If you’re a woman approaching menopause or deep in the throes of it, you have likely, and unfortunately, become acquainted with hair loss. Perhaps you’ve been noticing more hair in your shower and have a slew of questions, such as, “Is it normal to lose so much hair during the menopause transition?” and“How does menopause affect hair?” clogging your mind (much like your drain).

Join us as we unpack the causes, types, and ways menopause affects hair, and how to manage menopause-related hair loss.

Types Of Hair Loss With Menopause

What type of hair loss am I experiencing? is a natural question to ask when noticing more hair in your brush and your hair becoming sparser. Let’s distinguish the differences between the types of hair loss women experience surrounding menopause and what they look like:

• Female Pattern Hair Loss (FPHL) or Androgenetic Alopecia: This type of thinning is influenced by genetics and hormone sensitivity, often beginning with the estrogen-androgen shift during perimenopause.
• Telogen Effluvium Hair Loss: Telogen effluvium can also occur during the menopause era. While you don't have to be circling menopause to have telogen effluvium, this temporary, rapid, and highly noticeable shedding appears as diffuse, overall thinning.

Symptoms of Menopausal Hair Loss

The most common hair-related symptom during menopause is hair thinning and hair loss, with many women noticing new growth becoming sparser. However, each type has its own set of symptoms.

• FHPL Hair Loss: Female pattern balding is characterized by gradual thinning, usually widening along the part line, thinning at the crown or along the top frontal part, and at the temples.
  • It also includes textural menopausal hair changes with hair becoming coarser, drier, or suddenly wiry and curly. Still, others experience hair that appears finer and more prone to breakage. In general, the “quality” of the hair diminishes.
  • Even women who had fine or stick-straight hair are encountering new unruly strands. While no amount of hairspray could force their hair to the revered heights and volume of the 80s, now they can barely make it behave.
• Telogen Effluvium: Telogen effluvium often appears as clumps of hair falling out, with sufferers losing more than 150 hairs per day. This rapid hair loss is not hard to miss, as it presents dramatically in the shower, on pillows, in hairbrushes, or in smaller ponytails.

Menopausal Reason for Hair Loss In Women

Worried, “Why is my hair thinning during menopause?” Or, perhaps you’ve reached the other side and wondered, “Why is my hair thinning severely after menopause?” Either way, you’ve come to the right place.

Menopause alters hormone levels and changes how our bodies interact with hormones, the gut, and nutrient levels. Of course, environmental factors and stress can compound menopausal hair thinning.

• Hormones + Hair Loss: The most common cause of hair loss in women is androgenetic alopecia, which involves androgens (hormones) and genetics. Before approaching menopause, naturally occurring estrogen and progesterone helped promote hair growth, but, the drop in estrogen and progesterone with perimenopause creates a chain reaction that leads to a cascade of hair fall. Here’s what happens:
  • Declining Estrogen: Estrogen helps keep hair in the growth (anagen) phase longer. But when estrogen levels drop during perimenopause, hair loss tends to increase.
  • Increased Effect of Androgens: The decline in estrogen "unmasks" or unleashes the effects of male hormones (androgens) like testosterone.
  • Follicle Sensitivity: This estrogen-androgen shift, combined with a genetic predisposition, causes hair follicles to shrink (miniaturization), leading to finer, thinner hair strands. This also affects the hair follicle cycles, leading to slower growth, shorter strands, and reduced volume. Note: Even with normal androgen levels, the ratio between the two changes, contributing to hair follicle shrinkage and fine, peach fuzz-like hairs.
• Hormones + Textural Changes: Those whose hair takes on a whole new personality are asking themselves, Why is my hair texture changing? Lower estrogen levels lead to reduced sebum (oil) production and changes in the shape of the hair follicle, making hair wiry, frizzy, dry, and coarse.
• Hormones + Dry Scalp: The dip in estrogen that occurs with menopause dries and thins the skin all over the body, compromising the moisture barrier. This results in a tight, irritated, or inflamed scalp.
• Hormones + Physical Stress: Does hormonal imbalance from menopause cause telogen effluvium? Not exactly. But, telogen effluvium may be triggered by the physical stress of hormonal fluctuations, which push up to 50% of hairs to enter the resting (telogen) phase.
• Hormones + Stress + Sleep: What other factors contribute to hair loss in menopause? There is a strong connection between hair shedding and the stress, anxiety, and sleep disruption tied to menopause.

Menopause Hair Loss Prognosis

Will my hair grow back, or is this permanent? The answer depends on the type of hair loss someone experiences and the chosen management. FPHL tends to be gradual, progressive thinning, while telogen effluvium is typically temporary.

