How to Treat Menopause Hair Changes, Loss, and Thinning

Oct 15, 2023

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It's not your imagination: Hair can become drier, thinner, and frizzier before and during this life stage. Here, top experts explain these symptoms, plus serve up solutions for a smoother (thicker, and shinier) transition.

"The change" doesn't happen all at once. In fact, you'll likely start to notice smaller shifts during a phase called perimenopause—which can be quite the hormonal roller coaster. For the eight to 10 years preceding menopause, hormone levels rise and fall and rise and fall. It can be confusing: Was that a hot flash, or is it warm in here? Do I have insomnia, or did I drink my latte too late? Is my period gone for good or just a few months? And, surprisingly, you can add this one to your list of questionable symptoms: Is it just a bad hair day, or is it my hormones?

Yup, your hair is among the many things your hormones can alter during both the perimenopausal and post-menopausal years. The hormones involved—mainly estrogen and progesterone—affect your hair's growth cycles, your scalp and follicle health, and the natural oils that keep hair smooth and lustrous. Because of that, you may experience thinning, lack of density, texture changes, and dryness as estrogen wanes. But, again, it's not a linear process. "During perimenopause, it isn't that your estrogen is gone; it's fluctuating," says Debra Lin, PhD, hair science expert and chief scientific officer at Better Not Younger, a haircare brand. "So sometimes your hair may look thicker and healthier; other times it may be thinner and duller," she says. When your menstrual cycle has stopped for an entire year, you’re officially in menopause—and those less desirable hair changes may be permanent. To get to the root of these hormonal hair shifts, we asked experts—some of whom have experienced these changes firsthand—to break down exactly what's happening and recommend ways to combat it.

Whether you’re in perimenopause or have gone through menopause, you may experience the following hair changes.

If your ponytail feels lighter these days, you’re not alone. A recent study in the journal Menopause found that more than half of the nearly 200 postmenopausal women studied had experienced female pattern hair loss. "As estrogen starts to decline, the delicate balance between estrogen and the hormone dihydrotestosterone (DHT), which is responsible for masculinizing changes such as hair loss, gets disrupted," says Audrey Kunin, MD, a dermatologist in Kansas City, Missouri, and founder of DERMAdoctor, a skincare brand. Women who have a genetic predisposition to hair thinning may begin to see an increase in hair loss. "I’ve seen my hairline recede—a telltale sign of hormonal hair loss," says Kunin.

Low estrogen levels can also affect your hair growth cycle, shortening the growth phase and delaying the stage when the hair regrows, says Lin. Your hair follicles also miniaturize with age, so the strands coming out of them are finer, resulting in an overall lack of density.

While she hasn't noticed significant shedding, Ellen Marmur, MD, a dermatologist in New York City and founder of MM Skincare, has seen changes in her scalp and strand quality while in perimenopause. "My hair and scalp feel more fragile," she says. Just as your skin gets dry as estrogen is on the decline, your scalp and, by extension, your hair strands lack hydration, too. "A reduction in estrogen results in reduced sebum (oil) production, which normally lubricates the scalp. The result is dry skin and a flaky scalp," says Kunin. And, since that hydrating scalp oil isn't there to work itself down your strands, hair is also drier, as well as duller, more brittle, and breakage-prone.

Dryness can make a scalp cranky. The skin's barrier (the outermost layer) forms tiny cracks when it's dry, which allows irritants to get into it and cause inflammation. "Plus, if you’re experiencing thinning then your scalp is more exposed to environmental aggressors (such as UV rays) and harsh ingredients. This leads to more inflammation," says Lin.

"You may find that your hair feels wirier, or it's suddenly curly in the back, and you have two textures on one head," says Katelyn Ellsworth, owner of The Roslyn Salon in San Diego. Hormones can affect the shape of some hair follicles, changing them from, say, circle-shaped follicles that produce straight hair to oval-shaped follicles that produce curly hair. The coarse, wiry feel of some strands stems from the lack of natural oils. Sebum helps to maintain hair's pH in a healthy acidic range. "Acidity keeps the hair cuticle cells lying tightly against each other like shingles on a roof," says Kunin. But less sebum throws that pH balance off-kilter. "Without the acidity, the cuticle cells begin to lift up and pull apart, leaving hair looking dull and feeling rough," she says.

Hormone replacement (HR) is one way to stave off the changes in your hair—and the rest of your body—so speak to your doctor to see if this is an option for you. You can also consider these topical treatments, supplements, and styling tips.

Topical treatments can help keep hair in the growth phase longer. "If you’re losing more than 100 hairs per day, using a product with 5 percent topical minoxidil for women can help reduce the rate of hair loss," Kunin says. Research has also put a spotlight on LED therapy, in particular red light. A study in the Annals of Dermatology found that red light stimulated growth and reversed the miniaturization of the follicle. Marmur says research has also suggested that a pulsed red light setting is optimal for follicular stimulation; she recommends doing four 20-minute sessions a week.

"Caring for your scalp leads to healthier hair," says Lin. Keeping it clean, reducing buildup, and conditioning it will help reduce inflammation and support the follicles. Scalp serums provide lightweight hydration that won't clog follicles or leave roots greasy, and also moisturize hair. Look for one that has collagen-stimulating ingredients such as niacinamide, barrier-supporting lipids such as ceramides, and agents that wake up groggy follicles such as caffeine.

The products you use can temporarily thicken the diameter of your hair shaft, making the hair you do have feel fuller. Look for thickening shampoos and treatments that include biotin, hydrolyzed wheat or rice proteins, and kaolin clay, says Ellsworth.

At-home smoothing treatments and deep conditioners packed with nourishing oils such as coconut and avocado can soften coarse, brittle strands and help calm frizz, which stems from dehydration. But if you have really unruly hair, Ellsworth suggests an in-salon keratin treatment, which seals the cuticle layer. "It's going to make your hair more manageable and easier to blow out at home," she says.

"Vivascal and Nutrafol are very popular with my patients," says Marmur. "There is only anecdotal evidence that these home supplements work, but I still believe in trying a holistic approach to improving your hair," she says. And the proper amounts of vitamins and minerals will help optimize hair growth and health. Look for blends containing vitamins A and C, B vitamins such as folic acid and biotin, and minerals including zinc and silica.

Krista Bennett DeMaio has nearly two decades of editorial experience. The former magazine-editor-turned-freelance writer regularly covers skincare, beauty, health, and lifestyle topics. Her work has appeared in national publications including Oprah, Shape, Parents, Cosmopolitan, Allure, and websites such as HealthCentral.com bhg.com, and prevention.com."

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