Introduction
Hair loss in menopause is a concern some women start to notice in their 40s or 50s. Changes in hair texture, density or shedding often appear gradually and may be difficult to recognise at first.
Women may initially try supplements, hair treatments or dietary changes. However, hair thinning during midlife can progress slowly over several years.
Hormonal changes are one of the most common factors linked to hair loss around menopause, but they are not the only cause. In this article, we describe how hair loss may begin, why it occurs, possible contributing causes, and treatment approaches.
Hair Loss in Menopause: How It Usually Begins
Hair loss in menopause rarely appears suddenly. In many women, it develops gradually and may begin during perimenopause.
Early changes may include:
- Change in hair texture (duller, more brittle, harder to style)
- Increased hair shedding (hair on brush, pillow, shower)
- Reduced hair density(hair feels thinner, less volume)
- Widening of the central hair part
At this stage, some women try styling treatments or supplements to manage these changes, but hair thinning may continue to progress if the underlying cause is not identified.
Hair Loss in Menopause: Why It Happens
Hair growth follows a biological cycle with three phases:
- Anagen – growth phase
- Catagen – transition phase
- Telogen – resting phase
Research suggests that hormonal changes during menopause may influence this cycle and affect hair density.
Hormones and possible effects on hair
| Hormone | Effect |
|---|---|
| Oestrogen | May support the hair growth phase |
| Progesterone | May modulate androgen activity in hair follicles |
| Androgens (testosterone, DHEA, DHT) | May contribute to hair thinning |
Hormones may influence hair growth, but other factors can also affect hair health. Increased androgen activity may occur with certain treatments, supplements, or medical conditions, as discussed below.
Hair Loss in Menopause: Possible Causes
Hormonal changes during perimenopause and post-menopause may lead to hair changes in some women. The literature describes several hair conditions that may appear around this stage of life, including:
- female pattern hair loss
- frontal fibrosing alopecia
- increased facial hair
However, other medical conditions can occur at the same stage of life and may also contribute to hair thinning, including:
- Iron deficiency (e.g. untreated heavy bleeding during perimenopause)
- Nutritional deficiencies (restrictive diets)
- Thyroid disorders
- Insulin resistance ( seen with metabolic changes in late perimenopause)
- Increased androgen activity (medical conditions, androgenic treatments, or supplements such as testosterone pellets or DHEA)
Hair loss in Menopause: Treatment Approaches
Several treatment options may help improve hair loss around menopause. However, treatment is effective only when the underlying causes are identified.
Possible treatment approaches
| Approach | Examples |
|---|---|
| Hormonal therapy | HRT, COCP in selected cases |
| Medical treatment | Minoxidil, spironolactone |
| Nutritional correction | Iron replacement, adequate protein intake |
| Review triggers. | Androgen-increasing therapies (e.g., DHEA, testosterone pellets) |
Conclusion
Hair loss in midlife women can develop gradually and may involve several contributing factors.
Hormonal changes may influence the hair growth cycle, but other medical or nutritional conditions may also play a role.
Every woman is unique. Hormonal changes may play a role, but other factors can also contribute. A personalised medical assessment is often the first step to identify the cause and choose the most appropriate treatment.
Dr. Maria Zalazar. Founder and Medical Director MZ-medical
