Can perimenopause cause hair loss?

The short answer is yes, and perimenopause hair thinning is estimated to affect over 50% of women during the transition into menopause (did you know that over 80% of women experience more symptoms like hot flashes, night sweats, and disrupted sleep, too?) [1]. 

While each person’s menopause journey will be uniquely influenced by different factors such as genetics, stress levels, diet, and more, hopefully, you can take some solace in the fact that it’s quite common to experience hair loss during perimenopause, and it won’t last forever [1].

In this article, we’ll go over some of the changes happening in your body during perimenopause and how these can cause changes in your hair. We’ll also cover some tools and resources you can try to manage this transition and support your health at this pivotal life stage.

What causes perimenopausal hair loss?

First things first: what does perimenopause have to do with your hair? 

Perimenopause is the time in a woman’s life leading up to menopause. It often lasts for several years between the ages of 45 and 55 (the average age of menopause is 52 in the United States) [2]. Menopause is defined as not having a period or spotting for a full year, so perimenopause is the transitional time into menopause when your periods may become irregular, and you might experience other physical symptoms such as hot flashes and hair loss. 

During perimenopause, levels of the estrogen and progesterone hormones in the body decrease significantly. This shift is thought to cause many of the symptoms associated with perimenopause, including hair thinning and loss [2].

Is perimenopause causing my hair to fall out?

The exact hormonal chemical reactions that cause hair to thin and fall out during perimenopause are pretty complex, but to give you a high-level overview, your hair follicles go through a three-phase growth process throughout your life. When big hormonal shifts like perimenopause happen, that growth process is changed. You may lose more hair than normal, and your hair may not grow back at the same rate.

Believe it or not, your hair follicles actually have receptors for the estrogen hormone. While more research is needed on this, it’s thought that the decrease in estrogen that happens during perimenopause affects the hair follicles, causing them to behave differently and potentially creating hair loss. [1] 

Your metabolism also starts to slow down with age around the time of menopause, so it’s possible that there is decreased blood flow and nutrients getting to the hair follicles during perimenopause and menopause [1].

Symptoms of menopausal hair loss

Now that we’ve explored how our hormones influence our hair follicles, you may also be wondering if your hair loss is actually coming from perimenopause or something else (we’ll get into other possible causes later in the article).

If the hair loss is happening along with any or all of the following symptoms, it’s likely being driven by hormonal changes:

• Changes in your period (your periods may become more irregular, and your flow might be much lighter or heavier than usual)
• Cognitive difficulties
• Fatigue
• Hot flashes
• Increased anxiety
• Low libido
• Low mood
• Night sweats

While these symptoms are all unpleasant, they’re a normal part of the aging process during this stage of life. It’s important you talk to your doctor if you notice any unusual changes, or if your symptoms begin to impact your quality of life — help is available [1, 2].

How long does perimenopause hair shedding last?

More research is needed in this area, too, as it’s difficult to tell just how long perimenopause will last and how severe the symptoms will be from person to person. It is known, however, that each person’s unique environmental conditions, genetic factors, and whether or not they have any nutritional deficiencies have a huge impact on the way they experience perimenopause.

For example, smoking is associated with early onset menopause and much more extreme expressions of the symptoms listed above. Race seems to play a role as well — Black women are more to have early onset menopause and experience symptoms for longer amounts of time than White women. On the other hand, Asian women tend to have less menopausal symptoms in general than White women [2].

As a general rule of thumb, you can look forward to all of these conditions and symptoms subsiding as your body settles into postmenopause over the course of a few years [2].

Does hair loss stop after menopause is over?

If the hair loss you’re experiencing is definitely due to perimenopause and not other stressors or genetic factors, then yes — it should generally subside after menopause is over. Remember that it’s actually normal to shed about 50 to 100 pieces of hair per day, so while the excessive shedding might subside, you’ll still lose some hair each day because of the growth cycle of your hair follicles [3].

What else can cause hair loss?

There are many factors besides perimenopause that could be contributing to hair shedding or hair loss, but first, let’s make sure to define each of these terms, as it’s important to know the difference:.

Hair loss: This is when something is preventing the hair follicle from growing new strands of hair, causing bald spots. The most common causes of hair loss include:

• Hereditary history of hair loss
• Immune system disorders
• Harsh hair care products or treatments
• Some drugs and medical treatments like chemotherapy

Hair shedding: This is when a person sheds more than the normal 50 to 100 strands per day. It’s typically due to a stressful hormonal event or change in the body, such as:

• Giving birth (known as postpartum hairloss)
• Losing 20 pounds or more
• Undergoing an operation
• Stopping hormonal birth control
• Perimenopause

It’s common to experience excess hair shedding a few weeks or months after the actual stressful event, but your hair should return to normal as time goes on (typically within six to nine months). Hair loss is slightly more difficult to deal with because the underlying issue preventing the hair follicle from regrowing needs to be addressed [3].

What medications can cause hair loss?

Hair loss is a common side effect of chemotherapy. Aromatase inhibitors typically used to treat and prevent breast cancer in postmenopausal women have also been known to cause hair loss. But the good news is that in these cases, hair loss is typically recovered within 3 months of stopping the medication [4, 5].

