Can Hair Loss Be a Symptom of Menopause?

Menopause and hair loss go hand in hand for many women. Studies show slightly more than half of all women experience some degree of menopause-related hair thinning or loss.

By definition, menopause occurs when a woman has not had a menstrual period for at least 12 months. However, the hormonal drops that cause hair loss can begin years before menopause is official (perimenopause) and last long after the change is complete (postmenopause).

This article provides an overview of menopause and hair loss. It discusses the hormones that can cause hair to fall out and strategies for combating menopausal hair loss.

Symptoms of Menopausal Hair Loss

Hair loss from menopause may not be obvious at first. Humans lose an average of 50 to 100 strands of hair a day. During perimenopause, hair shedding starts to ramp up. The first signs of menopause-related hair loss are subtle:

• You need to clean your hairbrush more frequently.
• More hair collects in the shower drain.
• You find more hair on your pillow, clothing, around the house, or in your car than before.
• Hair breakage becomes more common.

Because the hair loss occurs slowly, it can take time for the changes to be noticeable in the mirror. Your part may start to widen, your ponytail might look thinner, and your hair can take on a flatter, lack-luster appearance.

Once this excessive hair shedding has gone on for a while, you may start to have visibly thinning patches in the top center of the scalp and near the hairline by your forehead. Thin patches can also appear on the back of the head, near the crown, or by the nape of your neck.    

Menopause-related hair loss can occur in other parts of the body as well. Many women notice hair growth slows or stops on their legs, arms, and armpits. Pubic hair can also begin to thin leaving bald spots. Even your eyelashes and eyebrows may thin out during menopause.

Causes of Menopausal Hair Loss

Hormonal fluctuations are the chief cause of hair loss associated with menopause. Menopause-related hair loss can occur during any of the three stages of menopause:

• Perimenopause is the time leading up to menopause. This is when hormone levels begin to fluctuate. It usually starts sometime during your 40s and can last up to 10 years.
• Menopause becomes official after 12 consecutive months without a period. While every woman is different, the average age of menopause in the U.S. is 52.
• Post-menopause starts once menopause is official and continues through the end of a woman's life.

During perimenopause, estrogen and progesterone levels begin to decline. These hormones play a role in promoting hair growth, density, and fullness. When they drop, it leads to thinning hair that doesn't grow as quickly as before.

A decrease in progesterone and estrogen also sparks an increase in androgens. These are male hormones that are found in women in smaller amounts than in men. Androgens can cause the hair follicles on the head to shrink, resulting in a type of hair loss known as androgenic alopecia.

What Medications Can Cause Hair Loss?

Medications prescribed to manage symptoms of menopause do not typically cause hair loss, and may in fact help to prevent hair loss. However, medications that treat other conditions that are common in women over the age of 40 can contribute to hair loss.

Types of drugs that can cause hair loss include:

• Medications used to treat hyperthyroidism
• Antidepressants
• Heart medications (blood thinners and beta-blockers)
• Epilepsy medications
• Disease-modifying anti-rheumatic drugs (DMARDs) used to treat rheumatoid arthritis and other autoimmune diseases
  

How to Treat Menopausal Hair Loss

Treatments for menopausal hair loss may include lifestyle modifications, medications, and professional treatments.

Rogaine

Rogaine (minoxidil), an over-the-counter hair-loss treatment for male pattern baldness, may help women with androgen-related hair loss as well. Research shows topical Rogaine treatments can promote hair regrowth in women with female-pattern baldness, which can occur during menopause. 

Rogaine comes in different formulas for men and women as both a serum and a foam. Minoxidil is also available as generic or off-brand products. The main difference between the men's and women's versions is the dosage strength:

• Serum: Men's Rogaine serum contains 5% minoxidil, while women's is just 2% minoxidil. Both should be applied twice a day.
• Foam: The foam only comes in 5% minoxidil formulas. The men's version is used twice a day while Women's Rogaine is only applied once daily.

Common side effects of topical minoxidil include itching, dryness, flaking, or burning. While severe symptoms are rare, call your healthcare provider immediately if you experience weight gain, swelling of the face, trouble breathing, lightheadedness, fast heartbeat, or chest pain. Women who are pregnant should not use topical minoxidil.

Prescriptions

Oral medications that may be prescribed for hair loss in women include finasteride and spironolactone.

Finasteride, sold under the brand name Propecia, is commonly prescribed for male pattern baldness. Some research shows finasteride can help to regrow hair loss in women as well. Finasteride is also used to treat hirsutism, androgen-related unwanted hair growth on a woman's face, chest, or back.

Spironolactone is a drug used to treat acne that may be effective for menopausal hair loss. While it doesn't appear to help regrow hair, research shows it can prevent further hair loss and improve the quality and thickness of hair for about 40% of women with female pattern baldness.

Microneedling

A newer therapy for hair loss is known as microneedling. Microneedling can be done in a dermatologist's office or at home. However, it's best to talk with your healthcare provider first before using it yourself.

