Overview

Menopause is a time in a woman’s life where many changes occur. These changes are mainly hormonal and can, in turn, influence our physical and mental wellbeing.
One of the main concerns we hear when a woman is progressing through menopause is hair loss or hair becoming dry and thinned. Hair begins to lack lustre, looks damaged and just isn’t as luscious as it used to be, and this can become problematic for many women.

What Causes Hair Loss During Menopause?

menopause hair loss

One of the main concerns we hear when a woman is progressing through menopause is hair loss or hair becoming dry and thinned.

Menopause can lead to the thinning, breakage, or loss of hair for a lot of women. This is mostly due to the consistently low levels of oestrogen and progesterone and an increased production of testosterone. These hormonal changes lead to the hair thinning and breaking, hair loss, or even sometimes facial ‘peach fuzz’ or sprouts of hair on the chin.

Other factors that may contribute to issues with hair growth include reduction in sebum (oil) secretion, thyroid dysfunction, nutrient deficiencies, commencement of new medications, stress, genetic influences and the list goes on. It is quite difficult to always pin point only one definitive cause for hair loss and quite frequently, there is more than one factor playing a role, at any given time.

It has been estimated that approximately 38% of women over the age of 70 experience female-pattern hair loss.

It tends to particularly affect the central portion of the scalp, sparing the frontal hairline and is characterised by a wider midline part on the crown than on the side of the scalp. Other manifestations of female hair loss include thinning on the lateral scalp.

Hormonal Causes

It is not fully understood how menopausal changes cause the selective targeting of the scalp and there is no proof of a hormonal basis however, studies have indicated that reductions in hair growth are thought to be mainly contributed by a reduction in the anagen phase (growth phase) and regression of scalp hair to finer, vellus hair (finer and lighter hair) due to changes in androgen levels.

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On average, a person loses around 100-200 hairs a day to allow for new hair growth. During menopause, when your hair is breaking, it may seem that you are losing more than the average amount.

Although a large proportion of women who suffer hair loss do have hyperandrogenism (excess testosterone), other women don’t display any elevations in testosterone levels and as a result, it is believed low androgen (testosterone) levels also contribute to hair loss however, the mechanism here is not entirely known.

Reductions in progesterone levels as a woman progresses through peri-menopause and menopause has been known to impact androgens and their influence on the sebaceous glands and hair follicles.

Androgens can change the type of hair present, leading either to reduction of hair follicles or actually changing the follicle structure and leading to an environment that isn’t conducive to appropriate and healthy hair growth.

There are a multitude of treatment strategies that can be implemented to aid with improved hair growth and reducing the progression of hair loss. As with many treatments, there is no complete guarantee that hair growth will return to its healthy state however, it can at least be improved.

Nutritional Causes

Although our diets may be balanced, as we age, we’re unable to digest and process food as efficiently as we should. Because of this, we may become nutrient depleted which can in turn, contribute to an inadequate consumption of essential vitamins and minerals.

Quite often our diets contain too many simple and complex carbohydrates and an insufficient amount of protein. Protein is crucial for the growth, development and strength of our hair, skin and nails. Inadequate protein consumption on a daily basis, may contribute to hair loss and when diets become balanced, this hair loss can be reversed.

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A daily multivitamin or mineral supplement may help replenish key nutrients missing in your diet.

Thyroid Health

Our thyroid governs many aspects of our health including our metabolism, hormone balance, thermogenesis and our moods. When there are imbalances in thyroid health, whether it is under active or over active, if left untreated, can contribute to significant hair loss. The loss can tend to be diffuse and may involve the entire scalp and the hair can appear uniformly sparse. Hair loss associated with thyroid disorders tend to occur after a long period of time, rather than in acute phases and takes months to develop, due to the length of time it takes for hair to grow.