Managing Menopausal Hair Loss

What can I do to manage or treat my hair loss? Changes in lifestyle and specialized hair care products are the first steps—paths that have been beneficial for many people with thinning hair.

• Boost Your Nutrition: As metabolic changes can affect how efficient your body is at processing protein—the building block of hair (keratin)—protein intake is vital. But more protein is just the beginning. Visit our blog, which outlines the key nutrients for hair, to learn what other foods to eat for healthier hair.
• Supplement Your Diet: While it is always best to get your nutrients from food, that isn’t always possible. Supplementation is the next best thing. So, what supplements (e.g., are critical for hair health during this phase? Good supplements for hair loss include iron, vitamin D, and vitamin B12, which are vital for hair cycling. As lower levels of these minerals and vitamins can contribute to hair loss, taking these supplements may help improve the health of your hair if you are deficient. Note: Before making any new dietary changes or considering supplements to address hair loss, consult your physician.

Hair Loss Solutions For Women In Menopause

What hair care products or routines should I use for thinning, dry, or brittle hair? From shampoos and conditioners to hair loss serums, medications, supplements, and treatments, the options are dizzying. And once you’ve searched, you’ll likely be targeted with copious ads for supplements, medications, and treatments, making it extra challenging to decide what path to take.

Giving over-the-counter, natural hair loss solutions a try is a good place to start, especially when you learn about the potential side effects of more invasive solutions.

Cleanse like you mean it:

• Shampoo Smarter: The best over-the-counter shampoo for menopausal hair loss is a good moisturizing shampoo with natural oils and humectants to help address the dryness that accompanies the drop in estrogen. For those with an oilier scalp (or even for an occasional clarifying shampoo), a scalp balancing shampoo can help you recover a more harmonious scalp.
• Condition With Intention: A hair thickening conditioner or a moisturizing conditioner will further help moisturize dry menopausal scalps.
• Supercharge Scalp Care: A natural, moisturizing hair loss serum is an ideal female hair loss solution for this pivotal time. To address menopausal hormonal imbalances, choose a formula with oleanolic acid to help reduce DHT (dihydrotestosterone), the hormone that induces hair-follicle shrinkage and hair thinning, symptomatic of female-pattern hair loss. It also provides antioxidant and anti-inflammatory support to combat the aftermath of menopause-related stressors, improving scalp health. 

One with moisture-enhancers, such as castor oil and olive oil, can help resolve scalp dryness associated with menopause.

Medications + Treatments for Menopausal Hair Loss

What are the best treatments, like hormone replacement therapy (HRT) or topical medications? For stubborn, significant hair loss that has not improved after 6 to 12 months of consistent dedication, consult a healthcare provider or dermatologist who can run tests to narrow down the precise cause of hair loss and discuss treatment options tailored to your individual health profile. They can also check your sex hormones to test your estrogen and testosterone levels to see where you are in the perimenopause/menopause transition.

Here are some dermatologist recommended treatments for menopausal hair loss that individuals may want to consider with care:

• Topical Medications: Topical minoxidil was deemed effective for hair loss but is fraught with side effects, including scalp irritation, unwanted hair growth beyond the area of concern, temporary hair shedding in the first few weeks of use, and changes in hair color or texture. It is also messy and inconvenient to use.
• Oral Medications: Low-dose oral minoxidil and spironolactone are also prescribed to treat hair loss.
  • Oral Minoxidil: The effectiveness of low-dose oral minoxidil for postmenopausal hair thinning is considered promising in some circles, owing to its vasodilatory effects and potential to prolong the growth phase of the hair cycle and increase follicular size. However, it may cause fluid retention, hair growth in unwanted areas, and temporary hair shedding.
  • Spironolactone: This off-label medication targets the hormonal aspects of hair loss, though there are possible side effects of spironolactone for menopause hair loss. It may come with high potassium levels, requiring regular bloodwork. Irregular menstrual cycles, tender or enlarged breasts, dizziness, headaches, nausea, and frequent urination (it is a water pill, after all!) can also occur. It is contraindicated for low blood pressure and pregnancy, and unsuitable for men due to its feminizing effects.
  • Estrogen therapy: Can HRT (hormone replacement therapy) help menopausal hair growth? While hair loss isn't FDA indicated for hormone therapy (unlike hot flashes, night sweats, osteopenia, and vaginal dryness), it can be helpful. However,  it can take anywhere from 6 months to a year to see results and isn’t recommended for women with a history of breast cancer and other hormone-sensitive cancers.

Stay tuned for information about other “Non-Invasive Hair Loss Treatments” such as dermarollers, microneedling, LED lights, lasers, etc

Disclaimer: This article and product references are intended for informational use only and are not intended to diagnose or treat any medical conditions.