Menopause in older females

Menopause & Hair Loss: Are the Two Connected?

The end of a woman’s menstrual cycle and fertility, also known as menopause, is a significant milestone.

And while the start of menopause can signal the beginning to a new and wonderful stage in your life, it can also cause hormonal issues.

One such issue associated with menopause? Female hair loss.

In this article, we’ll discuss the most common cause of hair loss in women 50 years and older: menopause.

This will include an in-depth look at the biology behind menopausal hair loss.

We’ll also share ways that you may be able to slow down (or stop entirely) this new pattern of hair loss.

Let’s begin.

Understanding the Stages of Hair Growth

While it’s important to understand why hair loss occurs in otherwise healthy individuals, it’s first critical that you understand how hair grows.

Every hair in the body, including the 100,000 follicles found on the scalp, undergoes three stages of growth (1): anagen, catagen, and telogen.

Anagen is the active growth phase in which hair sprouts from the hair bulb (found at the base of the follicle) and eventually penetrates through the scalp.

This stage is the longest of the three stages lasting anywhere from two to six years.

The next stage is catagen, which is the shortest in the cycle.

Catagen lasts for two to three weeks and, during this time, the hair stops growing.

The hair stays intact at this stage.

The final stage is telogen, and it lasts for six to eight weeks.

It’s at this point in the cycle that the hair shaft detaches from the root and is shed from the follicle entirely.

This occurs so as to make room for the new anagen hair which is already beginning to form at the base of the follicle.

Of course, the above is the hair growth cycle as experienced by individuals who aren’t suffering from hair loss.

So, how does menopause interrupt the above cycle and contribute to thinning and pattern hair loss? First, we’ll need to understand estrogen and the role it plays in the process.

What Has Low Estrogen Level To Do With It?

Menopause is a period in a woman’s life marked by a sharp decline of estrogen.

But what is estrogen, and what role does it play in the female body?

Estrogen is the primary female sex hormone responsible for female sexual development and reproduction (2).

This hormone is also found in men, though in lower levels.

The chemical formula of estrogen
The hormone estrogen (oestrogen.)

Menopause is accompanied by various symptoms arising from diminishing estrogen, such as (3):

  • Hot flashes
  • Night sweats
  • Inability to fall and stay asleep
  • Vaginal dryness
  • Irritability and depression
  • Slowed metabolism resulting in weight gain
  • Dry skin
  • Thinning hair

The majority of these symptoms are directly linked to the natural, but sudden, decline in estrogen. However, menopausal hair loss can actually be largely attributed to testosterone, the male sex hormone.

Let me explain.

When the level of estrogen drops, as in the case of menopause, the existing testosterone level gets an edge.

Testosterone doesn’t have to spike for women to see more hair than usual on their brushes.

This is because some women may be genetically sensitive to testosterone, and therefore react to it more strongly even though their testosterone level remains the same.

But to better understand the relationship between hair loss and testosterone, we first have to understand the role of this androgen in Male-Pattern Baldness (MPB), or Androgenetic Alopecia (AGA).

Understanding Testosterone

Testosterone is the primary hormone responsible for male sexual and reproductive development and secondary male characteristics, in the same way that estrogen is for women. Testosterone transforms boys into men, and makes men masculine (4).

The real culprit behind hair loss, though, is a testosterone derivative called Dihydrotestosterone or DHT (5). DHT is central to the development of the penis and prostate of the male fetus.

It is five times more potent than testosterone, without which men may develop female characteristics such as breasts.

DHT: The Real Culprit Behind Baldness (and Low Libido)

Baby boys born with a deficiency of an enzyme responsible for converting testosterone to DHT grow up to have severely underdeveloped prostate and genitalia. In male fetuses with severe enzyme deficiency, the penis may altogether be absent.

While DHT has no developmental role for female fetuses, in both men and women, DHT regulates:

  • The growth of hair on the body
  • Sebum and sweat glands activity
  • Sexual desire and function

Too much DHT, on the other hand, can result in not just hair loss, but also aggressive behavior, heightened libido, sweating and acne, and interestingly, increased facial and body hair.

So, where does DHT come from?

Circulating testosterone is converted to DHT by an enzyme called Type II 5a reductase. This enzyme resides in the oil glands of the hair follicles.

When DHT binds to receptors in scalp follicles, the latter shrink and the resulting hair growth is miniaturized. Because healthy hair doesn’t grow at the same rate as before, hair loss becomes more noticeable over time.

And as mentioned above, testosterone production among menopausal women does not have to rise for them to experience pattern hair loss.

After all, less circulating estrogen means that testosterone now has the hormonal edge.

