Spotting and Treating Hair Loss During the Menopause
Spotting and Treating Hair Loss During the Menopause
If you’re going through the menopause, you may’ve noticed yourself experiencing more hair loss than normal. That’s because there's a connection between menopause and thinning hair. It’s caused by your declining oestrogen levels, which affect hair growth cycles and follicle health.
Despite around 40-50% of women experiencing hair loss during the menopause, it remains a lesser-known symptom compared to hot flushes and mood swings.
While this increased hair loss can feel distressing, understanding why it happens and knowing your treatment options can help you take control of your hair during this transition.
Below, we walk you through why hair loss can occur during the menopause, the treatments available, and when to seek help.
Three key takeaways
Causes: Declining oestrogen and progesterone levels during menopause directly impact hair follicles, while stress, genetics, and nutritional factors can worsen hair loss.
Signs: Look for increased hair shedding, overall thinning, particularly at the crown and parting, and changes in hair texture rather than complete bald patches.
Treatments: Options include hormone replacement therapy (HRT), topical minoxidil, and targeted lifestyle and nutrition changes.
Female hair loss in menopause occurs when hormonal changes disrupt your hair's natural growth cycle.
Oestrogen is essential for maintaining healthy hair growth. However, during menopause, oestrogen levels drop significantly, which impacts the growth phase (anagen). This normally lasts 2-7 years.
Oestrogen helps hair stay in its growth phase longer and promotes thicker, healthier strands. When levels decline, hair follicles become more sensitive to androgens (male hormones that women also produce), particularly dihydrotestosterone (DHT). This increased sensitivity causes follicles to shrink, producing progressively thinner hair until they eventually stop producing hair altogether.
These hormonal shifts also affect your scalp's oil production and blood circulation. Lower oestrogen means less sebum production, leading to a drier scalp. And a drier scalp discourages any new, healthy hair growth. These changes can also reduce blood flow to hair follicles, depriving them of essential nutrients.
Other causes of hair loss during the menopause
Hormonal changes aren’t the only way the menopause can cause hair loss:
Natural ageing process: Hair follicles naturally shrink with age, producing finer strands regardless of hormonal changes, with the menopause potentially accelerating this process.
Genetic factors: If your female relatives experienced hair thinning during menopause, you're more likely to experience it too, as genetic predisposition affects how your follicles respond to hormonal changes.
Stress related to menopause: The psychological stress of menopause symptoms like hot flushes and sleep disruption can trigger rapid hair loss (telogen effluvium), where stress pushes follicles into the resting phase prematurely.
Nutritional deficiencies: Menopause can affect nutrient absorption, and deficiencies in iron, vitamin D, B12, or protein directly impact hair health and growth.
Hair loss commonly begins during perimenopause, the transitional period before menopause when hormone levels start fluctuating but periods haven't completely stopped.
Perimenopause typically starts in your 40s and can last 4-10 years, during which oestrogen levels fluctuate unpredictably rather than steadily declining.
These hormonal fluctuations can actually cause more noticeable hair changes than the menopause itself, as your body struggles to adapt to constantly fluctuating hormone levels.
Perimenopause hair loss typically looks like increased shedding or overall thinning, with many women first noticing these changes during this phase.
Catching hair loss early and treating it during perimenopause can help prevent further hair shedding when menopause is officially reached. So don’t be put off seeking help as soon as you can.
How to spot hair loss during the menopause
Spotting menopause-related hair loss early allows for quicker treatment, potentially preventing further thinning. Unlike male-pattern baldness, women typically experience hair thinning across the scalp rather than distinct bald spots. Here are the key signs to watch for:
Increased daily shedding: Finding more than the normal 50-100 hairs daily in your brush, pillow, or shower drain.
Widening parting: Your centre parting appears broader, with more scalp visible than before.
Overall volume reduction: Ponytails feel thinner, and hair lacks its previous fullness and body.
Crown thinning: The top of your head shows more scalp, particularly noticeable in bright light or photographs.
