Hair Loss During Perimenopause: Why It Happens and What Can Help
Hair changes can become noticeable during perimenopause, including increased shedding, reduced volume or hair that feels finer than it used to. Perimenopause hair loss can be unsettling, but it is not necessarily a sign that something is seriously wrong.
Perimenopause can affect the hair because changing hormone levels influence the hair-growth cycle. However, hormonal changes are not the only possible explanation for thinning or increased shedding. Nutritional deficiencies, thyroid problems, stress, medications and other factors can also contribute.
Understanding what may be behind the change is an important first step towards deciding whether any further assessment or treatment is appropriate.
Can Perimenopause Cause Hair Loss?
Yes. Perimenopause and hair loss can occur together, as hormonal fluctuations during this stage of life can affect the normal hair-growth cycle.
Oestrogen plays a role in supporting the growth phase of the hair cycle. As hormone levels fluctuate during perimenopause, some women may notice that their hair does not seem to grow as thickly or quickly as before.
Hair changes can vary considerably from one woman to another. Some may experience increased shedding, while others mainly notice that their hair looks less dense or that the parting appears wider.
Hair loss does not necessarily happen throughout perimenopause, either. It may become more noticeable at certain points as hormone levels fluctuate.
Why Does Hair Thin During Perimenopause?
Several changes can contribute to perimenopause hair thinning.
Hormonal fluctuations
Fluctuations in oestrogen and other hormones during perimenopause can influence the hair-growth cycle. Some women may notice increased shedding, while others find that their hair becomes finer or less dense. Understanding how hormonal changes can affect your hair can help explain some of these changes.
Changes in the hair-growth cycle
Hair naturally moves through different stages of growth, transition and shedding. When this cycle is disrupted, increased shedding may become noticeable.
This does not always mean that the follicles have been permanently damaged. The pattern and duration of shedding can vary depending on the underlying cause.
Other changes happening at the same time
Perimenopause can coincide with changes in sleep, stress levels, diet, weight and general wellbeing. These factors can also influence hair health.
For example, significant dietary restriction or inadequate intake of nutrients may contribute to increased shedding. Stress can also affect the hair-growth cycle.
What Does Perimenopause-Related Hair Loss Look Like?
Hair loss in perimenopause does not necessarily look the same for everyone.
You may notice:
- More hair than usual in your brush, shower or on your pillow
- A gradual reduction in overall hair volume
- A widening parting
- A thinner-looking ponytail
- Hair that feels finer than it used to
- More visible scalp in areas where the hair has become less dense
- Changes in hair texture, including increased dryness or brittleness
The pattern can provide useful information when assessing the possible cause. Gradual overall thinning may have different contributing factors from sudden or clearly defined areas of hair loss.
Is Perimenopause the Only Possible Cause of Hair Loss?
When hair thinning or shedding develops during perimenopause, assessment usually starts by looking at the pattern and timing of the change alongside your wider health.
A doctor may consider:
- When the thinning or shedding started
- Whether it developed gradually or suddenly
- Where the hair is becoming thinner
- Changes in menstrual patterns and other perimenopausal symptoms
- Your medical history and current medications
- Recent illness, stress or significant changes in weight
- Your diet and nutritional intake
- Any family history of hair loss
- The condition of the scalp and hair follicles
Depending on your symptoms and medical history, blood tests may also be considered to investigate possible contributors such as iron deficiency, vitamin deficiencies or thyroid problems.
The aim is to understand whether the hair changes are likely to be related to perimenopause alone or whether another factor may also be contributing.
How Is Hair Loss During Perimenopause Assessed?
A proper assessment starts with understanding the pattern and timing of the hair changes.
A doctor may consider:
- When the shedding or thinning started
- Whether it developed gradually or suddenly
- Where the hair is becoming thinner
- Changes in menstrual patterns and other perimenopausal symptoms
- Your medical history
- Current medications and supplements
- Recent illness, stress or significant changes in weight
- Your diet and nutritional intake
- Any family history of hair loss
- The condition of the scalp and hair follicles
Depending on your symptoms and medical history, blood tests may also be considered. These can help investigate possible contributors such as iron deficiency, vitamin deficiencies or thyroid problems.