Menopause and Female Pattern Hair Loss

Unlike the “M” pattern of hair loss seen among men with MPB that eventually recedes to a “U” shape, female pattern hair loss (FPHL) is first noticed as thinning on the part line (6).

Using the Ludwig Classification to describe FPHL, Type I manifests as minimal thinning that can be camouflaged with hair styling techniques.

As FPHL progresses to Type II, there is a noticeable widening of mid-line part accompanied by a decrease in hair volume.

The most severe classification is Type III, when diffuse thinning on the part line can be observed on the top of the scalp.

But how does FPHL differ from menopausal hair loss?

In many cases, they’re one and the same.

The fact is that your risk of developing pattern hair loss increases as you age. According to a 2005 study, this prevalence “increases from approximately 12 percent amongst women aged between 20 and 29 years to over 50 percent of women over the age of 80. (7)”

That’s not to say that you will experience thinning and balding as part of your menopause journey, but it’s a possibility. And this possibility increases significantly if female hair loss runs in your family.

Contributing Factors to Menopausal Hair Loss

While the drop in estrogen levels is certainly enough to contribute to hair loss, there are other factors that may also contribute.

The most common of these have to do with deficiencies in nutrients and vitamins.

Why is this?

Changes associated with aging result in a decline in a number of physiological functions that affect the way older bodies absorb nutrients.

For example, decreased gastric secretion of digestive juices has been observed among the elderly, which in turn results to inadequate absorption of vitamin B12 among other nutrients.

Vitamin B12 Deficiency

Vitamin B12 deficiency manifests in myriad ways, one of them is hair loss. But because B12 deficiency mimics a range of illnesses, hair loss is seldom attributed to lack of this vitamin.

Cobalamin, as B12 is sometimes called, is vital for cell division, metabolism, and red blood cell production (8).

Without adequate dietary B12, either from insufficient intake or the body’s inability to absorb it, the individual will not only suffer from fatigue, memory loss, depression, anaemia, visual disturbances, poor sleep, and poor digestion, but will also experience hair loss.

Without B12, cell processes that produce new hair will be impaired. Additionally, oxygen delivery to the hair follicle, which is connected to blood vessels, will be compromised.

Protein Deficiency

Another deficiency observed among the elderly is protein.

As hair is made of keratin, a type of protein, it is essential to have sufficient protein in the diet, and for the body to absorb it efficiently (9).

Protein doesn’t have to come from animal sources. Women into plant-based diet may want to pile on tofu, lentils, beans, and quinoa to their plates.

Incidentally, vegans and vegetarians are also likely to suffer from B12 deficiency. This is because B12 is mostly derived from meat sources. Soy products and fortified cereals offer a plant-based alternative to vegetarians.

Stressing Over Hair Loss?

The stress of menopause itself can be serious enough to cause hair loss. Compounding DHT-induced and nutritional deficiency hair loss, stress can cause telogen effluvium (TE), or an ‘outflow’ of hair during its resting phase.

In the same way that hair loss can occur to women who have just given birth (postpartum alopecia), hair loss can also occur to women who have just stopped menstruating.

This type of hair loss is a response to the drastic drop of hormone levels that “shocks” hair follicles into shutting down. In postpartum alopecia, the result is not total loss of hair but a thinning which is reversible once a woman’s hormone levels go back to normal.

Telogen Effluvium and Perimenopause

Telogen effluvium occurs when there is a drop in the number of hair follicles growing hair. With few follicles left in the anagen phase, there are more dormant hair follicles than growing hair. As more and more hair follicles enter the telogen phase, more hair is shed and the remaining hair thins out.

Telogen effluvium normally happens during perimenopause (the years preceding menopause), which means that women at this stage may experience thinning hair for years. Once their menstruation stops for good, androgenetic alopecia takes over.

Menopause is a New Beginning

Thick and bouncy hair is associated with the vitality of youth, so menopausal hair loss is a sobering reminder that women are indeed entering a new stage in their lives.

While no one can reverse the inevitability of aging, it’s still within the person’s power to change their diets and decide what to do with stressors in their life.

We may not be able to eat our way back to luxuriant hair, but it’s never too late to adopt healthy eating habits and an active lifestyle to celebrate the years we have left, hair or no hair.

What Can You Do To Stop Menopause Causing Hair Loss?

A smiling older woman
Menopause can cause hair loss, but it doesn’t have to. There is lots you can do to prevent it, and even re-grow your hair.

Contrary to mainstream belief, there’s actually rather a lot you can do to stop menopausal hair loss, and they all stem from promoting overall health.

During menopause your hormones change, so you have to be more careful about what you eat. There is a useful way to think about healthy eating: The more dead a food is, the more life it will take from you. The more alive a food is, the more life it will give you.

