Menopause Hair Loss: Explained16 min read

During menopause, your body experiences significant fluctuations and shifts in your hormonal landscape. Those fluctuations are responsible for menopause hair loss and thinning that you may experience during this time. A decrease in the production of oestrogen and progesterone and a relative increase in androgens – both can lead to changes in hair growth patterns. Oestrogen helps to promote hair growth by lengthening the growth phase of the hair follicle and delaying the shedding phase. As oestrogen levels decline during menopause, hair growth can slow down and become thinner.

Fluctuating oestrogen effect on hair health

It’s also very important to remember, that it isn’t that your estrogen is gone; it’s fluctuating. So sometimes your hair may look thicker and healthier; other times it may be thinner and duller. When your menstrual cycle has stopped for an entire year, you’re officially in menopause—and those less desirable hair changes may become permanent.

There is also a variation in skin thickness during the menstrual cycle, with skin thickness lowest at the start of the menstrual cycle, when estrogen and progesterone levels are low, which then increases with the rising levels of estrogen. Since your scalp is skin – the changes affecting your skin will also affect your scalp and your hair growth.

oestrogen levels during menopause decline

Specifically, low estrogen levels can cause hair follicles to become smaller, which can result in thinner, weaker hair. The hair growth cycle can also become disrupted, leading to increased hair shedding in menopause and slower hair regrowth. Additionally, low estrogen levels can lead to an increase in androgens, such as testosterone, which can further contribute to hair thinning and hair loss through binding to hair follicles thus causing their minituarisation. We discuss these further in the article.

Some women may wonder, will menopause cause hair loss? It’s worth noting that not all menopausal women will experience hair loss or thinning. However, for those who do, hormone replacement therapy (HRT) can help to increase estrogen levels and promote hair growth. It is more important to focus on your overall health, since menopause is associated with symptoms such as mood swings, sensitivity to stress, and an increase in blood pressure. Those symptoms can be alleviated through lifestyle changes, right diet and exercise.

Collagen in the scalp during menopausal hair loss

Menopause can have a significant impact on collagen production in women. Collagen is a structural protein that provides support and elasticity to the skin, as well as other tissues throughout the body.

Estrogen plays an important role in collagen production by stimulating the activity of fibroblasts, which are cells responsible for producing collagen. When estrogen levels decline, fibroblast activity decreases, leading to a reduction in collagen production.

As a result, women may experience changes in the texture and appearance of their skin, including thinning, dryness, and wrinkles. Even premenopausal women experience some of these effects – where in the first part of your cycle when oestrogen is high, your skin is actually thicker than in the second, post-ovulatory part – when levels of oestrogen are low.

It may be an obvious statement, but your scalp is your skin. So it is going to be affected by the same factors as your skin does. Meaning that the skin on your scalp is going to become thinner as menopause is approaching as the production of collagen is also decreasing. This means that your hair follicles don’t get enough structural support in the epidermis (upper layer) of your scalp and therefore collapse leading to menopausal hair thinning.

You might also notice drier scalp as you are approaching menopause due to skin losing collagen. Therefore you are more likely to experience dry and itchy scalp.

How to support collagen production during hair loss in menopause

There are several ways to support collagen production during menopause, including maintaining a healthy diet and incorporating strength-training exercises into your fitness routine. Vitamin C is especially important for collagen synthesis.

Local production of collagen however can be stimulated by scalp microneedling or dermarolling. This process creates small wounds in scalp and around hair follicles which signals your body to produce more collagen in those areas. This extra collagen provides structural support to your hair follicle and supports the growth of your hair.

Dermarolling for hair growth – micro needles penetrating the skin to prompt production of collagen in the dermis.

Mood swings, stress, and hair health

Serotonin is a neurotransmitter involved in regulating mood, appetite, and sleep, among other functions. Estrogen affects serotonin levels in several ways, both directly and indirectly:

  1. Estrogen can influence the production of serotonin by increasing the activity of the enzyme tryptophan hydroxylate. Estrogen also increases the density of serotonin receptors in the brain, which can make the brain more sensitive to serotonin.
  2. Estrogen can affect serotonin reuptake by modulating the activity of serotonin transporters, responsible for removing serotonin from the synapse after it has been released. By inhibiting the activity of these transporters, estrogen can increase the amount of serotonin that remains in the synapse, thereby prolonging its effects.

In other words, interactions between serotonin and estrogen often contribute to the mood changes (mood swings) that women may experience during their menstrual cycle, pregnancy, and menopause – the periods where oestrogen fluctuations are at their highest.

