Menopause and Hair Loss: Hormonal Changes and Solutions

Menopause and Hair Loss

Hello Doctor: I came to see you on May 14th this year, and since then, I have had intermittent periods of cessation, with two to three months in between visits, and it has now been five months since my last visit.
Last year, I had a blood test, and the doctor informed me that I would likely experience menopause within two years at the latest.
During this process, I have experienced symptoms such as hot flashes, sweating, dry and itchy skin, and slight facial sagging.
Occasionally, I have mild burning sensations when urinating.
I previously consulted a dermatologist about my hair loss issue last year, but the doctor deemed it not serious (I only went once).
I then sought treatment from a traditional Chinese medicine practitioner, but there was no improvement.
Due to having gray hair, I frequently dye my hair (approximately every 2 to 3 months) and suspect that the dye may be causing my hair loss, as I noticed increased shedding while washing my hair at that time, although I typically do not shed much while combing.
Recently, I have been experiencing significant hair loss while washing and combing my hair (my scalp is becoming sparse), and after seeing a dermatologist, I was told I have mild androgenetic alopecia.
I would like to ask you: Is this androgenetic alopecia caused by a decrease in hormones? What steps can I take to identify the cause and resolve this issue? I feel very anxious and fearful, and I hope you can help me.
Thank you.

Xiao Mei, 50~59 year old female. Ask Date: 2017/10/15

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Since May 14 of this year, I have experienced intermittent menstruation, with a few stops lasting two to three months, and now it has been five months since my last period.
Last year, I had blood tests, and the doctor informed me that menopause could occur within two years at the latest.
During this process, I have experienced symptoms such as hot flashes, sweating, dry and itchy skin, and slight facial sagging.
Occasionally, I have mild burning sensations during urination.
Last year, I consulted a dermatologist about my hair loss issue, but the doctor deemed it not serious (I only had one visit).
I then sought treatment from a traditional Chinese medicine practitioner, but there was no noticeable improvement.
Due to having gray hair, I frequently dye my hair (approximately every 2 to 3 months) and suspect that dyeing may have contributed to my hair loss, as I noticed more hair shedding while washing my hair at that time, although I typically do not shed much while combing.
Recently, I have been experiencing significant hair loss while washing and combing my hair (my hair density on the crown is thinning).
I visited a dermatologist again, and the doctor mentioned mild androgenetic alopecia.
I would like to ask: Is this androgenetic alopecia caused by decreased hormones? What should I do to identify the cause and resolve the issue?
Answer: Typically, androgenetic alopecia is not caused by decreased hormones.
For hair loss issues, it is advisable to consult a dermatologist.

Reply Date: 2017/10/15

More Info

Menopause can significantly impact various aspects of a woman's health, including hair loss. As you mentioned, you have been experiencing changes in your menstrual cycle, which could indicate that you are approaching menopause. This transition is often accompanied by hormonal fluctuations, particularly a decrease in estrogen levels, which can lead to various symptoms, including hair thinning and loss.

During menopause, the body undergoes a natural decline in hormone production, particularly estrogen and progesterone. These hormones play a crucial role in maintaining hair health. Estrogen, for instance, promotes hair growth and helps to keep hair in the growth phase longer. When estrogen levels drop, hair follicles may shrink, leading to thinner hair and increased shedding. This condition is often referred to as androgenetic alopecia or female pattern hair loss, which can manifest as diffuse thinning across the scalp or a widening part.

Your experience of hair loss, particularly at the crown and the thinning of your hair, aligns with the common patterns observed during menopause. The fact that you have also noticed changes in your skin, such as dryness and itchiness, further supports the idea that hormonal changes are at play. Additionally, the use of hair dye can sometimes exacerbate hair loss, especially if the scalp is sensitive or if the products used are harsh.

To address your concerns about hair loss during menopause, here are several steps you can take:
1. Consult a Dermatologist or Trichologist: Since you have already seen a dermatologist, consider seeking a second opinion or consulting a specialist in hair loss. They can perform a thorough examination of your scalp and hair follicles to determine the underlying cause of your hair loss.

2. Hormonal Evaluation: It may be beneficial to have a comprehensive hormonal evaluation. This can help determine if your hair loss is primarily due to hormonal changes associated with menopause or if there are other factors involved.

3. Topical Treatments: Minoxidil (commonly known as Rogaine) is an FDA-approved topical treatment for hair loss that can be effective for women experiencing thinning hair. It works by stimulating hair follicles and promoting hair regrowth. Discuss this option with your healthcare provider to see if it is suitable for you.

4. Nutritional Support: Ensure that you are consuming a balanced diet rich in vitamins and minerals that support hair health. Nutrients such as biotin, zinc, iron, and omega-3 fatty acids are essential for maintaining healthy hair. Consider consulting a nutritionist for personalized dietary advice.

5. Stress Management: Stress can exacerbate hair loss, especially during significant life transitions like menopause. Engage in stress-reducing activities such as yoga, meditation, or regular exercise to help manage your stress levels.

6. Gentle Hair Care: Be mindful of your hair care routine. Avoid harsh treatments, excessive heat styling, and tight hairstyles that can pull on the hair. Use gentle shampoos and conditioners designed for thinning hair.

7. Consider Hormone Replacement Therapy (HRT): If your symptoms are severe, you may want to discuss the possibility of hormone replacement therapy with your healthcare provider. HRT can help alleviate menopausal symptoms and may also have a positive effect on hair health.

8. Patience and Realistic Expectations: Hair regrowth can take time, and it is essential to have realistic expectations. While some women may see improvement in a few months, others may take longer to notice changes.

In summary, hair loss during menopause is often linked to hormonal changes, particularly the decline in estrogen levels. By consulting with healthcare professionals, exploring treatment options, and adopting a holistic approach to hair care and overall health, you can work towards managing your hair loss effectively. Remember, you are not alone in this journey, and there are resources and support available to help you navigate this transition.

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