Everything you need to know about hair loss in menopause and perimenopause and how to turn it around.
If the sight of hair in your shower drain or on your hair brush is causing you anxiety …. you are not alone.
For most women, hair is an expression of our style, our personality, and our image. When our hair looks good, we feel good. Midlife hair loss is more than just a never ending “bad hair day” and can be very distressing. If we lose a lot of hair, we may feel less attractive, less feminine, less in control, and that can affect our self-esteem.
I get asked all the time if hormonal hair loss can be reversed. The answer is yes! Fortunately, unlike genetic hair loss, most hair loss caused by hormonal imbalances is reversible.
In fact, back in my 20’s when I was diagnosed with primary ovarian failure – I had all the classic symptoms of menopause, including hair loss – I would often clog shower drains at my apartment since so much hair was going down it. My dad had to buy me a special drain cover because he was getting tired of coming over all of the time to deal with my plugged up drain! I went through a phase where I would dread washing my hair, because I didn’t want any more to fall out. It was hard for me, especially at such a young age. The good news is that once I restored my hormones to healthy levels, my hair grew back and thicker and fuller than ever. So, there is hope!
Perimenopause and Menopause are times of extreme hormonal changes that typically occur beginning in the 40s and going through to the 50s. During this transitional menopause time, many different physical symptoms can appear, including hot flashes, night sweats, moods swings, brain fog, insomnia, vaginal dryness and menopausal hair loss. Often times, hair loss is one of the first symptoms that appear.
Very commonly, women will notice that the volume and texture of their hair appears to worsen. Hair breaks more easily and doesn’t seem to grow in as fast as it used to. More hair seems to end up in the shower drain when washing, and hair brush fills up quickly with loose hairs.
When women in their 40’s, 50’s and beyond experience hair loss and other symptoms of menopause, it is predominantly due to hormonal changes. With age, the ovaries begin to decrease the amount of sex hormones that are normally produced. As the body responds to the fluctuations in hormones, numerous physical changes occur.
Menopausal hair loss is directly related to the decreased production of estrogen and progesterone. As these hormone levels drop, hair may begin to grow more slowly and become thinner. Over time, the decrease in estrogen and progesterone (hair growth hormones) causes a relative increase in the activity of androgens (hair loss hormones), which becomes a double whammy for our hair – I’ll explain that below.
Balancing our Hair Growth Hormones
Before we talk about hair growth hormones, it is important to understand the three phases that our hair goes through – The Growth Phase, The Rest Phase, and The Shedding Phase. Everyone’s hair goes through these three phases.
Typically, the growth phase for each hair follicle lasts 2-6 years. This is followed by a rest phase that can last anywhere from 2-12 weeks. Finally, there is the shedding phase where the hair falls out. It is normal for everyone to lose 50 to 150 hairs per day. This is not noticeable, because all of our hairs are in different phases.
The problem comes in when the growth phase gets shorter. This means that we have less time for hair to grow before it falls out. And so we shed more than we can replace.
Did you know that estrogen and progesterone, along with thyroid hormone, are actually hair growth hormones? They actually stimulate hair follicles to go into the growing phase. When estrogen and progesterone levels are optimal, we enjoy a longer growth phase for each and every hair on our head. But as we get into perimenopause and menopause, the cycle shortens and we end of losing hair faster than we are growing it.
To make matters worse, as we enter the transitional menopausal years, and our estrogen and progesterone decline, we have a relative increase in our androgen levels, such as testosterone. While testosterone is an important hormone and has many benefits, in some women, a high proportion of testosterone can break down into Dihydrotestosterone (DHT), which can block hair growth.
High levels of androgens, including DHT, can shrink your hair follicles as well as shorten the hair growth cycle, causing hair to grow out looking thinner and more brittle, as well as fall out faster. DHT can also cause it to take longer for your follicles to grow new hairs once old hairs fall out.
Some women have a natural genetic tendency to metabolize more of their testosterone down the DHT pathway. Stress and resulting high cortisol can also contribute to raising levels of DHT. This is why when we go through stressful times, our hair loss can increase.