Processed foods are completely dead, they contain no living enzymes, they don’t even resemble in any way the living things they once were. In contrast, a fresh blackberry, picked straight from the bush and eaten then and there is veritably alive. It’s brimming with exactly what your body needs.

Obviously we can’t just eat fresh blackberries straight from the bush all day, but if you consider it a spectrum you can continually push towards the more alive end of the spectrum.

When your body is unhealthy, it will do what it can to protect the most important parts first: the organs.

Your hair, fortunately, is quite far down the list of importance. Especially after menopause, your hair which would once signal mating fertility (and is therefore further up the priority list) now isn’t as important.

What matters more is not beautiful hair, but rather keeping you alive long enough to raise your children (evolutionarily speaking.) After menopause this changes.

This simply means its more important than ever to give your body everything it needs to thrive. And to eliminate wastes and toxins that damage your organs, skin and hair from your body as efficiently as possible.

Here are some of the best ways to do that.


Antioxidants remove the free radicals from your body that cause cellular ageing, thereby slowing the process of ageing and increasing longevity.

Where do antioxidants come from? Natural plant-based foods.

Go here for a long in-depth guide about using antioxidants for hair loss, but also feel free to take a look at this summary of the best antioxidant foods:

  • Herbs and spices like ginger and tumeric
  • Berries like blackberries and blueberries (as a rule of thumb, the more colorful the berry, the more antioxidants)
  • Cruciferous vegetables and greens (again, the more colorful, generally the better)

Antioxidants won’t solve all of your problems, of course. But the next step, alkalization, can help.

Alkalizing Your Body

When a food is metabolised by the body, there is a left over ‘metabolic ash.’ This ash either has a net alkaline or net acidic affect on your body.

Modern foods (like grains, dairy, and meats) and anything processed are generally more acidic. The effect is our body becomes more acidic over time.

The problem is, the scalp needs to stay at a certain pH (the measure of acid/alkaline balance) (10). Otherwise, disease will result. It will do anything to stay at this pH, including using keratin from your hair to reduce the blood acidity.

Luckily, you don’t have to lose your hair because you can use alkalizing foods to reduce the acidity.

Vegetables and some fruits are highly alkalizing. So you just need to eat more of them and less of the acidic foods like dairy and grains.

To learn more about the process, there’s a longer article about vegetable juicing for hair here.

And even if you don’t think that diet has such an effect on your hair, there’s still evidence to suggest an alkaline diet is beneficial.

Just a few of these benefits include (11):

  • Improved K/Na ratio which may “benefit bone health, reduce muscle wasting, as well as mitigate chronic diseases such as hypertension and strokes.”
  • Increased growth hormone which may “improve many outcomes from cardiovascular health to memory and cognition.”
  • Increased intracellular magnesium, “which is required for the function of many enzyme systems… .”

Learn more about the possibilities by taking a look at this in-depth review.

In Conclusion

Menopause is a time of great change.

And while these changes may be hard to accept at first, many of them will be for the better.

But there are changes – particularly those having to do with your hormone levels and hair as a result – that may be harder to accept than others.

The good news? You don’t have to live with thinning, lackluster hair.

For the majority of women, menopause doesn’t have to mean hair thinning and balding. This is true even for those who are susceptible to female pattern hair loss.

The ‘secret’? A healthier diet and overall lifestyle.

While you can’t combat the natural hormone changes that are occurring, you can take a proactive approach. This will ensure your body gets exactly what it needs during this critical time.

Do you have questions about the information we shared above? Leave a comment below!

4 thoughts on “Menopause & Hair Loss: Are the Two Connected?”

  1. Have a question you’d like answered about menopause and hair loss…? Leave your question in the box above and I’ll try to answer it asap.

  2. Hello. I enjoyed your article it was quite informative. My question is, if hair in front starts thinning during perimenopause does it mean that you always have a sensitivity to dht and genetic disposition? Or can it thin even if you don’t. Am I likely to have the sensitivity of my mother did not have any in her side but my father had it? I’m female. Thanks

    • Hi Kellie,

      It’s difficult to say, as there are many factors at play in your situation.

      I’d say it doesn’t necessarily mean that you have a sensitivity to DHT, but it’s likely the case. The good news, though, is that it’s possible to offset the sensitivity.

      I would recommend you take a look at Will’s in-depth guide on the topic of hair regrowth here:



  3. My doctor said my testerone is low at 0.5
    I’m 56
    Been shedding more than my dog
    I have androgenic alopecia my crown is very very thin
    Do I still need to take dht blockers ( shampoo and tablets ? Now she says my testerone is low at 0.5 it is this not true Many thanks

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