Does Menopause Cause Hair Loss?

While hot flashes, weight gain, and trouble sleeping are the hallmark symptoms of menopause, as many as 40 percent of women also experience hair loss, according to Christine Han, MD, the medical director of XYON Health and a dermatologist with False Creek Dermatology in Vancouver, British Columbia, Canada.

As with the other symptoms, hormonal changes are responsible for thinning hair or hair that has lost its luster in menopause.

Here’s why menopause can cause hair loss and what you can do to slow it down and improve your hair’s overall health.

Hair loss is common during menopause, but it isn’t usually the first symptom women notice, says Viktoryia Kazlouskaya, MD, PhD, a dermatologist with Dermatology Circle in New York City. Often the widening of the hair’s natural part is a first sign of hair loss. Other common hair changes that women may experience during menopause are to the hair’s overall density, shine, or volume, she says.

During menopause, levels of estrogen and progesterone drop.

“A drop in those hormones can signal to the follicles to miniaturize, especially in those women who are genetically predisposed,” says Dr. Han.

Another cause of hair loss in women is androgenetic alopecia, or female-pattern hair loss (FPHL). In FPHL the hair follicles are hypersensitive to androgens, including testosterone. While all women produce androgens, only those with a genetic predisposition are prone to this type of hair loss. Some research indicates that declining progesterone and estrogen during menopause may make hair loss due to FPHL more obvious.

Hair follicles shrink, causing the hair to become thinner and finer, with decreased numbers of hairs overall. The hair’s growing phase also gets shorter, and fewer hairs are in the active growing phase.

The human scalp has an average of 100,000 hairs, each of which goes through cycles that repeat over and over. These cycles include growth, transition, and shedding. Estrogen boosts the growth phase, as well as contributing to natural scalp oils.

“Because of that decrease in estrogen, menopause can also mean a dip in your hair’s growth cycle as well as less sheen and moisture due to the lack of oil production. Without treatment, the hair loss is likely to become progressively worse over time,” says Han.

While hormonal changes are a common cause of hair loss during menopause, other factors like genetics and stress can play a role. “It’s important to note that with women, hair loss can be multifactorial,” Dr. Kazlouskaya says.

Some of these factors include:

Genetics: Looking at the hair thinning (or lack thereof) of your closest relatives can give you some insight into your chances of your own hair loss.
Vitamin Deficiencies: Insufficient vitamin levels like D, B12, or iron can contribute to hair thinning alongside other factors.
Thyroid Issues: Both an underactive or overactive thyroid can lead to hair thinning. If you notice diffuse thinning throughout your hair (as opposed to patches or sections) or significant increases in shedding during washing or brushing, an underlying thyroid issue could be connected.
Frequent Chemical Hair Treatments: While dyeing, perming, or relaxing your hair won’t be the sole cause of hair loss, frequent chemical use can damage the hair, leading to an increased risk of hair thinning or breakage.

Navigating hair loss is hard, especially while your body is likely undergoing several other changes. There is good news: You have options. With adequate treatment and by focusing on the health of your hair, hair thinning doesn’t have to progress.

Dermatologists widely recommend minoxidil (Rogaine), an over-the-counter medication that can be taken orally or used topically, as well as finasteride (Propecia), available with a prescription.

Spironolactone, a blood pressure medication, is used “off-label” to treat hair loss due to FPHL, as it blocks the effects of circulating androgens.

These oral medications should not be used by women who are pregnant or planning to become pregnant.

But can you get back what’s already been lost? According to Kazlouskaya, it depends on the progression and what factors contribute to the thinning. For example, if diet or nutrient deficiencies are a major factor, amending those can increase your chances of regrowth.

“We may be able to reverse it if it’s in the early stages, but if it’s already a very long-standing process, we have to be realistic about how much we will be able to reverse,” she says. “We can boost the other hair to be thicker, healthier, and that can help mask what’s been lost.”

That means taking care of the hair you already have is paramount. Strategies include:

Choosing Sulfate-Free Products: Chemicals and additives to hair products can strip the hair and scalp of necessary nutrients.
Reducing Exposure to Heat, Dyes, and Bleach: According to Han, while heat and chemicals don’t affect your hair follicles, they can cause breakage to your already sensitive strands.
Using Heat Protectant: A quick application of heat protectant — a hair product used before using a blow-dryer, curling iron, or straightening iron — can make a huge difference in the long-term health of your hair, says Han.

If you’ve noticed a major change in your hair, especially alongside other menopausal symptoms, get in touch with your healthcare provider.

Many factors can play into hair loss, and a doctor can help you take a look at your health from a wide perspective. You can discuss things like your vitamin levels, family history, and stress. From here, they can help you determine what your next steps should be, potentially including a visit to a dermatologist.

Kazlouskaya also stresses the importance of receiving testing when significant hair loss occurs, especially for Black American clients, noting that certain types of hair loss are more prevalent in that community.

“You may think it's just menopause or that it's just hormonal changes, but it could be a completely different story that needs completely different treatments, like traction alopecia [from pulling the hair into tight ponytails] or scarring," she says. “Sometimes a biopsy [of the scalp] has to be done to find out what exactly is happening.”

Hair loss during menopause is common, with varying contributing factors including hormonal changes and genetics.
There are treatments and remedies for hair thinning and hair loss, ranging from over-the-counter medications to dietary changes.
If you’ve noticed changes in your hair, it’s a good idea to talk to your doctor to rule out underlying issues and come up with a treatment plan.

Menu