HRT and hair loss

Menopause is a significant transitional period in a woman’s life. Due to declining oestrogen and progesterone levels, your ovaries stop releasing eggs and your menstrual periods cease. As well as reduced hormone levels leading to the end of your natural fertility, they also cause a broad range of menopause symptoms including hot flushes, night sweats, mood swings and vaginal dryness.

Another symptom that many women experience is hair loss, with an estimated 20-60% of women affected before the age of 60. While common, hair loss can have a detrimental impact on your self-esteem, with one study revealing that 68% of women with hair loss said their hair was important to their overall well-being, 55% saying they suffered from a lack of confidence and 31% saying they felt depressed.

However, understanding what is happening to your body during menopause, and the steps you can take to help with hair loss can make a difference to your physical and emotional well-being.

Is hair loss a symptom of menopause?

Many people are well aware that menopause causes hot flushes but the changes occurring in your body can impact your hair too. Hair loss is a prevalent symptom of menopause and can be an issue that lasts well into postmenopause. It is estimated that 70% of women over 70 deal with hair loss.

How does menopause cause hair loss?

Menopause can cause hair loss due to decreased oestrogen and progesterone levels. These hormones are crucial in maintaining healthy hair growth by keeping hair in the growing (anagen) phase of the hair cycle for longer periods. When these hormones drop during menopause, their ability to support hair growth diminishes, leading to more hair entering the transition (catagen) phase and resting (telogen) phase, before shedding.

Additionally, as oestrogen and progesterone decrease, the effects of androgens (male hormones) like testosterone can become more pronounced. This hormonal imbalance may shrink hair follicles, which results in thinner, weaker hair and can slow down regrowth.

Hair loss in menopause can present itself in many different ways including:

Shedding: Increased hair shedding occurs when more hair enters the resting phase, resulting in noticeable hair loss, particularly during brushing or washing.
Thinning: Hormonal changes can cause the overall volume of hair to decrease, making the scalp more visible due to finer, sparser strands.
Widening of the parting: A wider parting is often one of the first signs of female-pattern hair loss, as the hair becomes thinner along the central part line.
Change of texture: Hormonal shifts may alter hair texture, causing previously straight or curly hair to feel coarser, more brittle, or less manageable.
Dryness: Lower oestrogen levels can reduce the scalp’s natural oils, leading to dry, dull, and brittle hair.

Menopause-related hair loss can also occur in other parts of the body. Many women notice that hair growth on their arms and legs slows or stops, and their pubic hair begins to thin.

Other causes of hair loss during menopause

The hormonal shift at menopause can result in hair loss but there are lots of other factors that can contribute to hair loss in midlife including:

Stress: Physical or emotional stress can trigger temporary hair loss (telogen effluvium) by pushing hair into the resting phase prematurely.
Nutritional deficiencies: Inadequate intake of nutrients like iron, vitamin D, zinc, and B vitamins can weaken hair and slow regrowth.
Thyroid disorders: Hypothyroidism or hyperthyroidism can disrupt the hair growth cycle, leading to thinning or shedding.
Medications: Certain medications for blood pressure, cholesterol, or depression can contribute to hair loss as a side effect.
Autoimmune conditions: Disorders like alopecia areata cause the immune system to attack hair follicles, leading to patchy hair loss.
Hairstyling practices: Frequent use of heat styling, chemical treatments, or tight hairstyles (like ponytails or braids) can cause traction alopecia, which damages hair follicles.
Genetics: A family history of hair loss can increase the likelihood of experiencing hair thinning or female pattern hair loss.

Can HRT help with hair loss?

Hormone replacement therapy (HRT) is the most common treatment for menopause symptoms as it typically uses body-identical hormones to replace the hormones that decline during perimenopause and menopause.

It is highly effective in alleviating hot flushes and night sweats in menopause but can help with other symptoms, including hair loss. It can slow down or even stop hair loss in some women but doesn’t work for everyone which is why prescribing HRT for hair growth alone isn’t usually done.

The best type of HRT for hair loss

Any HRT is prescribed based on an individual assessment of your medical history, health, symptoms and preferences. Therefore, the best type of HRT for a person will vary between individuals.

However, oestrogen gel, spray or patches are generally the best options for preventing hair loss because they offer consistent hormone levels, avoiding the spikes and dips that can lead to shedding. Oestrogen tablets are convenient but may contribute to fluctuations in hormone levels, increasing the risk of hair loss in comparison.

Furthermore, combined HRT with body-identical oestrogen and body-identical progesterone is better for hair health than synthetic progestins, which can sometimes worsen hair loss.

Can HRT cause hair loss?

As with most medications, HRT does have some side effects. Most are mild and disappear within three months of starting treatment. Hair loss is a listed side effect of HRT but it’s not among the most common.

Things you can do to help with hair loss

While you can’t necessarily prevent hair loss, there are steps you can take to promote good hair health, keep it in the best condition possible and minimise loss:

Supplements and vitamins

If you have a healthy, well balanced diet, you are probably getting all the vitamins you need to support healthy hair growth without supplementation. However, there are occasions where supplements can be beneficial, such as if you are deficient in iron, you may benefit from taking an iron and vitamin C supplement. Vitamin D (which is synthesised from sunlight) is often recommended to support healthy bones, but it can also support healthy hair.

Taking care of your hair

Gentle hair care practices are essential for preventing further hair loss. Use a mild shampoo and conditioner to maintain scalp health, and avoid excessive heat styling, chemical treatments, or tight hairstyles. Regular trims can also prevent split ends while using wide-tooth combs and soft towels minimises breakage. Opting for nourishing hair masks or oils can help keep your hair hydrated and strong.

Diet

A balanced, nutrient-rich menopause diet can support hair growth by providing essential vitamins and minerals. Include foods high in protein, iron, and omega-3 fatty acids, such as lean meats, fish, eggs, nuts, and leafy greens. Antioxidant-rich foods like berries and vegetables help fight inflammation and protect hair follicles. Maintaining a healthy diet promotes overall well-being and improves the condition of your hair.

If you’re concerned about menopause, HRT and hair loss, then it might be a good idea to talk to someone who understands. At Menopause Care, we have an experienced team who can give you personalised advice and treatment to help you navigate menopause and its symptoms. To get started, book a consultation with a menopause doctor.

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