The various symptoms of perimenopause and menopause affect each woman differently. Along with hot flashes, mood changes, and sleep problems, some women experience thinning hair. Hair loss during menopause is not a sign that something is medically wrong, but it can be startling to many women. Let’s look at why menopausal hair loss happens and what can be done to treat it.

Why it Happens

Hormonal fluctuations are responsible for hair loss during perimenopause and menopause. Estrogen and progesterone keep the hair in the growing phase, making it grow faster and stay on the head longer. When estrogen and progesterone levels decline, hair growth slows and hair loss becomes more pronounced. Also, the body produces more androgens during perimenopause and menopause in response to the loss of estrogen and progesterone. Androgens shrink hair follicles, which causes hair loss on the head. Interestingly, androgens can also increase hair growth on other parts of the body such as the face.

How Common is It?

Female hair loss is a common condition, especially in the years surrounding menopause. According to the Cleveland Clinic, it is estimated that over 50% of women experience hair loss. Age, diet, ethnicity, and genetic factors all influence your chances of experiencing hair loss throughout your life, including during and after menopause.

Symptoms to Look For

Because we lose hair every day regardless of age or health, it can be difficult to tell when actual hair loss begins. Eventually, the signs are more noticeable. If you see more hair than usual fall out on a daily basis, then it might be time to talk to your doctor about hair loss during menopause. Look at your hairbrush, on your pillow, in the sink, on the floor, and in the shower to check for excess hair loss. If you regularly wear your hair in a ponytail, you may notice the ponytail reducing in size.  The place where your hair parts at the top of your head may get wider or become more visible as the hair thins. Also, you may see more breakage than usual.

What Can I Do?

If you experience hair loss during menopause, then you can talk to your Certified Menopause Practitioner about your options for treatment.

Quick Aesthetic Fixes

If you want a quick fix to camouflage thinning hair while looking at treatment options, there are several things you can try. Hairstylists often recommend that women with thinning hair try a shorter haircut because long hair can make fine hair more obvious. Shorter cuts like a bob or a pixie are popular, as are layers that add volume and bangs to add texture. Some women wear hats when they’re feeling especially self-conscious.

Hormone Replacement Therapy

Because hormones play a part in hair loss during menopause, hormone treatments can be beneficial. Perimenopausal and menopausal women who are undergoing hormone replacement therapy with bioidentical hormone pellets may notice an improvement in hair growth during treatment. However, the HRT should be used to treat multiple symptoms of perimenopause and menopause. It is not recommended to use hormone replacement therapy to treat only hair loss.


Minoxidil, commonly known by the brand name Rogaine, is often prescribed for both men and women with hair loss. This medication is a vasodilator that widens the blood vessels to increase blood flow to the scalp and hair follicles. It is available over the counter or in prescription strength and comes in a spray, liquid solution, and foam form. Minoxidil must be used continuously to maintain hair growth.


Antiandrogen drugs like spironolactone are sometimes prescribed for both hair loss or excess hair on the face and body. These drugs are usually given in conjunction with a topical treatment like minoxidil.

Red Light Treatment

LED light therapies stimulate hair regrowth by targeting biochemical processes in the scalp. REVIAN RED uses two wavelengths of light to renew the cells responsible for hair growth. The treatment is given via a wireless light cap that connects to a mobile app where you can track the treatments. Treatments take just 10 minutes each day. Chapel Hill Gynecology has an affiliate program that allows patients to get the REVIAN device at a discounted price.

Make an Appointment

If you have questions or concerns about the symptoms of perimenopause or menopause, Dr. Karen Clark of Chapel Hill Gynecology can help. As a Certified Menopause Practitioner of the North American Menopause Society, Dr. Clark is an expert in managing the symptoms of menopause and perimenopause with both hormonal and non-hormonal methods. To make an appointment, call (919) 960-2720.