The purpose is not simply to confirm that you are experiencing perimenopause. It is to establish whether something else may also be contributing to the hair changes.
What Can Help With Hair Loss During Perimenopause?
There is no single treatment for perimenopause hair loss. What may help depends on the cause, the pattern of hair loss and your individual circumstances.
If an underlying nutritional deficiency or medical condition is identified, addressing that issue may be an important part of managing the hair changes. Lifestyle factors, including a balanced diet with adequate protein and nutrients and sensible management of stress, can also support overall hair health.
Where appropriate, medical hair-loss treatments may be considered following an assessment. The aim is to choose an approach based on the underlying cause rather than assuming that every case of hair thinning during perimenopause requires the same treatment.
What about HRT?
Hormone replacement therapy (HRT) may be appropriate for some women experiencing troublesome perimenopausal or menopausal symptoms. However, it should not automatically be viewed as a treatment specifically for hair loss.
Whether HRT for menopause is suitable depends on your symptoms, medical history, risks and individual circumstances. A doctor can discuss the potential benefits and limitations as part of a wider menopause assessment.
When Should You Seek Help for Hair Loss?
It is reasonable to seek medical advice if hair shedding is persistent, becoming progressively worse or causing noticeable thinning.
You should also consider an assessment if the hair loss:
- Develops suddenly
- Produces clearly defined bald patches
- Is accompanied by scalp inflammation, scaling or significant itching
- Occurs alongside other unexplained symptoms
- Begins after a significant illness or major change in health
- Is causing considerable concern or affecting your confidence
You do not need to wait until the hair loss becomes severe before seeking advice. Identifying possible contributing factors earlier can make it easier to decide what, if anything, needs to be addressed.
Personalised Support for Hair Loss During Perimenopause
If your hair continues to thin or shed, a doctor-led assessment can help identify whether hormonal changes, nutritional deficiencies or another underlying factor may be contributing.
For women who need a closer assessment of persistent thinning or shedding, Hair Loss Treatment can involve looking at the possible causes before deciding which treatment options, if any, are appropriate.
The aim is to understand the individual pattern of hair loss rather than assuming that every change in hair density is caused by perimenopause.
FAQs About Perimenopause Hair Loss
Does perimenopause cause hair loss?
Perimenopause can contribute to hair thinning and increased shedding because hormonal fluctuations can affect the hair-growth cycle. However, other factors such as nutritional deficiencies, thyroid conditions, stress, medications and genetic hair loss can also play a role.
How long does perimenopause hair loss last?
There is no fixed timeframe. Hair shedding can vary throughout perimenopause and may be influenced by the underlying cause. If shedding is persistent or progressively worsening, an assessment can help determine whether other factors may be involved.
Can hair grow back after perimenopause?
Hair regrowth depends on why the hair has become thinner or is shedding. Some causes of increased shedding can improve when the underlying trigger is addressed, while other forms of hair loss may require specific treatment. An individual assessment is therefore more useful than assuming that all perimenopausal hair loss will or will not grow back.
Can low iron cause hair loss during perimenopause?
Low iron can contribute to hair shedding in some women. If there are symptoms or risk factors suggesting iron deficiency, a doctor may recommend appropriate blood tests before deciding whether supplementation or other treatment is needed.
When should I see a doctor about hair thinning?
Consider speaking to a doctor if thinning is persistent, worsening, sudden, associated with bald patches or accompanied by other unexplained symptoms. An assessment can help determine whether perimenopause is the main factor or whether something else may be contributing.
About the Author
Dr Sandar Hlaing is a GP with a special interest in women’s health, menopause care, hormonal wellbeing, medical weight management, aesthetic rejuvenation, hair loss concerns, and healthy ageing. Through a personalised, evidence-based approach, she helps women understand the physical changes that occur during midlife and develop treatment plans tailored to their individual health and wellbeing goals.
