Menopausal Hair Loss: Is it Permanent and How to Prevent it?

Last updated 12.21.2023 | by Dr. Karen Pike | 12 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Did you know that more than 40% of women report some degree of hair loss during menopause? 

While most discussion of middle aged hair loss centers around men, a significant proportion of women also experience thinning hair, and it usually happens during menopause. 

Some women understandably panic when they notice the first signs of hair loss. But thankfully, hair loss associated with fluctuating hormones during menopause isn’t usually permanent. And, armed with the right knowledge, it’s possible to minimize the damage and keep your locks looking their best.

I first noticed my own menopause related hair loss part way through my perimenopause journey. At first, I was devastated to discover that parts of my scalp seemed more visible than they had done before. And as my hair brush collected more and more hairs each day, my thoughts rushed to the worst case scenario, and I worried that soon, I could be bald. 

But thankfully, that didn’t happen. As my hormones settled down and I got closer to menopause, my hair loss slowly began to reverse. I also took several steps to give my existing strands a boost, and though my hair is not quite as thick and full as it was in my 20s and 30s, it’s still healthy and shiny, and I no longer worry about bald spots being on show. 

So, is your hair looking a little thinner than it used to? Are you noticing the first signs of menopause related hair loss, and you’re wondering how to slow or even reverse the problem? In this post, I’lI delve into the reasons why it happens, and explore some of the things we can do to combat it.

Can Menopause Cause Hair Loss?

Unfortunately, the answer is yes.

Hair loss is a normal part of menopause for many women, myself included.

In my case, the process happened gradually, and it took me a while to notice that I was losing hair. But one day, I was looking in the mirror, adjusting my parting before work, and suddenly, it was all I could see. It was obvious that my hair had been thinning for some time, but between my busy job at the hospital and my hectic homelife, I’d missed the early warning signs.

Thinning wasn’t the only hair related issue I noticed during perimenopause. The texture of my hair began to change, too. My once soft and shiny mane was looking increasingly dry, brittle, and dull. And, after sharing my worries with some close friends and work colleagues, I realized that I wasn’t the only one facing these types of issues.

Menopause hair loss and hair damage are a surprisingly common problem, and almost half of women experience these types of changes throughout their menopausal transition.

What Causes Hair Loss During Menopause?

According to the American Academy of Dermatology, it’s normal for men and women of all ages to lose 50-100 hairs every day. But during perimenopause and menopause, this number can increase dramatically.

That’s because estrogen and progesterone have a direct impact on the growth cycle of the hair.

When estrogen and progesterone levels are high, hair is in the growing phase, known as the anagen phase, for much longer. Hair grows faster, and the hair shaft itself may also become thicker.

But during perimenopause (the build-up to menopause), estrogen and progesterone levels begin to plummet.

As a result, the hair spends less time in the anagen-growing phase. Instead, it skips ahead to the telogen phase. This is the follicle’s resting phase, where the hair prepares to shed to make room for new growth.

This means more hairs fall out at the same time. So, instead of losing just 50-100 hairs a day, your hairbrush could be collecting upwards of 300 in less than 24 hours. The longer this cycle continues, the thinner and patchier your hairline will become.

This type of shedding is called telogen effluvium hair loss, and it’s the main type of hair loss experienced by menopausal women.

As we’re busy losing hair on our heads, we may start to notice some extra strands appearing on our faces. This is because as estrogen and progesterone fall, male hormones, known as androgens, can increase. Androgens promote facial hair growth, as well as acne. They’re also responsible for hair follicle shrinkage, which makes the hair shaft thinner, causing more hair loss from the head.

What Are the Signs and Symptoms of Menopausal Hair Loss?

the Signs and Symptoms of Menopausal Hair Loss

Hair loss is a gradual process. Most people don’t have major hair loss overnight. Instead, it takes weeks and even months for hair loss to become noticeable.

Some of the main signs that you may be experiencing menopause hair loss are:

  • Excess hairs in your hairbrush
  • Excess hair in your shower drain
  • Noticing hairs on your pillow in the morning

You might also experience the following changes:

  • Hair feels drier and more brittle
  • Hair becomes more prone to breakage
  • Greasy roots in between washes

Once hair loss is noticeable, it may appear as:

  • A noticeably wider parting
  • More space between hair follicles
  • Sparse patches, especially around the top center of your scalp and the front of your hairline
  • A thinner ponytail

How Can I Prevent Hair Loss During Menopause?

Hair loss is a common symptom of menopause. But thankfully, it’s not usually permanent. I’m happy to report that my own hair loss stopped around the same time that my periods ended. Since then, my locks have recovered and my hair is looking significantly healthier, shinier and more full.

This reversal of hair loss is due to my hormones naturally stabilizing after perimenopause. But I didn’t just leave it up to nature. I also took steps to improve the quality of my hair and prevent further loss and damage. 

Below, I’ll share the extra interventions that worked for me.

Eat Well

Maintaining a nutritious, balanced diet improves every aspect of your health, including the health of your hair. What you eat also has a big impact on your hormones, which are the driving force behind menopausal hair loss.

According to research, many women don’t get the right nutrition during this transitional time. This makes thinning hair much worse.