Now that you understand how hormones contribute to hair loss, let’s talk about some things you can do to control and reverse hair loss during perimenopause and menopause.
Hormone Healing Tip 1: Control Hair Loss Hormones
One of the best ways to determine if you favor the conversion of testosterone to DHT is with a hormone metabolite test. This test will measure the amount of testosterone (as well as estrogen and progesterone) that you produce, and also how much of that is going down the pathway to DHT.
Symptoms that indicate women may be producing too much DHT include oily skin, acne, dark hairs on their chin and face, and excessive hair loss. Conditions like PCOS, where women produce excess testosterone can be a cause; in that case, making diet and lifestyle choices to balance testosterone, cortisol and insulin can be helpful in reducing DHT.
But many women have normal levels of testosterone, but they favor the metabolic pathway that leaves them with too much DHT. In this case, we are not looking to reduce the total amount of testosterone, but rather prevent testosterone from converting into dihydrotestosterone. There are some herbs that are very helpful in blocking the 5 alpha reductase enzyme and therefore, blocking excessive DHT production. These include Saw Palmetto, Pygeum and Nettles. .
Hormone Healing Tip 2: Boost Hair Growth Hormones
In addition to reducing our DHT levels, you also want to boost your hair growth hormones. So for females, we want more estrogen and progesterone in order to grow hair. We also want to have healthy levels of T3, our active thyroid hormone. So getting your hormones in balance is incredibly important to growing healthy hair. One of the little known benefits of bio-identical hormone replacement therapy is the confidence that women gain as their hair and skin becomes much healthier and youthful, which is a result of their hormones being in balance. By increasing the growth hormones that are related to growing hair, and by getting more of those hormones to the hair follicle, this allows for a longer growth cycle and less dormant follicles, which means a healthier, fuller head of hair.
Hormone Healing Tip 3: Beauty Sleep
Poor sleep quality leads to a number of health issues, whether it’s stress, skin issues, energy levels or a poor immune system.
Did you know that your sleep cycle affects your hair’s overall health? A good and restorative night’s sleep is required for the protein synthesis of the hair and the release of enzymes and growth hormones that are necessary for overall hair health.
The way that sleep affects your body’s natural hormones is probably the most important part of preventing hair loss. Your body produces a hormone called melatonin. This hormone helps your body regulate your sleep cycle, and it has been shown to increase hair growth. If your body decreases in its melatonin levels, it’s possible that this could result in hair loss.
Sleep deprivation, which is so common as our female hormones decline, can eventually lead to stress, and stress has been known to result in telogen effluvium hair loss. This is when stress pushes the hair follicle into a premature “resting state,” which is then followed by a premature “shedding phase.”
I formulated GLOW PM to help with perimenopause and menopause sleep disruption and support healthy hair growth. GLOW PM contains a blend of melatonin, GABA, 5-HTP and gentle calming herbs to help melt away stress, calm the body and mind, and allow for restful sleep, night after night. And as a result, that bed-head will be fuller and thicker!
Hormone Healing Tip 4: Nutrition
A lack of the right nutrients, including Vitamins A, C, D and E, Zinc, B Vitamins, Iron, Biotin, Protein and Essential Fatty Acids, may slow down hair growth or even cause hair loss. Fortunately, correcting a deficiency in any of these nutrients may help treat hair loss and promote the rate of hair growth. I formulated Daily GLOW, a first of its kind, physician formulated, whole-food based, hormone and thyroid specific multi-nutrient to provide all of the essential vitamins and minerals for healthy hair growth, and also promote the healthy production of thyroid hormone, healthy estrogen and progesterone production and metabolism, and support the adrenal glands for better stress response. Daily GLOW is probably one of the easiest ways to ensure a healthy head of hair!
The bottom line is that hormonal hair loss is a sad reality for so many women, but as you can see, there is a lot you can do to prevent and reverse it. Consider bio-identical hormone replacement, sleep support, daily nutrient support and if needed, herbs to decrease the conversion of testosterone to DHT.
Recent studies have reported that menopausal hair loss occurs in more than 50 percent of cases. It’s often an unavoidable side effect of changes in hormone levels during menopause, but in most cases menopausal hair loss is not permanent.