menopausal hair loss treatment
When we think of hair loss, we often think of male hair loss, but the reality is that women are increasingly experiencing hair loss too.
During menopause, hormonal fluctuations can impact the hair follicle, leading to hair thinning, loss of volume, and changes in hair texture. These changes are primarily due to a decrease in oestrogen levels and higher than normal testosterone levels. Therefore, menopausal hair loss is pretty much the same as female pattern hair loss (aka androgenic alopecia) but occurring later in life.
Not all women experience significant hair changes during menopause, and the extent of transformation is influenced by genetic factors, stress and diet. It is also important to note that not all women who experience hair loss have elevated levels of androgens. This suggests that it is the imbalance of oestrogen:androgen ratio that may be the contributing factor for hair loss in women.
What is menopause?
Menopause is defined as “the permanent cessation of menses for 12 months resulting from oestrogen deficiency." According to a recent article published in the Journal of Biomedicines, the pace and duration of the menopausal transition phase are two concurrent processes that are influenced by chronological aging and ovarian aging. Said differently, how fast we reach menopause is determined by our chronological age and ovarian age. Since we don't have control over our chronological age, we do have control over ovarian aging.
Numerous variables that can influence ovarian ageing include nutrition, activity level, smoking status, socioeconomic situation, body mass index (BMI), ethnicity, cultural beliefs, and concomitant medical/gynecological health conditions, affect the age at menopause onset.
This should breathe a sign of relief for women who are constantly told by society that if you are approaching 40, it is time to start preparing for menopause. This is completely inaccurate. It is time to start getting ready for that yoga class and the nutrition that is going into our body (and don't forget your strength training to safeguard against osteoporosis, it's one less prescription to fill).
What does menopausal hair loss look like?
Hair loss during menopause often manifest as diffuse thinning or a widening of the middle part (similar presentation to female pattern hair loss). It is believed that low oestrogen shortens the anagen phase (growth phase) and the follicles becomes more sensitive to androgens and shrinks over time. As a result of follicle miniturising (shrinking), the hair follicle becomes weak and falls out easily.
What nutrients are important to support hair growth?
- Beta-carotene
- Omega-3 fatty acids
- Biotin
- Zinc
- Iron
- Vitamin D
What other treatments can you use to support hair growth?
- Correcting the estrogen:androgen ratio, whether with topical treatments or oral treatments such as spironolactone
- Scalp massages to improve blood flow
- Other topicals with peptides and rosemary (data is limited)
In recent years, topical finasteride has been attracting great interest for managing female pattern hair loss and hair loss post menopause, however, the data are still preliminary and the finasteride concentration have not been standardised for women.
Topical minoxidil still remains a popular choice for treating hair loss in women by improving blood flow and promoting hair growth. Combining minoxidil and re-establishing the oestrogen:androgen ratio is a consideration for pharmacists.
References:
- Rinaldi, F et al.The Menopausal Transition: Is the Hair Follicle “Going through Menopause”? Journal of Biomedicines.(2023) Nov 14;11(11):3041. doi: 10.3390/biomedicines11113041
- Treating female hair loss. (2024) Harvard Health. https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss
- Kinosita-Ise, M et al. Recent Advances in Understanding of the Etiopathogenesis, Diagnosis, and Management of Hair Loss Diseases. J. Clin. Med. 2023, 12(9), 3259; https://doi.org/10.3390/jcm12093259