The Typical Hair Loss Experience

On average, a person loses around 100-200 hairs a day to allow for new hair growth. During menopause, when your hair is breaking, it may seem that you are losing more than the average amount. In reality, however, your hair is not falling out but breaking somewhere along the hair strand itself, giving the appearance of thinner hair.

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What Can I Do To Prevent Menopause Hair Loss?

1. Eat plenty of good foods
A balanced diet fill of vitamins and minerals and is low in saturated fat.

2. Add Supplements
A daily multivitamin or mineral supplement to get the nutrients you may have missed in your diet and help to replenish key nutrients.

3. Exercise Regularly
Exercise can help in keeping your mood swings in check, maintaining your weight, and helping you sleep, all of which help to contribute to hormonal balance and promote healthy hair growth.

4. Stay Hydrated
Staying hydrated can keep your skin and hair healthy and also improve blood circulation, which keeps your follicles nourished.

5. Look after your hair
Use a gentle, moisturising shampoo and conditioner when you wash your hair. Choose products that are made specifically for dry or damaged hair that will increase its elasticity.

Treatment For Menopause Hair Loss

Nutrients and Alternative Remedies:

Nutrients:

  • Iron, in situations where anaemia is present. Anaemia can cause hair loss.
  • Zinc and biotin are considered helpful with hair growth. A lack of these nutrients can cause brittle hair and nails.

Ginseng: Has been shown to promote hair growth in several studies, its effects on isolated human dermal papilla cells (hDPCs) were evaluated using cytotoxicity assays, immunoblot analysis of signalling proteins, and the determination of associated growth factors.

Black Cohosh: Is thought to assist in preventing hair loss by serving as an “oestrogen buffer” to protect hair follicles to DHT. It helps slow down the thinning process.

Aloe Vera: this works to soothe and calm a damaged scalp which may create a healthy environment for hair cells to replenish and flourish

Garlic: applying garlic gel to areas of the scalp that have experienced hair loss together with a steroid treatment has been shown to lead to more hair regrowth compared to a placebo.

Hormone Replacement Therapy
In recent years, one of the most important shifts in menopause research and treatment is the recognition that body-identical hormone treatments have proven to be much safer than synthetic hormone treatments. This is something that the doctors at the Centre have supported since our inception in 2003. This has also meant that commercially produced TGA-registered body-identical hormones are available in specific doses.
‘Body identical’ hormone therapy refers to a hormone that is identical to those produced by the body. These are TGA approved treatments and have a documented profile of benefit as well as short term and long-term risk. Commercially available body-identical oestrogen is available in Australia as tablets, transdermal patches or gel in specific doses. Examples of these include Estraderm, Estradot, Climara, Estrogel and Sandrena gel. It is also available for topical vaginal treatment – Ovestin and Vagifem.
Commercially available body-identical progesterone is now available in capsule form in Australia (as Prometrium). Prometrium is currently available as a 100mg capsule. Many of the studies/research available on commercial products do not extend to bioidentical hormones alone, as they predominately focus on synthetic hormone preparations. In studies that use bioidentical hormones, it does appear that the health outcome is more favourable compared to the synthetic alternative. 
Bio-identical Hormone Replacement Therapy (BHRT)
These products are compounded to an individual prescription from your doctor. Although the active constituents are pharmaceutical USP grade bioidentical hormones, the preparations are not individually TGA approved. Some large cohort studies including the French E3N study, have been conducted on patients using compounded bioidentical hormones and these studies have contributed to the development and controlled trials of set dose products that have been listed on the TGA register. However, because each prescription is compounded for an individual’s needs, there is no data available from controlled studies on these specific preparations regarding efficacy and safety.
Compounded bioidentical hormones may provide an option for patients where a commercial/pharmaceutical product does not achieve the desired therapeutic outcomes for patients and an alternate strength or mode of application, which is not commercially available, is indicated.

References:

 

If you’re noticing hair loss, that has become sudden, it is important to always consult your medical professional to ensure your health is fully assessed as in many instances, complex diagnostic testing may be required.

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