So, be sure to eat a diet rich in the following hair growth-supporting nutrients:

  • Protein: Protein supports keratin hair protein synthesis, strengthening the hair shaft and follicles.
  • Healthy fats: Fats play a vital role in steroid hormone synthesis. A diet rich in healthy fats such as omega-3 fatty acids and omega-6 polyunsaturated fatty acids boosts the quality of your hair and your skin. Plus, it can help to alleviate several other hormone-related symptoms of menopause too.
  • Vitamins and minerals: Vitamin C and group B and A vitamins are all vital to maintaining hair quality. The same goes for minerals such as magnesium, copper, iron, and selenium.

Researchers also recommend eating a low glycemic index (GI) diet rich in complex carbohydrates and fiber.

Low GI foods take longer to raise blood sugar levels. This plays an important role in the balance of our hormones. I’ve found that a low GI diet has improved the health and texture of my hair, but that’s not all. Eating this way has helped me to stave off menopause related weight gain, and it’s also stabilized my energy levels, too. Previously, I’d often crash in the afternoon after eating my lunch. I’d suddenly feel tired and sleepy, which is far from ideal as a doctor in a busy emergency room.

But eating meals with a low glycemic index has dramatically reduced my fatigue and helped me to stay focused and energetic all throughout the day.

Manage Stress

Women going through perimenopause and menopause are already predisposed to higher levels of stress. But stress can play havoc on your hormones and make hair loss much worse.

So, if you’ve noticed your hair is thinning, it’s important to manage stress to keep your locks as strong and healthy as possible.

I find exercise to be a particularly fantastic stress buster. Research shows that regular physical activity increases the production of feel-good neurotransmitters called endorphins. Endorphins are the antidote to stress and the reason for what is commonly termed as ‘runners high.’

To relieve stress, I’ve also begun practicing meditation and yoga. These mindfulness practices help me to feel more grounded and present, which allows me to navigate  menopause (and hair loss!) with a greater sense of ease.

Be Gentle With Your Hair

The way you care for your hair can have a big impact on how much hair loss you experience.

Practices such as blow drying, bleaching, tinting, and using straightening and curling irons all take their toll.

So, now I try to limit my use of heated styling tools and harsh chemicals, and take it back to basics. These days, I let my hair air dry, and I style it around its natural wave, instead of using straighteners. 

Many women go the extra mile and stop dying their hair, embracing their grays and letting their true color show. Personally, I’m not quite ready to do the same just yet, but I have switched to an all-natural product without harsh chemicals like peroxide and ammonia, and my hair is much happier for it.

Another tip I suggest is to limit brushing your hair as much as possible, and tie your hair back with soft-coated elastic hair bands that don’t promote breakage.

Keeping your hair hydrated and nourished is also key during menopause. So, use a moisture-rich conditioner each time you wash, and treat your locks to a regular deep conditioning mask that will strengthen and care for your strands.

FAQs

Q. Are there any medications that can help with menopause-related hair loss?

Rogaine, which contains the active ingredient minoxidil, is an over-the-counter hair loss treatment designed to treat male pattern baldness. But research suggests that it can help menopause-related female pattern baldness too.
If Rogaine alone doesn’t help, prescription medications such as spironolactone and finasteride have also been shown to be effective.
Finasteride has been shown to help regrow hair after menopause-related hair loss. Spironolactone can’t regrow hair that has already been lost, but it can help to strengthen the existing hair and prevent further damage and loss.
It’s important to note that these over-the-counter and prescription medications all come with potentially serious side effects, including birth defects, miscarriage, hormone disruption, and even heart failure. So, they should be used as a last resort, under the close supervision of your health care provider.

Q. Are there any treatments that can reverse menopause-related hair loss?

Alongside lifestyle modification and medication, several treatments can minimize hair loss. In some cases, it can even reverse it.
Micro-needling is a technique often used for treating wrinkles and scars. But it can also be used to promote hair growth.
The process involves using a roller or micro-needling pen to create tiny microscopic holes in the skin. As the skin heals from this controlled injury, the hair can grow back denser and thicker than it did before.
Other, more invasive treatments include laser therapy, also known as light therapy. This can boost the number of hair follicles on the scalp and increase the strength of your hair. And in severe cases of menopausal hair loss, a hair transplant can be a pricey but permanent solution.

Q. Is menopause-related hair loss permanent?

Nobody wants thinning hair and bald patches. But the good news is that unlike hair loss commonly experienced in men, most menopause-related hair loss isn’t permanent. 
That’s because the root cause of hair loss is hormonal rather than genetic.  Like many women, I found that once my hormonal imbalance was addressed and perimenopause was complete, the hair began to grow back by itself. And in all likelihood, the same will happen to you.

Conclusion

I know from personal experience just how challenging menopause related hair loss can be. After all, for many of us, hair is part of our identity. But thankfully, in most cases, menopausal hair loss isn’t permanent.

As you journey through menopause, it’s important to be kind to yourself and practice self-love. For many of us, hair loss is a normal and natural part of the menopause process. It’s also an opportunity to explore and embrace the wisdom and self-acceptance that comes with age.

If you’re struggling with menopause-related hair loss, talk to your doctor or consult with a dermatologist. They can confirm the underlying cause and suggest a treatment plan that works for you.

References:

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.