Menopause: Why You are Sprouting Hair in New Places and Losing Hair in Others

So are you in a hairy situation at midlife?  As we get closer to menopause, our hair growth patterns can start acting a little funky. Some of us might notice that our hair growth slows down or we start losing hair, while others might be sprouting hair in places we never expected! And you know it- it’s all because of those crazy hormonal fluctuations during perimenopause and menopause. Don’t worry though- we got this!  It’s just one of those things us ladies have to deal with as we age gracefully.

Less Estrogen causing thinning and fragile hair:

During perimenopause, a woman’s body begins to produce less estrogen, which can affect hair growth. Estrogen plays an important role in promoting hair growth by increasing the growth phase of hair follicles, thereby prolonging the hair’s lifespan. Estrogen also helps to increase the production of hair’s natural oils, which keep the hair moisturized and healthy.

As estrogen levels decrease during perimenopause, the hair growth cycle may become disrupted, resulting in thinner and more brittle hair. This is because as estrogen levels drop, the hair follicles shrink and the phase of hair growth shortens. This means that hair spends less time in the active growth phase, resulting in slower hair growth and thinner hair.

In addition to this, as estrogen levels decrease, the production of sebum or natural oils in the scalp also decreases. This can lead to a dry and itchy scalp, which can further weaken the hair and contribute to hair loss.

Stress causing hair loss in Menopause:

Furthermore, perimenopause can also be a very stressful time for women, and stress can contribute to hair loss and thinning. The stress hormone cortisol can cause hair follicles to go into a resting phase, leading to hair loss.

Role of Androgens in hair growth and hair loss in Menopause:

During perimenopause and menopause, the ratio of androgens (male hormones such as testosterone) may increase in relation to the decrease in estrogen and progesterone in some women. Androgens are normally present in women in small amounts, but they can become more dominant as estrogen/progesterone levels decrease during this time.

Androgens can affect hair growth in women in several ways. They can cause hair to grow in new areas of the body, such as the chin, upper lip, or chest, which can be unwanted and embarrassing for some women and lead to low self esteem and decreased confidence. This is because androgens stimulate the growth of terminal hair, which is the thicker, coarser hair that grows in areas such as the face and chest.  This is called hirsutism.

The increase in this body hair continues through perimenopause until menopause, where it will then start to decrease.  However, unwanted facial hair will continue to increase, even into our elderly years.  Approximately 50% of women over the age of 50 will experience this unwanted hair growth and/or hair loss.

At the same time, androgens can also contribute to hair loss and thinning on the scalp. Androgens can bind to hair follicles and cause them to shrink, leading to shorter and finer hair. Androgens can also shorten the anagen or growth phase of hair follicles, leading to more hairs entering the resting or shedding phase at the same time, which can result in noticeable hair loss.

Managing changes in hair growth in Menopause:

There are several ways to manage changes in hair growth during menopause. Unfortunately, there is not a lot of quality research on hair changes in premenopausal and menopausal women.

One option is to consider hormone replacement therapy (HRT), which can help balance hormone levels and reduce symptoms such as hair loss and unwanted hair growth. However, HRT is not suitable for everyone and should be discussed with a healthcare provider, and it is often not considered unless symptoms other than hair loss are occurring at the same time.

 

Managing  unwanted hair growth in Menopause:

Medications for hirsutism can include:

• Anti-androgens such as: Cyproterone acetate (CPA), Chlormadinone acetate (CMA), Denogest,  Drospirenone,  Spironolactone,  Flutamide and bicalutamide.
• Enzyme Inhibitors such as: Finasteride and Eflornithine
• Insulin-sensitising agents such as: Metformin
• Gonadotropic-releasing hormone analogues such as: Leuprolide and Nafarelin

Another option is to use hair removal methods such as:

• Physical and chemical removal(tweezering, shaving, waxing, sugaring, and threading)
• Electrolysis
  • Electrolysis is a method of hair removal that uses a direct current to create a reaction in the hair follicle, causing damage and preventing hair growth. This can comprise of galvanic, short-wave diathermy, and blend. These methods of electrolysis are commonly used in the beauty esthetics industry for permanent hair removal.
  • Home electrolysis devices: There are also home electrolysis devices available on the market that use galvanic electrolysis. These devices are typically smaller and less powerful than professional-grade machines and may require more frequent treatments to achieve permanent hair removal. One seemingly good option from the research I’ve done is the One Touch.  The issue with electrolysis at home is that it takes a very long time to achieve permanent hair removal results.
• Laser or photoepilation
  • Laser hair removal and Intense Pulsed Light (IPL) are methods of hair removal that use a concentrated beams of light to damage hair follicles and prevent hair growth. It is a popular hair removal method in the beauty industry, and there are several industry examples of laser hair removal, including:
  • Laser hair removal clinics: There are many clinics that specialize specifically in laser hair removal services.  Unfortunately, this method although effective, can be quite pricey.  Many beauty salons and spas also offer laser hair removal services in addition to other hair removal methods, such as waxing and threading.
  • Home laser hair removal devices: There are also home laser hair removal devices available on the market which allow individuals to perform laser/IPL hair removal treatments at home.  While these are less pricey, they take longer to work because the strength of the light wavelength produced is not as strong as professional devices.  For an excellent review of at home hair removal devices, see the Marie Claire article: The 14 Best At-Home Laser Hair Removal Devices, Selected by Dermatologists and Editors

Managing thinning and hair loss in Menopause:

There are several steps that women can take to help prevent thinning of their hair and breakage during Perimenopause and Menopause:

1. Eat a healthy diet: Consuming a balanced diet rich in vitamins and minerals can help support healthy hair growth. Foods such as leafy greens, vegetables, fruits, healthy fats, complex carbohydrates and lean proteins can provide the nutrients needed to maintain healthy hair.  It’s important to note that if you are dieting, or severely restricting a food group, you may develop hair loss or thinning because of this as well.
2. Consider supplements if you are deficient: Taking supplements such as biotin, vitamin C & D, Saw Palmetto, and omega-3 fatty acids can be considered to help promote healthy hair growth and prevent breakage.  Social media has also recently been touting the benefits of Rosemary Oil/tinctures to the scalp, even though it has been used for centuries to treat hair loss.   There also is a supplement called Nutrafol Balance that also showed increased hair growth in several studies (not sponsored).  Talk to your medical provider or naturopathic doctor if supplementation is appropriate for you.
3. Avoid harsh treatments: Chemical treatments such as coloring, relaxing, and straightening can weaken hair and lead to breakage. Try to avoid these treatments or limit their use.
4. Use gentle hair care products: Choose hair care products that are gentle and free of harsh chemicals. Look for products that contain natural ingredients such as  argan oil, which can help moisturize and strengthen hair.  Use sulfate-free hair products, and limit washing to at least every other day.
5. Practice good hair care habits: Be gentle when brushing or combing hair, and avoid pulling or tugging on hair, especially when wet. Use a wide-toothed comb or a soft-bristled brush to avoid damaging hair.  Also consider limiting the use of heat styling products like blow dryers and curling/straightening irons.
6. Manage stress: Stress can contribute to hair loss and thinning, so it is important to manage it through activities such as meditation, yoga, or exercise.  See my posts here and here on mindfulness, which can help as well.
7. Consider medication or topical treatments: If hair loss or thinning is severe, medications or topical treatments may be necessary. Talk to a healthcare provider about the best options for your specific situation.  Minoxidil used topically has shown to be effective, and oral finasteride can be considered as well- although it has traditionally been used only in men.
8.  Platelet-rich plasma (PRP) therapy: This treatment involves injecting your own platelet-rich plasma into your scalp. PRP contains growth factors that can stimulate hair growth and improve the thickness of existing hair.
9. Low-level laser therapy (LLLT): This treatment involves using a specialized device that emits low-level lasers to stimulate hair growth. LLLT is thought to improve blood flow to the scalp, which can promote hair growth.
10. Hair transplants:  This can be considered, although is extremely costly.  In general, hair transplant surgery tends to work best for women who have androgenetic alopecia (a type of hair loss that is often hereditary), rather than hair thinning caused by menopause.
11. And lastly, find a hairstyle that you feel good in:  Consider wigs, hair extensions, hats or headscarves, if you wish.  Do what makes you feel confident and beautiful!

It’s important to remember that changes in hair growth during menopause are a normal part of the aging process, and every woman’s experience will be different. If you are concerned about changes in your hair growth or any hair loss, speak with your healthcare provider to determine the best course of action for you.

This blog post is for informational purposes only and is not intended to replace the advice of any healthcare professional.  If you have any concerns about your health, it is important to consult a healthcare professional.  Although I am a Registered nurse, I am not your nurse and the information provided in this blog post is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  I am not responsible for any actions taken based on the information provided in this blog post.  Please see my disclaimer here for more information.

Take care,

 

 

 

Resources:

 

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