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Hair Loss During the Menopause

Picture of Elisa Chistyukhina
Elisa Chistyukhina
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Many women experience hair loss during the menopause. Oestrogen levels drop sharply, increasing the risk of the hair thinning out and bald spots appearing.

The first thing to say is that losing hair is a completely normal physical process. Even a person with full hair growth loses up to 100 hairs a day. However, it becomes an issue when the hair that has fallen out suddenly stops growing back. This is when bald patches start appearing or hair starts to thin out.

Genetically induced hair loss is not a male-only affair. Some women suffer from it too. However, this is usually a little later in life compared to men, namely with the onset of menopause.
Many women affected by menopausal hair loss suffer enormously from it, because particularly for women, full and healthy hair is a beauty ideal. This is not least because thick and beautiful hair also stands for attractiveness and youthfulness.

Female hair loss therefore often means that women experience an associated loss of self-esteem.

What happens during menopause?

The menopause is when women stop having periods. For most women, menopause begins between their mid-40s and mid-50s, although this should not be generalized. In the UK, the average age for the menopause is 51.
During this period, oestrogen and progesterone production gradually decreases. Menstrual periods become more irregular until they eventually stop.

The menopause affects many aspects of women’s lives. Very typical symptoms of menopause are the famous hot flashes, mood swings, thickening facial hair, and troubles getting to sleep.

These hormone fluctuations also affect the hair. Hair becomes thinner, and hormone-induced hair loss is not uncommon in menopausal women. The male hormone testosterone plays a major role in this.

Hereditary hair loss during the menopause

Just as in men, the hair roots of women suffering from hereditary hair loss are sensitive to the androgen DHT, which in turn is formed from the male hormone testosterone.

Before the menopause, however, oestrogen keeps the male hormone testosterone in check. The production of this hormone, however, as already mentioned, steadily decreases during menopause. Therefore, its ability to counteract the effects of testosterone and DHT reduce.

The DHT ensures that the growth phase of the hair is shortened in the hair follicles which are oversensitive to it. As a result, the hair grows back thinner overall, until at some point only a very thin fuzz remains, which is virtually invisible to the human eye.

Symptoms of hereditary hair loss during the menopause

Unlike men, women affected by female pattern hair loss are usually not at risk of complete baldness.

However, hair starts to fall out along the crown of the head. The process is gradual. Initially, the hair in this region becomes thinner until eventually the scalp shows through the remaining hairs.

The causes have not yet been conclusively clarified. It is suspected that several other factors can come together in addition to the genetic aspect of the hair loss.

These can be, for example:

• PCOS (polycystic ovary syndrome)
• Abuse of anabolic steroids, or the side effects from certain medications
• Androgenital syndrome (a hormonal imbalance in the adrenal cortex)

Treatment options for hair loss during menopause

As a women affected by the menopause, you should not be afraid to go to the doctor if you suspect that you are suffering from hereditary hair loss. The doctor can, for example, perform a trichogram to determine the status of the hair roots.

There are some medicinal products which may help. For example, minoxidil can be applied directly to the scalp. It stimulates the scalp and ensures good blood circulation to the scalp. This is essential for healthy hair growth, and the use of this drug may help matters.
Some women also opt for hormone replacement therapy (HRT). This helps alleviate many of the negative symptoms of the menopause. It can sometimes help with menopausal hair loss.

There are also nutritional products that have been specially adapted to the needs of women. Many women find that they can also do a lot from the inside to stimulate hair growth again. A balanced diet helps to maintain the splendour of the hair. Particularly helpful are protein and iron-rich foods. Also, vitamin B is important to full hair growth.

A permanent solution: a hair transplant

If hereditary hair loss is already advanced, or you are suffering psychologically because of your hair loss, a hair transplant can provide relief.

In this minimally invasive procedure, an experienced surgeon removes hair follicles from the donor area between the ears at the back of the head. They are then reinserted into the recipient area to fill in the bald spots. What is special about the hair from this donor area is that it is relatively insensitive to the hormone DHT.

Dr. Acar and our team at Cosmedica Clinic offer years of experience in such matters. We offer a free consultation to make sure that a transplant is the correct treatment for you.

We will be happy to answer any questions you may have about hair transplantation for women.

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