During your menstrual cycle, oestrogen levels fluctuate affecting serotonin levels which contribute to premenstrual syndrome (PMS) symptoms: mood swings and irritability. Similarly, when you see menopause hair loss it’s because there is a decline in oestrogen levels that can lead to a decrease in serotonin levels. This also results in mood changes and even depression.

mood swings during menopause

How does your mood swings affect your health?

Your mood swings play a huge role in your hair growth. When you are irritable, sad or experience feelings of depression – you are more likely to resort to trying to quickly fix those uncomfortable emotions. Such quick fixes often include reaching to a glass of wine, or snacking on foods high in sugar and saturated fats.

The issue here is: that your hair health starts from within: you cannot expect your body grow healthy hair if what you’re putting in it – is junk. Lifestyle and a balanced diet play a huge role in hair growth. So if you’re feeding your body with alcohol and unhealthy foods – your hair will show the same.

In addition, with lower serotonin levels, you are more susceptible to stress – and stress is one of the primary reasons for female-pattern hair loss. Therefore it is important to treat your mood swings holistically – specifically by adopting a regular meditation practice, which in more recent studies show significant results in improvement management of mood swings linked to hair loss in menopause.

High blood pressure during menopausal hair loss

Estrogen has a complex relationship with blood pressure, and the effects of estrogen on blood pressure can vary depending on a variety of factors, such as age, health status, and lifestyle factors.

During the reproductive years, estrogen has a protective effect on blood vessels. It helps maintaining their elasticity and flexibility as well as helping and promoting relaxation of blood vessels and improving blood flow. As a result, premenopausal women tend to have lower blood pressure than men of the same age.

However, during menopause, decline in estrogen can lead to an increase in blood pressure. This happens due the effects of estrogen on the renin-angiotensin-aldosterone system (RAAS), a system which regulates blood pressure. Estrogen normally regulates and inhibits the activity of the RAAS, which can help to lower blood pressure. But when estrogen levels decline, the RAAS can become more active, leading to an increase in blood pressure.

Other factors, such as lifestyle habits and underlying health conditions, can also influence the relationship between estrogen and blood pressure. For example, women who are overweight, have a sedentary lifestyle, or have a family history of hypertension may be more likely to experience an increase in blood pressure during menopause.

Blood pressure and menopause hair loss

But why we’re even talking about blood pressure so extensively and why is it important to hair growth?

blood supply to hair follicles anatomy of the hair follicle

Each hair follicle has a tiny blood vessel attached to it – through which your hair receives nutrients and oxygen. The better the blood supply to your hair follicles, the better and stronger is your hair. Since oestrogen has a vasodilatory (expansive) and relaxing effects on your blood vessels, during the menopause reduction in oestrogen leads to restriction of blood supply to your hair follicles. Constricted blood vessels cannot deliver the nutrients to your hair follicles – which leads to hair follicle minituarisation (reduction in size), menopausal hair thinning and hair loss.

True, you can get a prescription for a blood pressure-regulating medication, but there are also holistic and natural ways to manage your blood pressure during menopause:

  1. Lose extra weight and watch your waistline
  2. Regular exercise
  3. Eat a healthy diet
  4. Reduce amount of salt (sodium) in your diet
  5. Limit alcohol
  6. Quit smoking
  7. Get good night sleep consistently
  8. Reduce & manage stress
  9. Monitor your blood pressure and get regular checkups

Overall, the link between estrogen and blood pressure is complex, and further research is necessary to fully understand the mechanisms. However, it is clear that oestrogen plays an important role in maintaining cardiovascular health linking directly to blood supply to your hair follicles, your hair health and hair growth.

Iron levels during menopause hair loss

As we were on the subject of blood supply, we need to mention haemoglobin – the part of red blood cells that gives blood its red colour and enables the red blood cells to carry oxygenated blood throughout your body. Your body needs iron to produce haemoglobin, so if you have an iron deficiency, the levels of oxygen and its efficiency of delivery is also going to be reduced.

blood test for iron deficiency during menopause hair growth

During menopause hair loss, levels of irons decline as a result of the same hormone fluctuation:

  1. Reduced Iron Absorption: Estrogen usually enhances the absorption of iron from the gastrointestinal tract. It promotes the production of a protein called duodenal cytochrome B, which increases iron uptake from the diet in the small intestine and ensures adequate supply of iron from the food you eat. During menopause, fluctuation and reduction in estrogen decrease this activity.
  2. Regulation of Hepcidin: Estrogen helps regulate the production of a hormone called hepcidin, which controls iron homeostasis. Hepcidin regulates iron absorption and distribution by inhibiting the release of iron from storage sites and reducing iron absorption in the intestines. Estrogen suppresses hepcidin production, allowing for increased iron availability for utilization. Fluctuation in estrogen levels affects how much iron hepcidin makes available in your body.
  3. Iron Storage: Estrogen promotes the storage of iron in the body. It enhances the synthesis of ferritin, a protein that binds and stores iron within cells. This helps maintain iron reserves, which during menopause is reducing due to fluctuation and reduction in estrogen levels.

