Hair Loss in Menopause

Around 50% of women will experience some form of hair loss during their lifetime, although it's more common later in life.

Hair loss is often accompanied by additional stress, anxiety, and depression for the women involved. This is an unfortunate catch 22, as feeling stressed out is another possible reason for hair loss and it can exacerbate the problem.  Hair loss is also linked with lower self-esteem, a negative body image, and self-isolation. If you are in this vicious cycle please considering talking to a coach, counselor or psychologist.

Some women have also found these practices helpful:

• changing their shampoo and condition to be chemical-free versions
• reducing the overall frequency of washing, brushing, and styling (especially the use of hairdryers and hair straighteners or other devices that use heat). It goes without saying the wet hair should not be brushed, but it can be combed
• scalp massages including the stimulation of acupressure points or even acupuncture
• oil treatments for both your scalp and hair
• certain yoga asanas (or positions) may be beneficial in promoting good blood flow to your head and reducing hair loss

Pattern hair loss in women is the most common and is characterised by excessive hair thinning and slow hair regrowth. This starts in the mid-front hairline (your hair part) and widens. This is different from male pattern hair loss, which starts at the front and recedes backward. 

The most probable cause of hair loss around menopause is hormonal change. Hormonal change can also cause hair to start growing in new areas such as your chin, face, and chest. The hormones related to hair changes include estrogen, progesterone, and testosterone - especially the DHT form. 

Other potential causes include:

• Thyroid dysfunction (often accompanied with loss of the outer third of your eyebrow)
• Parathyroid dysfunction
• Autoimmune conditions (often accompanied with underarm and pubic hair thinning)
• Diabetes
• Digestive dysfunction 
• Dietary issues: excessive fasting, protein deficiency, gluten intolerance
• Stress
• Genetics
• Cardiovascular issues 
• Chronic inflammation
• Infections such as syphilis (this looks different as it’s more of a patchy hair loss).
• Nutritional deficiencies (common deficiencies include vitamin A, vitamin B complex (Niacin, Biotin, B6, B12), vitamin D, zinc, silica, selenium, iron, iodine, essential fatty acids.)
• Smoking
• Working long hours under ultraviolet light
• Toxin exposure, such as heavy metals
• Certain medications

Testing

• Hormones: estradiol, testosterone, dihydrotestosterone (DHT), DHEAs, SHBG, prolactin, progesterone
• Cortisol: saliva test four times during the day is the gold standard, but a morning blood test is a possible starting point 
• Thyroid testing TSH, FT3, FT4, rT3, TPO, TGAb, TRAb, urinary iodine
• Parathyroid hormone PTH
• Full blood count
• Iron/ferritin
• Zinc 
• Vitamin D
• ANA (to consider auto-immune component)
• ESR and CRP (inflammatory markers).
• Glucose, insulin, HbA1c
• Blood pressure
• Cholesterol
• HTMA (heavy metal hair test)

Possible treatment options

• Peonia and licorice herbal combination to reduce testosterone levels
• Saw palmetto to help reduce DHT form of testosterone
• Cod liver oil is a source of vitamin A, D and essential fatty acids 
• Silica is a building block for new hair
• NAC (N-acetyl cysteine) can help balance hormones and reduce hair loss
• Iron, if found to be low
• Zinc, if found to be low
• Thyroid support if needed
• Withania to help reduce cortisol levels
• Inositol for blood sugar support and hormonal balance
• B complex with high amounts of biotin, niacin, B6, B12 and choline
• Probiotics (especially L. reuteri strain and Saccharomyces boulardii)