Symptom Guide: Hair Loss

Mar 7, 2022
Medically reviewed by: 
Leah Millheiser, MD

What is Hair Loss?

As you go through menopause, you might notice more hair falling out in the shower or left behind on your pillowcase after sleeping. The hair on your head might start to feel thin or look bald in spots, and clumps of it might come out while brushing. While hair loss can be alarming, know that it’s a normal part of menopause for many women and can be addressed in several ways. 

Up to two-thirds of postmenopausal women will experience hair loss. There are many different types of hair loss, driven by a variety of factors, but the most common type that occurs during menopause is called female pattern hair loss (FPHL, also known as female pattern baldness or androgenic alopecia). Women with this type of hair loss usually see thinning and a decrease in volume in the hair along the sides and top of the head, often along the middle part. Unlike men, women don’t usually experience hair loss at the hairline and rarely become completely bald.

What Causes It?

Menopausal hair loss is largely caused by changing hormone levels. Menopause is associated with a decline in levels of estrogen and progesterone—hormones that promote thicker, fuller hair. At the same time, there’s an increase in the effect of male hormones known as androgens (a group that includes testosterone), which can lead to hair loss (but in some cases can also lead to hair growth). Stress, illness, poor diet, and a lack of certain nutrients can also drive hair loss during menopause.

What’s Happening Inside Your Body?

Female pattern hair loss is known as androgenic alopecia because of the role that the androgen hormones play. The role of androgens is not fully understood, but they are thought to shrink the hair follicle (the opening through which hair grows out of the head), which causes hairs to become thinner. They also cause hair to fall out more quickly than usual. Individual hairs normally go through three phases: growth; transition toward falling out; and resting, when the hair actually falls out. Androgens can shorten the growth phase and extend the period of time it takes for hair to start growing back again. 

What Does the Research Say?

  • A study published in 2022 in Menopause, the journal of the North American Menopause Society, showed that female pattern hair loss affected 52.2% of healthy postmenopausal women, and 60% of women with hair loss experienced low self-esteem as a result of the condition.
  • Research published in the Journal of Drugs in Dermatology in 2021 showed that treatment with the nutraceutical Nutrafol resulted in a decrease in hair shedding of 32.4% after 180 days.
  • A presentation at the 2021 annual meeting of the North American Menopause Society suggested that treatments including minoxidil, finasteride, and platelet-rich plasma injections show promise in addressing female pattern hair loss.

How is hair loss addressed?

Treatment for hair loss ultimately depends on the cause, and your health care professional can help you determine whether your condition is being caused by menopausal hormone changes or other factors, like stress, a nutritional deficiency, or a medical condition. Menopausal hair loss can potentially be treated with certain medications, nutritional supplements, over-the-counter treatments like minoxidil, and procedures such as the injection of platelet-rich plasma or laser therapy.

What are effective medical treatments?

Minoxidil: A common treatment for female pattern hair loss is a solution of 5% minoxidil foam applied to the scalp. This over-the-counter drug, which is approved by the FDA to treat women’s hair loss, is known as Rogaine and is commonly used to treat hair loss in men, but generic versions are available too. The treatment must be applied to the scalp every day, and improvement (decreased shedding/increased hair growth) is typically seen after 3-4 months of use. It isn’t effective in everyone, however, and though it’s safe to use, it can cause some mild side effects, including skin irritation. 

Other anti-androgen drugs: According to the American Academy of Dermatology, drugs including finasteride, flutamide, and dutasteride are sometimes prescribed off-label to treat female pattern hair loss.

What are some non-medical treatments?

Nutraceuticals: Food-derived compounds said to have some physiological benefit are known and sold as nutraceuticals. So far, the research on these compounds on female hair loss is scant. One study published in 2021 showed promising but early results on hair loss for a nutraceutical compound sold as Nutrafol that suggested it safely improved hair quality and decreased hair shedding.

Laser therapy: A dermatologist or other health professional can help determine if laser therapy is a good option for your hair loss. These treatments can come in the form of caps, combs, and other devices and use low-level light to stimulate hair growth. Like other non-medical treatments, research on laser therapy is limited, but according to the American Academy of Dermatology it can encourage thicker, fuller hair growth in some people.

What to do next:

  • Talk to a professional about hair loss. Your doctor or other healthcare professional can help you determine what’s causing your hair loss and suggest a targeted treatment. They can also help identify other factors that might be contributing to hair loss, such as stress, side effects from other medications, or nutritional deficiencies.
  • Stick with the treatment. Many medical and non-medical treatments for hair loss require continued use before effects begin to show. Try your best to stick to the recommended treatment schedule for the best effects. 
  • Visit a hair professional. A professional hairstylist won’t be able to address the underlying causes of hair loss, they can help find hairstyles and products for you that help you look and feel your best. They can also provide advice on how to style and maintain hair without leading to further hair loss. 
  • Take care of yourself inside and out. Since stress can contribute to hair loss, taking steps to manage it can help support a healthy head of hair. Doing so can include eating a balanced diet, getting exercise, sleeping well, and seeking mental health support if you need it. Importantly, be kind to yourself and know that hair loss during menopause is normal. 

Learn more:

Are you experiencing other symptoms that you want to better understand and learn how to treat and manage them? Check out our following guides:

Disclaimer: This information isn’t a substitute for professional medical advice, diagnosis, or treatment. You should never rely upon this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.