Menopause 
Approximately 30 million women in the United States experience thinning hair. While this symptom of menopause is common, it can still be an unsettling occurrence if a woman is caught off guard. In fact, in a recent poll of 500 women, 24% likened losing their hair to losing a limb. Many women undergoing menopause don't notice their hair loss at first, and when they do, don't know how to cope with it. Keep reading for some of the most frequently asked questions about hair loss.
Q: What Is Hair Loss?
A: Hair growth is cyclical. It goes through a normal process of growth before falling out after a few years only to be regenerated again. On average, men and women alike lose approximately 50 - 100 hairs per day. This is normal. When losing more hair than this, which is common during menopause, hair loss can become an issue.
Q: How Does Hair Grow Normally?
A: Hair is composed of keratin, a protein that also forms the nails and outer layer of skin. Each strand of hair is actually dead tissue growing from hair follicles that exist below the scalp's surface. This visible section is called the hair shaft.
Hair remains on the head for two to six years, during which time it is continually growing. This growing phase is known as anagen. Afterwards, there is a resting phase known as telogen, which lasts for about three months. During telogen, the hair stops growing and soon after falls out, creating normal hair loss.
Q: What Are the Symptoms of Hair Loss?
A: While daily hair shedding is quite normal, there are signs that may indicative of acute hair loss, particularly during the time leading up to menopause.
Common Symptoms of Hair Loss
- Hair falling out in large clumps when washed
- Large snarls of hair coming out in the brush or comb
- Small bald patches appearing on the scalp
- Red, itchy, or oily scalp
- Noticeable hair thinning on the front, sides, or top of head
Q: What Are the Types of Hair Loss?
A: As hair loss occurs in women in different patterns and from different causes, there are several classifications for female hair loss during menopause.
Androgenic alopecia
This is the most common form of hair loss to affect women. Thought to be triggered by hormonal imbalance, it is most frequently seen in women who are in the menopause transition. It is characterized by overall thinning as well as a bald spot at the crown, or female pattern baldness.
Telogen effluvium
This occurs when sudden stress or malnutrition causes large numbers of hair follicles to enter the telogen phase at the same time. A couple of months later, when they reenter anagen, this provokes a mass shedding of hair.
Alopecia areata
Occasionally a woman will lose her hair in spots or patches rather than the more common, subtle thinning. It is thought to be an autoimmune disease in which the body attacks its own hair follicles, thinking them to be foreign bodies.
Trichotillomania
An obsessive-compulsive disorder that involves the pulling of one's own hair, this is most commonly seen in younger women, typically pre-teens or teenagers, but it can be triggered by menopausal anxiety.
Traction alopecia
Hair loss caused by extreme stress to the hair through severe hairstyles, such as braiding, cornrows, or extensions.
For women undergoing menopause, the most commonly-encountered type of hair loss is androgenic alopecia. Keep reading to learn about the hormones that cause this condition.
Q: What Causes Hair Loss?
A: Hair loss in menopausal women is primarily due to hormonal changes. Estrogen plays a large role in hair growth by helping hair to grow faster and staying on the head for a longer duration. When estrogen levels are lowered during menopause, this can lead to thinner hair.
At the same time, androgen levels spike, binding hair follicles and causing them to go into their "resting" mode sooner than is normal, causing a cycle of thinner and thinner hair production.
In addition, there is a number of other factors that can come into play and cause premature hair loss. Emotional, psychological, and lifestyle-related risk factors all can cause hair loss in women.
Medical Causes
- Pregnancy
- Thyroid disorders
- Anemia
- Chemotherapy
- Chronic illnesses
- Scarlet fever
- Eating disorders
- Syphilis
Psychological Causes
- Emotional stress
- Traumatic events
- Anxiety
Lifestyle Triggers
- Iron deficiency
- Lack of vitamin D
- Excessive amounts of vitamin A
- Too little exercise
- Lack of protein
- Aggressive hair styling
Q: What Amount of Hair Loss Is Considered Normal?
A: On average, it is considered normal to lose anywhere from 50 - 100 hairs per day. If a woman is noticing an amount that seems excessive or hair is coming out in clumps, it may be hair loss.
Q: When Can Women Expect to Experience Hair Loss?
A: The onset of hair loss is difficult to predict, as it can strike as early as a woman's late teens or early twenties.
However, hair loss is often one of the first signs of impending menopause. Many women start to see this symptom in their 30's or 40's, but postmenopause is when hair loss affects almost everyone, with approximately two-thirds of women experiencing some sort of thinning.
Q: Are There Any Ways to Hide Hair Loss?
A: As hair thinning begins, there are several tactics at women's fingertips that may help to hide the damage right from the outset of menopause. Thickening shampoos and tonics are on the market to increase the volume of the hair that remains, though they are not effective for all women.
Many women dye their hair darker to give it the appearance of more volume. When hair loss becomes more severe, hats or wigs can be helpful, safe, and inexpensive options.
Q: Is Hair Loss Reversible?
A: Depending on the specific type of hair loss that a woman is experiencing, it is often reversible. For instance, in the case of telogen effluvium, which is typically triggered through a stressful event, it may be only one cycle of hair growth that is affected, and the hair follicles will enter anagen normally afterward and hair will be regenerated.
In the case of androgenic alopecia, on the other hand, there may not be a cure at this point. However, by treating the hormone imbalance that is at the heart of the disorder, it is possible to manage the symptom and slow down, if not prevent, significant hair loss.
Q: What Are the Best Ways to Cope with Hair Loss?
A: Three approaches can be considered for treating hair loss: (1) lifestyle changes, (2) alternative medicine, and (3) medications and surgery. It is generally recommended that women begin with the least aggressive approach and move to the next level of treatment only if symptoms persist. Click on treatments for hair loss to discover the best route to relief.
Sources
- National Health Service UK. (2015). Women and hair loss: coping tips. Retrieved April 15, 2016, from http://www.nhs.uk/livewell/hairloss/pages/womenandhairloss.aspx
- National Institutes of Health. (2014). Female pattern baldness: MedlinePlus Medical Encyclopedia. Retrieved April 15, 2016, from http://www.nlm.nih.gov/medlineplus/ency/article/001173.htm
- National Institutes of Health. (2014). Hypervitaminosis A. Retrieved April 15, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/000350.htm
- Park, S.Y. et al. (2013). Iron plays a certain role in patterned hair loss. Journal of Korean medical science, 28(6), 934-938. doi: 10.3346/jkms.2013.28.6.934
- Rasheed, H. et al. (2013). Serum ferritin and vitamin D in female hair loss: do they play a role? Skin pharmacology and physiology, 26(2), 101-107. doi: 10.1159/000346698
- Riedel-Baima, B. & Riedel, A. (2008). Female pattern baldness may be triggered by low oestrogen to androgen ratio. Endocrine regulations, 42(1), 13-16. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18333699