What Causes Hair Loss During Menopause?

Key Takeaways 

• Menopause-related hair loss is common. It is driven by predictable hormonal shifts that directly affect the hair growth cycle.

• Hormones affect hair growth: A drop in oestrogen shortens the growth phase of the hair, while increased sensitivity to androgens causes follicles to shrink and produce thinner strands.

• Hair thinning during menopause is rarely caused by a single factor. Stress, nutrient deficiencies, medications, and styling damage often accelerate the process.

• Pattern of hair loss: Most women experience diffuse thinning rather than bald patches, particularly around the crown and parting.

• The most effective treatment approach is layered: lifestyle support, medical therapy, and finally advanced options such as Platelet Rich Plasma (PRP) or hair transplantation.

• Early action matters. The sooner hormonal hair loss is addressed, the better the long-term outcome.

Many women notice increased hair shedding and thinning during menopause. This happens because hormonal changes directly affect the hair growth cycle, shortening the growth phase and weakening follicles. 

Understanding these changes is the first step toward choosing the most effective treatment options.

What is Menopause?

Menopause is the permanent cessation of menses, resulting from the depletion of the ovarian follicle supply. This transition isn’t an overnight event. Perimenopause, the preceding phase, is often where the first signs of hair thinning appear, characterised by erratic hormonal fluctuations and irregular cycles.¹

Perimenopause is the transition state that precedes menopause, which is characterised by wide hormonal fluctuations and irregular menstrual patterns with women having at least one menstrual cycle every 3 months¹.

Beyond natural ageing, menopause can occur due to surgical interventions like oophorectomy (removal of ovaries) or hysterectomy, as well as side effects from chemotherapy or genetic predispositions. 

Regardless of the cause, the common denominator is a sharp drop in oestrogen, which previously supported hair growth in women

How hormonal changes disrupt the hair growth cycle

Once hormone levels begin to fluctuate during menopause, the hair growth cycle is affected. 

This results in hair thinning over time, and we must examine the follicle’s growth cycle to understand how this happens. Every hair on your scalp operates on a repeating three-phase cycle:

Anagen (Growth): The active phase where cells divide rapidly.

Catagen (Transition): A brief regression where the hair prepares to rest.

Telogen (Rest/Shed): The phase where the hair eventually falls out to make room for new growth.

Oestrogen helps keep hair in the anagen phase for longer. When oestrogen levels drop, the growth phase shortens, and more hairs enter the resting and shedding phases at the same time.²

Simultaneously, the body’s sensitivity to androgens (like DHT) increases. These hormones cause follicles to undergo miniaturisation, a process in which the follicle physically shrinks, producing thinner, shorter strands until it eventually stops producing hair altogether.²

Over time, this leads to:

• Reduced hair density
• Thinning at the crown or parting
• Loss of overall volume

This change of hair entering the resting and shedding phases is commonly seen in menopause-related hair loss.

Other causes of hair loss:

Hormones are the main driver, but other factors are involved as well. The other factors are; 

Stress: This can disrupt the normal hair growth cycle, resulting in a type of hair loss called Telogen Effluvium. 

Nutritional deficiencies: Deficiencies in vitamins and essential minerals, such as Vitamin D, iron, B12, folate, and zinc, can significantly affect hair growth and contribute to hair loss. 

Medications: Certain medications, such as chemotherapy drugs, can cause hair loss as a side effect.

Damaging Hairstyles: Harsh treatments, tight braids, or ponytails can put excessive tension on hair follicles, leading to hair loss, also called traction alopecia.
Hair loss can be complex with multiple contributing factors. You can read our blog article on types of hair loss.   

What does menopausal hair loss look like?

Most women experience diffuse thinning rather than bald patches.³ You may notice:

• A widening part

• A smaller ponytail

• More hair in the brush or shower

• Reduced volume on the crown

This pattern differs from male pattern baldness and tends to affect hairlines and crowns over many years

Does Hair Loss from Menopause Grow Back?

For many women, some regrowth is possible, especially when hair loss is addressed early.

Menopausal thinning usually occurs because follicles become miniaturised and dormant, rather than destroyed. This means hairs grow back thinner and more slowly, but the follicles can often still respond to treatment.

Regrowth is less likely when thinning has been long-standing, follicle shrinkage is advanced, or an underlying condition hasn’t been treated. In these cases, therapies may slow further loss but may not fully restore density.

How To Treat Hair Loss In Menopause?

The most effective treatment plans are built in layers, progressing from non-invasive maintenance to advanced restorative care.

1. Medical interventions 

• Minoxidil (first-line treatment): Topical minoxidil improves blood flow and prolongs the growth phase, helping increase density when used consistently.⁴

• Finasteride: Prescribed only for postmenopausal women, finasteride reduces androgen-related follicle damage.⁵

• Hormone Replacement Therapy (HRT); While HRT is prescribed for systemic symptoms like hot flushes, restoring oestrogen levels often has the “side effect” of stabilising hair density.

• Spironolactone: Spironolactone lowers androgen activity and may slow thinning in hormonally sensitive women.

2. Advanced Options

• Low-Level Laser Therapy (LLLT): LLLT uses red light to stimulate hair follicles and increase hair density.

