Struggling with hair loss in your 40s, 50s or beyond? Menopause and hair loss often go hand and hand- let’s explore this connection and what you can do about it!

Menopause and Hair Loss: What Are Your Options?

Going through menopause is a natural part of aging for women. But when your hair starts thinning along with those hot flashes, it can feel like adding insult to injury.

Let’s dive into what’s happening and how you can address it.

What is Menopause?

Menopause marks the end of a woman’s reproductive years, officially diagnosed after 12 consecutive months without a menstrual period. This biological transition involves significant hormonal shifts that affect various systems in your body—including your hair follicles.

During this time, your body undergoes a complex hormonal dance that can manifest in numerous symptoms beyond the commonly discussed hot flashes and mood swings.  Check out my full blog and video on the 34 symptoms of perimenopause here!

Age of Onset and Its Implications

The average age for menopause is approximately 51 years, though it can occur anywhere between 45-55 years for most women.  This timing coincides with numerous other life changes, which can include aging parents, teenage kids, and changes in pressures at work, all of which can compound stress levels.

Early menopause (before age 45) may intensify certain symptoms, including hair loss, as the body experiences more abrupt hormonal shifts.  And all of these changes can also start before the “official menopause” timeline is hit.  But hair loss is complex- keep reading we will review all of the possible causes!

The Connection Between Menopause and Hair Loss

Hormonal Changes During Menopause

The hair on your head is significantly influenced by your hormonal balance. During menopause, several key hormonal changes occur:

• Estrogen decline: Estrogen supports hair growth and helps keep it in the growing phase longer. When levels drop, hair may grow more slowly and become thinner
• Progesterone reduction: This hormone also supports healthy hair growth, and its decline contributes to thinning.  As noted in my blog on the stages of perimenopause, progesterone starts declining even from the initial stages of perimenopause, so this thinning can start early on.
• Testosterone influence: While levels don’t necessarily increase during perimenopause and menopause, the ratio of testosterone to estrogen changes. This can activate androgen receptors in hair follicles, causing miniaturization and thinning, particularly at the crown and hairline.

Thyroid imbalances, which become more common during menopause, can further exacerbate hair loss issues.  More about this in the following sections!

Patterns of Hair Loss in Women

Unlike men, who typically experience receding hairlines, women’s hair loss during menopause presents differently. You’ll likely notice:

• Overall thinning across the entire scalp
• Widening of the part line
• More visible scalp, especially at the crown
• Reduced ponytail thickness

This pattern, known as female-pattern hair loss (FPHL), rarely progresses to complete baldness but can significantly reduce hair volume and density Source.

Statistics on Hair Loss During Menopause

Prevalence of Hair Loss Among Women

You’re definitely not alone in this experience! Research indicates that approximately 50% of women will experience noticeable hair loss during menopause Source.

In the United States alone, female-pattern hair loss affects about 30 million women, making it an extremely common condition (and a big market for social media and target marketing) despite being less openly discussed clinically than many other menopausal symptoms.

Impact of Female-Pattern Hair Loss

Beyond the physical changes, hair loss can take a significant emotional toll. Many women report:

• Decreased self-confidence
• Social anxiety
• Feelings of premature aging

These psychological impacts shouldn’t be minimized, as they can affect the overall quality of life during an already challenging time in a woman’s life.

Expert Insights on Managing Hair Loss

Importance of Early Diagnosis and Treatment

Early intervention can significantly improve treatment outcomes, as hair follicles that have been dormant for too long may not respond as well to treatments.

Treatments started early in the menopausal transition, such as topical options, hormone balancing therapies, nutritional supplements, or laser therapies, have been shown to yield better outcomes, preserving existing follicles and stimulating dormant ones.

Practical Recommendations for Hair Health

Several factors beyond hormones can contribute to menopausal hair loss:

Nutritional Deficiencies- Several vitamin and mineral shortfalls can worsen hair loss:

– Iron deficiency (particularly common in women)

– Vitamin D insufficiency

– B vitamin deficiencies (especially biotin/B7)

– Zinc deficiency

– Inadequate protein intake

Stress and Cortisol Imbalance: Chronic stress elevates cortisol levels, which can push hair follicles into the resting phase prematurely and contribute to shedding.

Thyroid Dysfunction: Both hypothyroidism and hyperthyroidism can cause diffuse hair loss, and thyroid disorders become more prevalent during menopause.

To support hair health during this transition, consider these approaches:

Dietary support:

1. Consume adequate protein.  This means at least 1.2 g per kg of body weight; if you work out regularly, shoot for 1.4-1.6 grams per kg of body weight.  If you prefer to use pounds as your guideline, then aim for 0.55-0.73 grams per pound of body weight.
2. Include iron-rich foods like leafy greens, eggs, nuts seeds and beans, and if you eat animal meat then also include lean meats, fish, and poultry. It’s also a great idea to have your iron and ferritin levels checked with your healthcare provider.
3. Ensure sufficient healthy fats from sources like avocados, nuts, and olive oil, and healthy omega 3 fats like chia, flax, walnuts, and if you eat fish, salmon.

Potentially Beneficial Supplements:

Supplements can be helpful for hair loss in menopause and perimenopause, but they must be used with care.

