A wider parting, a thinner ponytail, more hair in the brush. Hair changes are common in midlife and can be surprisingly distressing.
Why hair changes around menopause
Estrogen helps keep hair in its growing phase. As levels fall, the balance shifts relative to androgens, the hormones linked to female pattern hair loss — gradual thinning over the crown and top of the head, with the hairline usually preserved. Hair strands may also become finer and drier.
Other causes to rule out
Midlife hair loss isn’t always hormonal. Worth checking:
- Iron deficiency, common with heavy perimenopausal periods
- Thyroid disorders
- Telogen effluvium — widespread shedding a few months after illness, surgery, major stress or rapid weight loss
- Medications, including some for blood pressure and mood
- Low protein intake
Sudden, patchy or rapid hair loss, or loss with scalp pain or redness, should be seen by a clinician or dermatologist.
What helps
- Minoxidil applied to the scalp is the best-studied treatment for female pattern hair loss and is available without prescription. It takes several months to show results and must be continued.
- Prescription options a dermatologist may discuss include oral minoxidil and anti-androgen medications.
- Treat underlying causes such as low iron or thyroid problems.
- Gentle care — avoid tight hairstyles, harsh treatments and excess heat.
Supplements marketed for hair rarely help unless you’re actually deficient, and high-dose biotin can interfere with some blood tests, including thyroid and heart tests. Tell your clinician if you take it.