How to manage hair loss during perimenopause

While the best course of action is to see your healthcare provider or specifically a dermatologist to assess the root cause of your hair loss and get a personalized treatment plan, some of the most common ways to manage hair loss are listed below. We’ll go from least to most invasive:

Switch to gentle hair care

Thinning hair is typically very fragile, so it’s recommended to use gentle, highly moisturizing shampoos and conditioners without any harsh dyes. It’s also a good idea not to and not wash hair too vigorously. You may also want to try a leave-in conditioner to help reduce breakage, and stop using hot oil treatments as the heat can create brittle strands [6]. 

Regular use of at-home hair dye, as well as relaxers, curling irons, flat irons, and hot combs, should be avoided if you’re experiencing hair loss and want to prevent further damage. We know this is tough to avoid when you’re trying to regain control of your hair but it might be the best decision you can make for your hair in the long run [6]. Consult with a trusted hair stylist about the best option for your hair type.

Concealers or wigs

Available in many drug stores, wigs or concealers may help you feel more confident as you deal with the temporary hair loss associated with perimenopause. While they won’t help regrow hair, they can help reduce the appearance of hair loss and may help boost your self-esteem immediately. Oftentimes, wigs can be tailored specifically to you, or you can get a simple spray or powder concealer, apply it on the sparse areas, and get right on with your day [7].

Nutrition adjustments

Nutrient deficiency, along with eating too few calories, can contribute to hair loss, so make sure you’re getting your essential vitamins and nutrients from your diet (particularly protein, iron, and vitamin D). You can work with your healthcare provider to assess your dietary needs and come up with a tailored nutrition plan [1, 6].

Managing stress

It’s clear that stress, whether it’s associated with menopause or not, can contribute to hair thinning and hair loss. Though it can be challenging, particularly when going through something very stressful, it’s best to get on top of stress management and coping techniques as effectively as you can manage [1]. Many people may find that breathing techniques, yoga, exercise, talk therapy, or journaling are effective stress management strategies, for example.

Rogaine (minoxidil)

If you’re experiencing clinical hair loss with underlying factors affecting your hair growth patterns, your doctor may recommend a medication called minoxidil, commonly referred to as its brand name Rogaine. Rogaine is meant to address early hair loss, but it can also help stimulate new hair growth and prevent more loss. There are some drawbacks, however — it typically takes about 6-12 months to see results, and you’ll need to keep using it every single day. If you stop using it, any new growth from the medication is likely to fall out [7].

Laser treatment

Studies are still limited on laser treatment for hair loss, but initial results are promising. It’s thought that the regular exposure to specific laser wavelengths can help the hair follicle start its regular growth process once again. 

While some patients saw significant improvement in the thickness and fullness of their hair after using laser treatments three times per week for 26 weeks, others did not. More research is needed to figure out why this works for some individuals and not others, and while it’s a more expensive option than others listed in this article, it's a relatively non-invasive and promising route to take [7,8].

Microneedling treatment

Microneedling has become quite a trendy treatment in recent years particularly in the skincare world, but there are microneedling devices for hair loss specifically as well. They’re typically available in a clinical setting rather than at home, and have hundreds of tiny needles that are rolled along the scalp just like the facial devices. The needles are slightly longer to penetrate the hair follicles more deeply. 

We highly recommend consulting with a dermatologist before beginning any sort of microneedling treatment as it can cause more damage than repair, but when used in conjunction with other medications like Rogaine, people tend to see results more quickly. On the other hand, microneedling is going to be on the more costly side of the treatments in this list.

Hair transplant

Transplants are generally one of the most effective and permanent solutions for hair loss, although one of the most invasive and expensive. This procedure involves taking a graft of healthy hair follicles from the back of your head and placing it where you’re experiencing hair loss as a permanent fixture in your scalp [7,8].

There are a few more hair loss treatments currently being tested, including a medication called Finasteride (or its brand name, Propecia), platelet-rich plasma (PRP) injections, and corticosteroid injections, but the methods listed above are some of the most common and effective currently available [7].

Are there tests to diagnose the cause of menopausal hair loss?

If you’re considering any of the treatments mentioned above, it’s best to consult with your healthcare provider first to make sure you’re addressing the root cause of the hair loss or hair thinning (many of those treatments can actually do more harm than good if it’s not the right method for you). 

Your doctor will generally do a non-invasive exam and ask questions to assess your condition before conducting further testing. This will probably involve taking a close look at your scalp, nails, and anywhere else you’re experiencing hair loss, along with slightly tugging on the hair to assess its overall health. 

If they suspect that there is some sort of disease, deficiency, or imbalance causing the hair loss, they might want to do more testing to figure out the underlying cause. This will likely be a blood test or scalp biopsy done in their office [7].

When to speak to your doctor

Speak to your healthcare provider as soon as possible if you’re experiencing unmanageable mental health symptoms from hair loss, or you are finding the hair loss you’re experiencing distressing. We know this can be a tough condition to deal with at any stage in life, especially during the menopausal transition. Your healthcare provider can support you in creating a care plan to rebuild healthy hair and move forward with confidence.

Get to know your body with Natural Cycles

Getting to know your body better by tracking symptoms and changes throughout your cycle can help you in the long run if and when hormonal shifts occur. Natural Cycles makes it easy to track your cycle, and the app is the first of its kind to be certified as birth control. Natural Cycles is packed full of cycle insights and even features an easy-to-download cycle report that you can share with your doctor at your next consultation. Find out if Natural Cycles is right for you!