When we think about Menopause struggles, we often think of symptoms such as hot flashes, night sweats, weight gain and brain fog. What about the changes to our hair? Did you know that we have approximately 120,000 hair follicles on the scalp alone? What happens to those hair follicles as our estrogen decreases? What about the role of genetics in hair loss? What can we do to improve hair volume and texture? We went straight to an expert trichologist for answers.
A trichologist is a someone who specializes in the hair and scalp. Lisa Caddy is a trichologist at Philip Kingsley who studies the many reasons for hair loss and she understands the strong emotional effects hair loss can have on women. Lisa believes that it is first important to understand the difference between hair loss and hair thinning. Hair loss is when you find large amounts of hair coming out when shampooing or brushing your hair while hair thinning means that the hair is actually thinning on your scalp. Some of the symptoms she includes in hair thinning are:
- thinner ponytail
- hair growth is slowing down
- your part is wider
- your scalp is more visible around the “crown of your head”
- hair is receding at temples
- loss of density in your front hair line
- and a reduction in the thickness and length of each strand.
Now that we understand the difference, Lisa answers some of the most common questions women have about hair changes:
- Why do women in perimenopause often notice hair loss/shedding? Hair follicles are sensitive to changes in your body especially the roller coaster ride of hormones during perimenopause. Estrogen helps keep you hair in a protected growth phase but as it declines in your body, your hair follicles begin to lose that protection. Testosterone then gains access to those hair follicles and can shrink them down. When hair follicles start shrinking, the result is fine hairs and shorter hairs. The longer this is happening, the more visible your scalp may become.
- What is the relationships between our genes and our hair? A woman can inherit the genetic predisposition to female pattern baldness from either her father or mother. If you have this predisposition, then your hair is more likely to shrink when the estrogen decreased and the testosterone becomes apparent. While the testosterone may not be increasing in your body, it has gained more access to the hair follicles that hypersensitive to it.
- Can stress cause hair loss? Lisa believes that there is a relationship between hair loss and stress. Stress causes your body to go into survival mode and it will focus on those bodily functions that keep us alive. Your body views the quickly dividing hair cells as high maintenance and therefore, nonessential, and it may shut down hair production.
- What about the relationship between the hair thinning and the frequency of washing hair? Lisa explains that this is not accurate. When you are shampooing, you are cleaning dead skin, bacteria, oil, and sweat from you scalp. If you do not wash your hair for a long period of time (more than 3 days), you can cause inflammation in the hair follicles. This inflammation may lead to hair loss for some women. As Lisa explains, “your face does not self clean and neither does your hair.”
- Do the ingredients in shampoos/conditioners cause hair loss? Hair loss is “systemic” so the quick process of shampooing your hair is not going to actively promote hair growth. However, if you hair is feeling thin or lacks volume, you may want to want to try a volumizing shampoo. It is important to look at the full list of ingredients in any shampoo.
- Does hair coloring cause hair loss or shedding? No, coloring your hair does not cause hair loss. It can make it dryer and the hair can break off but it is not going to make your hair thin. It is important to note that fine hair is more fragile so be careful when coloring.
- What about changes in the texture of your hair during perimenopause/menopause? Some believe that aging can affect texture of the hair similarly to the lack of collagen affecting the elasticity of the skin. If we are losing elasticity in the skin around the follicle it may change the movement of the hair follicle so that it grows to be curly or wavy.
- Why does our hair turn grey? Lisa explains that we have little cells inside the hair follicles called melanocytes that produce melanin. When the melanocytes stop producing a color pigmenation, the hair loses color. It is not actually grey, it is colorless. Genetics normally determine when the melanocytes discontinue production.
What can we do to slow down or stop the hair loss? Will HRT’s help? Lisa explains that there is good news and bad news. The bad news is by the time you are on HRT, the hair loss that you have already seen is permanent and irreversible. The good news is that you can halt the progression of additional hair loss. There are prescriptive hair loss treatments that you can use to slow the progression. She recommends a combination of monoxidil, low levels of estrodial and antiandrogens. While you can’t reverse the size of hair follicles that have already shrunk over time, Monoxidil is proven to help in growth and density. It may also stimulate older dormant hair follicles to reflect an improvement in hair density. Hair masks and hair treatments can also help.
There is some more good news. If the shedding is caused by hormonal changes, then it should slowly settle down. If you add the right hair products and treatments, you can also improve the volume and texture of hair. However, if the hair loss caused by thyroid issues, iron deficiency or if it goes on longer than 12 weeks, Lisa recommends seeing a doctor to check your thyroid, nutrition and levels of vitamins B12, D, zinc and red cell folates. Hair changes in midlife happen but there is help and solutions available.