• Platelet-Rich Plasma (PRP): PRP injects growth factors into the scalp. Some studies suggest improved density, though results vary.⁶

3. Hair transplant surgery

When hair loss has stabilised and a distinct area of thinning has developed, a transplant becomes a viable option. FUE (Follicular Unit Excision) or FUT hair transplant surgery allows us to redistribute healthy, DHT-resistant follicles into thinning areas, focusing on a natural-looking density.⁷

Depending on the stage my menopausal women present to me, I will advise them on medications, lifestyle changes or hair transplant surgery. Most commonly, they will require investigations that check their iron levels and other deficiencies that could be contributing to their hair loss. I work alongside Dermatologists to ensure that my women who are going through or have gone through menopause receive the holistic care their hair needs. 

Dr Roshan Vara, Co-Founder and Surgeon at The Treatment Rooms London

How to Help Prevent Hair Loss During Menopause

While hormonal changes are a natural part of menopause, there are simple, evidence-based steps you can take to protect your hair and slow thinning. These changes do not replace medical treatment, but they can create the right environment for healthier hair growth and help prevent avoidable damage.

Reduce everyday stress

Gentle stress-reducing habits such as yoga, breathing exercises, walking, journaling, or mindfulness may not feel directly linked to your hair, but they help stabilise your stress levels, which in turn reduces your cortisol hormone level and helps improve the vitality of your hair. 

Stay physically active

Regular exercise supports circulation, reduces stress hormones, and improves sleep, all of which influence hair growth.

It also helps manage common menopausal symptoms such as mood changes, weight gain, and fatigue, which can indirectly worsen hair shedding.

You do not need intense workouts; even brisk walking, swimming, or stretching several times a week can make a difference.

Nourish your hair with a balanced diet

Hair is made primarily of protein and requires a steady supply of iron, B vitamins, vitamin D, zinc, and healthy fats to grow normally.

Rather than relying solely on supplements, aim for a balanced, whole-food diet. Supplements should only be used when a deficiency is confirmed by your GP, as unnecessary supplementation can sometimes worsen hair loss rather than help it.

Limit heat and chemical damage

As hair becomes finer during menopause, it is more vulnerable to breakage and dryness. Frequent use of straighteners, curling wands, and blow dryers can weaken the hair shaft, making thinning appear worse.

Allow hair to air-dry when possible, use heat protectants, and keep tools on low-heat settings.

Be gentle with styling

Tight hairstyles, extensions, and constant scalp tension can damage follicles over time and contribute to traction alopecia.

Choose looser styles, avoid constant pulling at the hairline, and give your scalp regular breaks from tension.

When to Seek Help?

If you are seeing a significant increase in daily shedding or a visible change in scalp density, the best first step is to consult a dermatologist. Ruling out thyroid issues or specific deficiencies via blood tests is essential before starting any advanced treatment.

​At The Treatment Rooms London, we don’t just look at the hair; we look at the whole patient. Whether you require medical management or are a candidate for a precision hair transplant, early intervention remains the most powerful tool in your arsenal. 

Conclusion

Menopausal hair loss reflects biological changes inside the body that directly affect the scalp and hair follicles.

The good news is that when these changes are identified early, most women can stabilise shedding, improve density, and regain confidence through a combination of medical treatment, lifestyle support, and targeted procedures.

Hair does not have to be something you lose quietly. With the right plan, it can be something you actively protect.

Hair Loss During Menopause Frequently Asked Questions

Can hair regrow after menopause?

Yes, if addressed early, hair thinning can be partially reversed using a combination of lifestyle and medical treatments to stimulate hair growth. 

How long does menopausal hair loss last?

Menopausal hair loss can last as long as your body goes through hormonal changes, which can span several years.

Does everyone going through menopause undergo hair loss?

Everyone sheds around 50-100 hairs a day, regardless of whether they are menopausal or not. Not everyone going through menopause will experience hair loss.

References 

1.NHS. Menopause Overview. Available from: https://www.nhs.uk/conditions/menopause/

2. Rinaldi F, Trink A, Mondadori G, Giuliani G, Pinto D. The Menopausal Transition: Is the Hair Follicle “Going through Menopause”? Biomedicines. 2023;11(11):3041. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669803/ 

3. Zouboulis, C. C., Blume-Peytavi, U., Kosmadaki, M., Roó, E., Vexiau-Robert, D., Kerob, D., & Goldstein, S. R. (2022) ‘Skin, hair and beyond: the impact of menopause’. Climacteric, 25(5), pp. 434–442. Available at: https://doi.org/10.1080/13697137.2022.2050206

4. Suchonwanit, P., Thammarucha, S., and Leerunyakul, K. (2019) ‘Minoxidil and its use in hair disorders: a review’, Drug design, development and therapy, 13, pp.2777–2786. Available at: https://doi.org/10.2147/DDDT.S214907 

5. Iamsumang W, Leerunyakul K, Suchonwanit P. Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. Drug Design, Development and Therapy. 2020;14:951–959. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7060023/

6. Gentile P, Garcovich S, Bielli A, Scioli MG, Orlandi A, Cervelli V. The effect of platelet-rich plasma in hair regrowth: a randomised placebo-controlled trial. Stem Cells Transl Med. 2015;4(11):1317–1323. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4622412/

7. International Society of Hair Restoration Surgery. “Hair Transplantation for Women.” Available from: https://ishrs.org/hair-transplantation-in-women/