More commonly used for treating scars, the technique involves a roller with hundreds of tiny needles that poke microscopic holes in the skin. This controlled injury prompts an immune system response that may help to promote hair growth.

The research on microneedling for hair regrowth focuses on androgenetic alopecia. A 2020 review of studies found microneedling shows promise for increasing hair density, thickness, and quality of hair. Combining microneedling with topical minoxidil is recommended for best results.

Laser Treatment

Laser treatments, also known as light therapy, work by applying low-intensity light to the scalp, triggering a reaction that signals new hair to grow. It’s thought that light increases the number of hair follicles and increases hair strength.

Hair Transplant

If menopausal hair loss is severe, a hair transplant can help. A hair transplant is a surgical procedure that moves hair from one part of your body (commonly the back of the head) and implants it into bald spots.

Different types of hair transplants include grafting, scalp reduction, flap surgery, and tissue expansion. Of these, hair grafting is the most common hair transplant procedure. It is performed by a dermatologist or plastic surgeon using a local anesthetic.

During hair grafting surgery, small pieces of skin (a graft) with healthy hairs are removed from the back of the scalp and transplanted to bald or thinning areas. Sometimes referred to as hair plugs, each graft contains one to 15 hairs.

It can take up to a year to see the full results from hair grafting. Additional surgeries may be needed over time to fill in new bald patches. 

Reduce Stress

The hormonal changes from menopause can cause your stress levels to rise. When that happens, it can be difficult to rebalance the hormones. What's more, stress is a common cause of hair loss.

To keep stress in check, you can try stress-reduction techniques such as:

• Meditation
• Breathing relaxation techniques
• Yoga

In addition, getting regular exercise can help reduce stress. Walking, cycling, dancing, and hiking are low-impact options than can help keep your stress levels down.

Eat a Balanced Diet

Diet plays a vital role in hormonal balance. Research has found that women who experience hair loss during menopause may not be getting all the nutrients they need. Eating a well-balanced diet that is high in nutrients can aid in the reduction of hair loss.

Some specific nutrients you should be incorporating are:

• Protein: Protein can strengthen hair and hair follicles, thus reducing hair loss.
• Fats: Healthy fats play a role in the production of steroid hormones, which protect both the hair and the skin. Some healthy fats include omega-3 fatty acids and omega-6 polyunsaturated fatty acids.
• Vitamins: Vitamins A, B, C, and D all play a role in hair health. Getting enough of these nutrients is vital to help with hair loss caused by menopause.
• Minerals: Zinc, iron, copper, selenium, calcium, and magnesium are all important for proper hair growth.

Gentle Hair Care 

To prevent further damage to your hair, practice gentle hair care. Avoid using heated styling tools, including blow dryers, straighteners, curling irons, and hot curlers. Don't tease your hair, which can cause breakage.

You should also avoid dying your hair, when possible, and choose an all-natural dye if you need to.

Using a conditioner that is hydrating and nourishing for your hair will also promote healthier hair and encourage hair growth.

If your hair is prone to tangles, keep it tied up in a ponytail, bun, or braid when possible. However, avoid pulling hair too tight, which can cause hair to break.

Are There Tests to Diagnose the Cause of Menopausal Hair Loss?

Blood tests are sometimes used to determine the cause of hair loss in menopausal and perimenopausal women. These include checking the following hormone levels:

• Androstenedione
• DHEA
• Follicular stimulating hormone (FSH)
• Leutinizing hormone
• Prolactin
• Testosterone

Your healthcare provider may run additional tests to rule out other potential reasons for the hair loss.

When to See a Healthcare Provider

If you are experiencing hair loss, talk to your healthcare provider. While menopause is commonly associated with hair loss, other conditions that can cause hair loss include:

• Adrenal insufficiency
• Anemia
• Nutritional deficiencies, including biotin, iron, protein, and zinc
• Medication side effects
• Psoriasis of the scalp
• Stress
• Syphilis
• Thyroid disease

These conditions should be ruled out as part of the diagnostic process for menopausal hair loss.

Summary

About half of all women experience some degree of hair loss associated with menopause. The primary cause is a drop in hormone levels that begin during perimenopause and continue through the post-menopausal years.

Hormones like estrogen and progesterone affect the rate of hair growth, the volume of individual strands, and the rate of hair shedding. Other health factors can contribute to hair thinning, so discuss excessive hair shedding with your healthcare provider to rule out other causes.

Treatment options for menopausal hair loss can include medication such as Rogaine and procedures like microneedling. It can also include lifestyle changes, including reducing stress, exercising, and eating a healthy diet. Being kind to your hair by avoiding harsh hair-care practices can also encourage a healthier scalp and less hair loss.

A Word From Verywell

Losing your hair can be a difficult and upsetting experience. Many people see their hair as an extension of themselves and their personality. Seeking treatment is the best way to lessen the effects of menopausal hair loss. Speak to your healthcare provider as well as a hair-care professional if you want to address your hair loss.