Hair Loss in Menopause: Why We’re Having More Bad Hair Days

As if weight gain and belly fat aren’t insulting enough, a loss of estrogen in Menopause can also cause our hair to fall out!  And what’s left often turns thin and brittle, “like hay,” as one friend put it.  Why is this happening? And is there anything we can do about it?

I asked Dr. Diane Berson, a dermatologist in New York City, who explained that there’s a perfect storm of conditions that are conspiring to ruin (my word not hers) our hair as we begin the second half of our lives.

“Certainly aging and genes are contributing factors. But as we  lose estrogen in Menopause, our hair gets thinner and dryer, just as our skin and mucous membranes do.  Hair follicles becomes “miniaturized” causing hair to shed – first on top, then along the forehead hair line.

“Hormones keep hair in a growing phase,” Dr. Berson continued.  “That’s why during pregnancy, when all hairs enter the growth cycle at the same time, a woman’s hair gets nice and thick.  After childbirth,  her hair enters a falling out stage and you begin to see hair loss.  Estrogen has a beneficial effect on hair loss, so if a woman is on birth control pills or hormone replacement, she will see an improvement in the quality and thickness of her hair.”

Dr. Berson told me that in addition to hormonal changes, hair loss can result from medical stress on our bodies such as:

• high fever
• general anesthesia
• certain medications for the treatment of blood pressure and depression
• psychological stress such as grief
• protein deficiency (the result of a crash diet)

But if a post-menopausal woman is experiencing hair loss, and none of these situations apply to her, she does have a few options, according to Dr. Berson.

“Assuming that you’ve ruled out anything medical that could cause hair loss, such as a thyroid problem, anemia (iron deficiency)  or auto-immune disease,  I’d suggest trying Rogaine (or Minoxidil, the active ingredient) which is rubbed into the scalp.  (Rogaine is one of only two drugs approved by the FDA for the treatment of hair loss). No one knows exactly how this works. It may increase circulation to the hair follicles, but the sooner you start using it when you notice the thinning, the better the chance it has of working, particularly for women who have diffused thinning.

“Another alternative in Biotin (a B vitamin) supplements, which often makes nails and hair stronger.  You have to take adequate doses of it. I usually prescribe 2000 mcg daily.

“A third option is a hormonal treatment -  either estrogen in the form of HRT or possibly Spironolactone, an androgen blocker.  It blocks the androgen –or testosterone — receptor.  Some women have found it to be helpful for hair thinning whether they’re pre-menopausal or post-menopausal.  We prescribe it for hair thinning and for women who have excess facial hair growth or acne.”

Dr. Berson also recommends non-medical, camouflage techniques such as getting makeup that matches your hair color and applying it to the thin areas of your scalp, or wearing a short, curly hairstyle or hair extensions.

Have you noticed changes in your hair (i.e. amount, texture) since you began the menopause transition?  Have you found any remedies or products that work? I hope you’ll share your stories below.