Can menopause really cause hair loss?
Many of us experience concerns around changes in our hair as we approach and go through menopause. First it starts sprouting in places we don’t want it, like our chins. Then, for some of us, it seems like our hair is getting thinner. Something else to think about.
Our hair can often be a big part of our identity, something we can normally control and choose how we cut, style and wear it. So it can be hard to come to terms with our changing or thinning hair. But what is actually going on?
While hormone disruption can sometimes lead to hair loss, there are other factors at play too. Here are some of the facts behind hair loss, plus some tips about what you can do.
Why may we be losing hair?
Ultimately, hair loss becomes more common as we get older. Of course it isn’t inevitable, but hair loss or thinning is more prevalent in women as they age.
The medical term for hair loss is alopecia. Hair loss or thinning which affects the general distribution of our hair, as opposed to losing it in patches, is known as ‘diffuse alopecia’.
How does our hair normally grow?
Hair follicles go through growing and resting phases.
- The growth phase (anagen) lasts two to six years.
- This is followed by a short transitional phase (categen), lasting four to six weeks.
- Finally, there’s a resting phase (telogen), which lasts two to three months and ends with the release of the hair from the follicle
There are some conditions that may cause excessive shedding and others that may cause hair thinning. We’ll explore these and see how menopause may play its part.
Abnormal hair shedding – known as effluvium – may occur during the first or last phase of the hair cycle.
- Sometimes we experience temporary hairloss after a shock to our system, such as a severe infection, extreme stress or as a result of certain medications. This is excessive shedding or resting hair, and is known as telogen effluvium
- If the anagen phase is interrupted, it can cause premature termination of hair growth, leading to abrupt hair shedding (anagen effluvium). This can commonly occur as a result of chemotherapy.
Lots of us have heard of Male Pattern Baldness. But there is an equivalent for women, Female Pattern Hair Loss (FPHL). And the way our hair changes as we get older can often have a lot to do with our genetic predisposition. Evidence indicates there are many genes that contribute to hair loss in women, and these can be inherited from either parent or both.
Hair loss in women presents quite differently from hair loss in men, where the hairline normally gradually recedes from the front of the head into a bald patch on top. In women, the hair loss is normally a more gradual thinning from the mid hairline.
Is hair loss caused by menopause?
The million dollar question. Androgens (hormones found in both men and women) play a clear part in male hair loss but we don’t know if they can also cause hair loss in women.
Equally, the role of oestrogen is uncertain. Hair loss in women is more common after the menopause, suggesting oestrogen may be stimulatory for hair growth. Studies have shown that the hair is prone to ageing, much like the skin (and every other organ of the body). In women, hair follicles start to shrink from the mid 40s, and so hair becomes finer with each year. The total number of hair follicles also goes down.
Hair loss can affect women in any age group, but it occurs more commonly after menopause. However, it is unclear if this is due to general ageing or hormone decline.
The hair loss process is not constant and usually occurs in fits and bursts. It is not uncommon to have accelerated phases of hair loss for 3-6 months, followed by periods of stability lasting 6-18 months.
What are the effects of female pattern hair loss?
Many studies have shown that hair loss is not merely a cosmetic issue, but it can also cause significant psychological distress. Compared to unaffected women, those affected have a more negative body image and are less able to cope with daily functioning. Hair loss can be associated with low self-esteem, depression, introversion, and feelings of unattractiveness. It is especially hard to live in a society that places great value on youthful appearance and attractiveness.
For women going through menopause, the cause of hair loss may be related to hormonal changes. However, there are many other factors that can contribute to hair loss during menopause. These include extremely high levels of stress, illness, or a lack of certain nutrients. Diagnostic blood tests that can help rule out other causes of hair loss include thyroid tests, and/or a complete blood count.
The NHS guidelines on hair loss state most hair loss doesn’t need medical treatment as it is considered either temporary or a normal part of getting older.
There are things you can do if your hair loss is causing you distress but most treatments aren’t available on the NHS so you would have to pay for them.
Your first stop would be to see your GP who can look to exclude other reasons for hair loss, or refer you to a dermatologist. Some women find HRT can help, although this isn’t the case for everyone.
If you’re noticing significant hair loss and you are taking any medication, talk with your GP to understand if it could be a side effect from any medication. Don’t stop taking medication that you need but discuss with your doctor as they may be able to look at alternatives.
It is important to seek reliable information and advice from authoritative sources as there are many bogus treatments that are expensive and do not work.
What can you do to support healthy hair?
As with many things at this time in our lives, the way we look after ourselves and our bodies plays a major role in the way our bodies work. Here are some things you can do:
Drink plenty of water
We know water is good for us and being well hydrated supports so many functions in our bodies. The amount of water each of us needs depends body to body but on average around 2 litres a day is a good target.
Avoid heated hair tools
Where possible, allow your hair to dry naturally. Excessive use of heat tools such as straighteners can weaken and damage your hair. If you are using these tools make sure you use protective oils.
Use natural hair colourants
Again, where possible, if you want to colour your hair, use all-natural products as artificial chemicals found in dyes can damage the health of your scalp and hair
Stress can have a detrimental effect on so many things in our bodies. Extreme stress can cause sudden temporary hair loss so reducing stress will have a positive impact on the health of your whole body, including your hair.
Eating a balanced diet supports healthy hair. Focus on including whole grains, fruits and vegetables. Essential fatty acids also play a crucial role in maintaining hair health and can be found in foods such as salmon, tuna, flaxseeds, walnuts, almonds
Dr Tina Peers and Consultant Gynaecologist Nick Pannay discuss supplements that could be considered in supporting hair loss and hair thinning if you have a deficiency in any of the following:
- Vitamin A
- Vitamin B12 and Folate
- Vitamin B2
- Omegas 3 and 6
So the short answer to the question ‘does menopause cause hair loss?’ is we don’t fully know. What we do know is that many women can experience hair thinning or loss as they age.
- Yip L, Sinclair R. Antiandrogen therapy for androgenetic alopecia. Expert Rev Dermatol 1(2):261-9 (2006).
- Sinclair R, Patel M, Dawson TL, Yazdabadi A, Yip L, Perez A, Rufaut NW. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol 2011; 165: 12-18.
- Sinclair RD. Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. Int J Dermatol. 2017 Dec 12. doi: 10.1111/ijd.13838. [Epub ahead of print] PubMed PMID: 29231239. PubMed.