Hairloss in Menopause
Hair Loss in Menopause: What’s Really Going On?
Written by : Dr. Madeleine Clark, ND MSCP
Menopause often brings a variety of symptoms, including changes in hair. Here’s why this can happen during the menopausal transition.
Why does hair loss happen in menopause?
Several factors can influence hair growth and quality during the peri- and post-menopausal years, including:
The natural aging process
Existing health conditions
Genetics
Environmental exposures
Certain medications
That said, we still don’t fully understand why hair changes occur in some individuals during menopause. What we do know is that these changes can significantly affect self-esteem, quality of life, and overall well-being.
What are the common causes?
The two most common causes of hair loss during menopause are telogen effluvium (TE) and female pattern hair loss (FPHL).
What does Female Pattern Hair Loss look like?
FPHL typically shows up as thinning on the crown of the scalp, leading to a widened part through the centre, while the frontal hairline remains unchanged.
Telogen Effluvium, on the other hand, tends to appear as a sudden increase in hair shedding.
Why does this happen?
The role of hormones
We think this happends due to a relative increase in testosterone compared to estrogen during menopause. Both estrogen and testosterone decline in menopause, but we are typically lower in estrogen, leading to a state where testosterone is higher than our estrogen (but not high overall). Hair follicles have both estrogen and androgen receptors. Estrogen appears to protect against hair loss by playing a role in the telogen-anagen cycle (growth cycle of the hair). This theory is supported by the fact that women often have fuller hair during pregnancy - which is due to prolonged anagen phase (from exposure to hormones throughout the pregnancy) and experience shedding postpartum. Androgens are known to affect hair follicles, shortening the anagen phase or growth phase—this is well documented in male pattern baldness, especially when genetics are involved. However, estrogen therapy does not appear to prevent hair loss - which leads us to some answers, but still many questions
The role of inflammation
We think that inflammation and the environment may also play a role. Microinflammation is often seen in biopsies of the sclap in FPHL. This may be triggered by external factors such as UV exposure, pollution, or microbial changes on the scalp.
What about my genetics?
FPHL often runs in families, particularly in cases of early onset. However, there is still limited understanding of the underlying genetics. Twin studies suggest that lifestyle and health factors such as poor sleep, high stress, smoking, diabetes, hypertension, low iron, and low vitamin D are also associated.
What can we do about it?
The most effective treatment available for hair loss is topical minoxidil (Rogaine). But supporting your overall health is equally important. Addressing iron levels, stress, thyroid health, and inflammation can help optimize your results.
👉 Work with me for a comprehensive, evidence-informed plan that looks at your hormones, nutrition, and full health picture—so you can get the right diagnosis and the most effective treatment for your type of hair loss.