• Saw palmetto- if you have a certain type of elevated testosterone (helps block DHT, a testosterone derivative that shrinks follicles).  If this applies to you, and under the guidance of your healthcare provider, you could consider choosing the following dosing :
  • Standard Extract (85–95% fatty acids and sterols):
    • 160 mg twice daily (320 mg total per day)
    • Important Considerations: Look for a standardized extract labeled with fatty acid content (usually 85–95%). It typically takes at least 3 to 6 months to see noticeable results for hair loss.  Always take with food to minimize potential gastrointestinal upset.
• Evening primrose oil- can help support menopause-related hair loss primarily by balancing hormones, reducing inflammation, and improving scalp health.  If this applies to you and under the guidance of your healthcare provider, you could consider the following dosing:
  • 500–1000 mg capsules, typically standardized to 8–10% GLA.
    • Usually taken as:
      • 500 mg capsules, twice daily (total 1000 mg/day)

Adaptogens- Adaptogens help menopausal hair loss by regulating stress hormones (especially cortisol), balancing estrogen and androgen levels, and reducing inflammation, all of which support healthier hair growth.

Here are some of the best adaptogens for menopausal hair loss, how they work, and the usual effective doses:

Ashwagandha

How it could help:

• Balances cortisol, reducing stress-induced hair loss.
• Supports thyroid hormone balance (important for hair health).

Dosage:

• Standardized extract (KSM-66 or Sensoril): 300–600 mg/day
  (Best taken in divided doses: 150–300 mg twice daily).

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Rhodiola Rosea

How it could help:

• Reduces cortisol levels and stress-related hormonal imbalances.
• Improves circulation to scalp, enhancing hair growth.

Dosage:

• Standardized extract (3% rosavins, 1% salidroside): 200–400 mg/day, taken in morning or early afternoon.

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Holy Basil (Tulsi)

How it could help:

• Lowers stress hormones, reducing hair shedding linked to stress.
• Anti-inflammatory, antioxidant support to scalp health.

Dosage:

• Capsules: 300–600 mg/day
• Tea: 1–2 cups daily

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Maca Root

How it could help:

• Balances estrogen, progesterone, and androgens during menopause.
• Promotes hair growth by supporting hormonal equilibrium.

Dosage:

• Gelatinized Maca powder or capsules: 1,000–3,000 mg/day (typically 500–1000 mg, 2–3 times daily).

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Schisandra Berry

How it could help:

• Balances stress hormones and improves liver detoxification, indirectly improving hair health by reducing hormonal stress on hair follicles.

Dosage:

• Capsules (standardized): 250–500 mg twice daily
• Tincture: 20–30 drops, 1–2 times daily.

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Reishi Mushroom

How it could help:

• Reduces inflammation, improves blood flow to the scalp.
• Balances androgens and estrogen metabolism.

Dosage:

• Extract capsules: 500–1500 mg/day
• Powdered extract: 1–2 tsp daily

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General Recommendations:

• Start with one adaptogen at a time to evaluate its effectiveness.
• Consistent use for 3–6 months is recommended for best results.
• Consult a healthcare provider before you start to ensure compatibility with other medications or supplements.

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Marine Collagen

How it helps:

• Provides key building blocks (amino acids like glycine, proline, and hydroxyproline) for the formation of hair keratin, while also supporting skin elasticity and scalp health.

Recommended Dose:

• 2.5–10 grams daily, typically in powder or capsule form
• Best taken on an empty stomach or 30 minutes before meals for optimal absorption
• Look for hydrolyzed (aka “collagen peptides”) marine collagen for better digestibility and bioavailability

Pro Tip: Combine with Vitamin C (250–500 mg) to enhance collagen synthesis.

synthesis.

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Biotin + B Vitamins (B-complex)

How they help:

• Biotin (B7), along with other B vitamins (B12, B6, B2, folate), supports keratin production, reduces hair thinning, and enhances overall scalp circulation and energy metabolism in hair follicles.

Recommended Dose:

• Biotin: 2,500–5,000 mcg daily
• B-complex (with B1, B2, B3, B5, B6, B12, and folate): Once daily, preferably with food

Pro Tip: Choose a methylated B-complex (with methylfolate and methylcobalamin) for better absorption, especially if you have the MTHFR gene variant.

Lifestyle modifications:

Lifestyle and stress management can be integral to addressing the root cause of hair loss. Hair loss often isn’t due to one singular factor, particularly in our peri- and menopausal years.

1. Prioritize stress management! This can be done through meditation, yoga, or other relaxation techniques like nature walks, time spent with a friend, or even setting boundaries.  This blog also has some great ideas.
2. Get good sleep (7-9 hours nightly).  Try keeping your room extra dark at night and opening your curtains to let in sunshine in the morning.  Keep your room temperature around 68 degrees F.  Avoid screens for at least 1-2 hours before going to sleep.
3. Minimize heat styling and harsh chemical treatments- these products can definitely damage your hair.  Limit your blow drying and straightening and avoid harsh products with SLS, parabens, or denatured alcohol in them.
4. Consider gentle scalp massage to stimulate circulation.

Medical interventions (consult with a healthcare provider before trying these)

1. Topical minoxidil (the only FDA-approved treatment for female pattern hair loss).  This is a much better option than oral minoxidil when it comes to the side effect profile.
2. Low-level laser therapy- offered at many spas and dermatologists office this can be an effective way to treat hair loss in perimenopause and menopause.
3. Platelet-rich plasma (PRP) treatments- PRP is used for many different purposes and can be helpful for hair loss.  Check out this blog for more info. 
4. Hormone replacement therapy (when appropriate).  HRT can be an option to not only help with hair loss but also weight gain, mood changes, insomnia, hot flashes, and more.  I recommend working with a provider who is well-trained in HRT and open to exploring customized solutions.

Conclusion

Menopausal hair loss, while common, doesn’t have to be something you simply accept. Understanding the complex interplay of hormones, nutrition, and lifestyle factors empowers you to take proactive steps.

Remember that addressing this issue often requires a multi-faceted approach and some patience. With the right combination of self-care, lifestyle adjustments, and possibly medical interventions, many women see significant improvements in their hair health during and after menopause.

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The BEST Menopause Skin Care products: Top 5 Doctor Recommended Products

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