Texture changes: Hair feels finer, more brittle, or grows more slowly than previously.
Scalp visibility: You can see your scalp through your hair more easily, especially when hair is wet.
Don't feel alarmed if you notice these changes—they're incredibly common and treatable. Taking photos as your hair changes can help you track your progress once you begin treatment.
How to treat hair loss during the menopause
Menopause hair loss treatments have expanded significantly in recent years, offering hope for women experiencing hair fall out. The key is finding the right combination of treatments that work for your specific situation and symptoms.
Hormone replacement therapy (HRT)
HRT can be highly effective for menopause-related hair loss by increasing oestrogen levels. According to NICE guidelines, HRT can improve hair thickness and reduce shedding in many women. Results typically appear within 3-6 months of starting treatment, though individual responses vary.
Topical treatments
Minoxidil (Regaine for Women) is the only topical treatment licensed for female pattern hair loss in the UK. Available without a prescription, it works by improving blood flow to follicles and extending the growth phase. The MHRA confirms its effectiveness, with studies showing 60% of women experience hair regrowth.
Specific vitamins can support hair health during menopause: biotin (30-100mcg daily), vitamin D (10mcg daily), iron (if deficient), and omega-3 fatty acids. You should always consult your GP before starting supplements, as excessive intake can be harmful.
Hair care adjustments
Handle your hair with care. Use wide-toothed combs, avoid tight hairstyles, minimise heat styling, and choose sulphate-free shampoos. You can even consider silk pillowcases to reduce friction and breakage during sleep.
Scalp massage and oils
Regular scalp massage (5 minutes daily) can improve circulation and potentially stimulate growth. Rosemary oil, when diluted and massaged into the scalp, has shown promise in small studies for improving hair density.
Can you reverse thinning hair after the menopause?
While a complete reversal isn't always possible, you may be able to achieve significant improvements with consistent treatment. The extent of recovery depends on how long follicles have been dormant, the amount of hair lost, and the underlying causes of your hair loss.
We’ve spoken to one of our in-house pharmacists, Ayesha Bashir, for their comment:
"I often reassure patients that menopause-related hair thinning isn't necessarily the end of the story. While we can't always restore hair to its pre-menopause glory, I've seen many women achieve encouraging results with the right approach.
“The key is starting treatment sooner rather than later, as dormant follicles can often be reawakened if they haven't been inactive for too long. In my experience, combining treatments works best; usually HRT (if appropriate) alongside topical minoxidil and good nutrition.
"Most women see initial improvements within 4 months, with optimal results after 12 months of consistent treatment. It's about being consistent and realistic—you might not get back the fullness of your hair, but noticeable improvement is absolutely possible."
How can Chemist4U help with hair loss and the menopause?
Chemist4U offers comprehensive support for menopause-related hair loss through our online consultation service for HRT. Simply complete a quick and easy questionnaire and one of our prescribers will decide whether HRT is right for you.
We also offer a range of clinically proven topical hair loss treatments specifically formulated for women that are ideal to use alongside your medication, if suitable, to help you achieve the best results.
What's the best shampoo for hair loss during the menopause?
Look for gentle, sulphate-free shampoos containing caffeine, biotin, or saw palmetto, which may support scalp health and hair growth. While shampoos alone won't reverse hair loss, products like Plantur 39 or Alpecin Caffeine Shampoo can complement other treatments.
Does the menopause cause facial hair?
While scalp hair may thin, facial hair often increases during menopause due to unbalanced hormones. As oestrogen decreases, existing androgens become more dominant, potentially stimulating coarser, darker facial hair growth, particularly on the chin and upper lip.
Various removal methods exist, from threading to laser treatment, and HRT may help rebalance hormones to reduce unwanted facial hair growth.
Is menopause hair loss permanent?
Menopause hair loss isn't necessarily permanent, especially with early intervention and appropriate treatment. Many women experience significant regrowth with HRT, minoxidil, or combination treatments.
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