It’s very common for men to lose hair as they get older, due to the effects of a particular type of testosterone known as DHT. Many people think of hair loss as primarily a male problem. However, it’s also common for women to experience hair loss as they age, particularly after menopause.
Why do women lose hair at menopause? Is there a relationship between estrogen levels and hair loss? Can estradiol cause hair loss, or can drops in various forms of estrogen cause it? Do changes in estrogen with menopause lead to changes in hair growth?
Estrogen and Hair Growth
Estrogen triggers hair follicles to spend more time in the growth phase and less time in the resting phase. When women have higher levels of estrogen (for example, during pregnancy), the hair spends far more time in the growth phase, leading to thicker and longer hair. When estrogen levels drop, hair follicles will spend less time in the growth phase and more time in the resting phase, leading to thinning hair.
Can lack of estrogen cause hair loss?
Estrogen levels fall dramatically at menopause. As a result, women commonly experience some degree of hair loss. Usually, women don’t experience a receding hairline and eventually go completely bald on the top of the head, as is common with men. Instead, for women, hair loss usually begins around the center of the scalp, and spreads across the top of the head. As estrogen levels drop, women rarely go completely bald, but the hair on the top of the head becomes significantly thinner and the scalp may be visible between the hairs.
In addition, when estrogen levels fall at menopause, this triggers an increase in the levels of androgens (such as testosterone). Certain androgens act on hair follicles to make them produce hairs that are finer and less pigmented – more like the hairs on the back of your hand. As androgens act on the hair follicles, those that are in the growth phase will produce these smaller hairs, which makes your hair look thinner overall.
Does estrogen help hair loss?
Some postmenopausal women take hormone replacement therapy (HRT), which involves taking estrogen and sometimes also progesterone. HRT may help with symptoms of menopause, including hair loss. Many women notice an increase in hair thickness after they start taking HRT.
It’s generally not recommended that women take estrogen solely for hair loss, because there are certain risks associated with HRT. However, women may be prescribed HRT for other symptoms of menopause (like hot flashes and anxiety), and may also experience increased hair growth as a pleasant side effect of the estrogen, along with other effects like weight loss.
It’s important to note that, besides estrogen levels, there are also other conditions that can lead to hair loss. For example, hypothyroidism, or low levels of thyroid hormones, can cause this issue. If you’re not sure whether you’re entering menopause, then it’s a good idea to test your hormone levels (including estrogen) to be sure. In addition, testing thyroid hormone levels is also a good idea, to make sure that this isn’t contributing to your hair loss. You can visit your doctor to talk about your concerns, and ask them to order the lab tests that you need. Another possibility is to test your hormone levels using a home testing kit. You’ll then have the opportunity to discuss any abnormal results with a medical professional.
Hair loss can also be caused by issues like nutrient deficiencies, stress, or other diseases, so if changes in your levels of estrogen and other hormones don’t explain your hair loss, it’s a good idea to discuss the issue with your doctor to decide how best to proceed.
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Sources
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Brzozowska M, Lewinski A. Changes of androgens levels in menopausal women. Prz Menopauzalny. 2020 Dec; 19(4): 151–154. doi: 10.5114/pm.2020.101941
Grymowicz M, Rudnicka E, et al. Hormonal Effects on Hair Follicles. Int J Mol Sci. 2020 Aug; 21(15): 5342. doi: 10.3390/ijms21155342
Hair loss in women. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16921-hair-loss-in-women. Accessed 12 July 2022.
Zouboulis CC, Blume-Peytavi U, et al. Skin, hair and beyond: the impact of menopause. Climacteric. 2022 Apr 4;1-9. doi: 10.1080/13697137.2022.2050206.
