

Multiple studies show that HRT may support hair growth by replacing estrogen and progesterone levels during menopause. Women taking HRT may experience less thinning and stronger hair compared to those who have never taken HRT.⁽⁴⁾

However, HRT is typically not recommended solely for managing hair or skin changes during menopause. A physician will evaluate an individual’s overall health and consider all symptoms to determine if HRT is the right option.

Exploring Other Treatment Options

Women might also benefit from these approaches along with lifestyle changes and HRT to manage hair changes during menopause:⁽³⁾

Pharmacological Treatments

Some effective medications that support hair growth include the following:

• Antiandrogens: These medications help counteract the effects of androgen on hair follicles and may slow down hair loss. A common example is spironolactone.

• Minoxidil: The FDA has approved minoxidil for managing hair loss in women. A 2% solution is available over the counter, while a stronger 5% dose requires a doctor’s prescription.

Non-Pharmacological Treatments

The following options may help address hair loss:

• Cosmetic camouflage: This includes using wigs, hairpieces, or styling techniques to conceal thinning areas. Cosmetic hair powders with tiny fibers that cling to hair follicles are also available to create a fuller appearance.

• Hair transplant: This surgical procedure involves implanting hair from other parts of the body or the back of the head into thinning or bald areas.

• Low-level laser therapy (LLLT): This method involves applying low-intensity light to the scalp, which may support the growth of hair follicles and improve hair strength.

Experiencing menopausal hair loss? Discover if HRT is right for you.

If you’ve entered the menopause transition and are struggling with hair loss, you don’t have to suffer in silence. Take our brief menopause quiz to see if you’re an eligible candidate for HRT. Get started with Winona to take the first step toward feeling better.