During menopause, as estrogen levels decline, this affects iron absorption and storage. As a result, your blood produces less haemoglobin and therefore has less oxygen carried throughout your blood supply system. Your hair needs oxygen in order to grow healthy hair, so as a result this can lead to hair loss and hair thinning with menopause.

Estrogen and scalp dryness

You often forget that your scalp IS your skin – so anything that affects your skin will affect your scalp, too. And you cannot grow healthy hair without a healthy scalp.

Normally oestrogen helps promote the production of collagen and hyaluronic acid, two compounds that are essential for maintaining skin hydration and elasticity. As estrogen levels decline during menopause, there is a decrease in the production of these compounds, leading to skin dryness, thinning of the skin, and a loss of elasticity.

scalp dryness during menopause

In addition to its effects on collagen and hyaluronic acid production, estrogen also affects sebum production, which can impact skin and hair hydration. Sebum is an oily substance produced by the sebaceous glands in the skin, located next to each hair follicle – which helps to lubricate and protect your skin and hair. Estrogen stimulates sebum production, keeping the hair hydrated and reducing dryness. When estrogen levels decline during menopause, sebum production may decrease as well, contributing to hair dryness.

As a result of these changes, you may experience a variety of skin-related symptoms during menopause hair loss, including scalp dryness, itching, and irritation. These symptoms can be exacerbated by other factors, such as exposure to harsh weather conditions, the use of certain medications, and changes in hair care routine.

How to manage dry scalp during menopause hair loss?

To help manage overly dry hair during menopause, it is important to:

  • Minimise use of shampoos with harsh surfactants (e.g. SLS)
  • Avoid using of high heat styling tools (e.g. hair straighteners, curling irons, blow dryer on high heat)
  • Moisturise your scalp with regular oiling
  • Massage your scalp at least twice a week for 10+ minutes to stimulate your hair follicles and sebaceous glands

Androgens effect on the hair follicles during menopause hair loss

Androgens are male hormones that are present in both men and women, but at lower levels in women. During menopause, when estrogen levels decline, androgen levels may become relatively higher, which can have a negative impact on hair follicles – leading to hair loss and hair thinning.

Interestingly, androgens can actually stimulate hair growth in certain areas of the body, such as the face, chest, and pubic area. But in your scalp, androgens have the opposite effect. Androgens interact with the hair follicles, leading to a process known as miniaturization. 

In this process, the hair follicles become smaller and produce thinner, shorter hairs, which can eventually lead to menopause hair loss and hair thinning. 

Higher amounts of androgens during this stage of your life can lead to female-pattern menopause hair loss and thinning – otherwise known as diffuse thinning. This pattern occurs all over the crown, as opposed to men where hair loss occurs usually above the temples.

androgen hair loss in men and women

The sensitivity of hair follicles to androgens can vary between individuals and can be influenced by genetic factors. Women genetically predisposed to hair loss may be more susceptible to the effects of androgens during menopause.

How to manage androgens during menopause for hair growth?

The relationship between androgens and hair loss during menopause hair loss is complex, for example in some studies androgens have shown to change the shape of the hair follicle – which can impact your hair texture (e.g. making it go curly while your entire life you had straight hair!). Further research is needed to fully understand the mechanisms involved. However, it is clear that androgens can play a role in hair loss during menopause, and women who are experiencing hair loss or thinning during menopause should discuss their symptoms with a healthcare provider to determine the best course of treatment.

To help manage relative increase of androgens during menopause you can:

  • manage excess weight – people with excess weight have increased amount of androgens
  • lower your blood sugar levels which can help alleviate insulin resistance (insulin has shown to promote androgen production)
  • use topical solutions that have natural DHT blockers such as caffeine
  • taking 30g of flaxseed (linseed) on a daily basis – linseed has shown to promote oestrogen-androgen balance in women

A hair plan for your menopause hair loss

Some changes to your body during menopause are permanent, however some changes – are not and can be managed. During your menopause it is important to treat yourself with compassion, patience and kindness – it is also important to connect with others who either have gone or are going through the same process – which will help you feel less alone.

When it comes to your hair health, prepare yourself to discover your hair once again – it may change texture, it may change colour (and not only going to gray!) – so it’s important to stay curious about those changes. Examining carefully your haircare products and ensuring they contain the highest quality ingredients that are gentle to your scalp and scalp is key.

Last but not least, looking soberly and honestly at your lifestyle from the nurturing perspective – will help you develop rituals and new habits that will support your hair health.

At The Hair Fuel we believe in a holistic approach to hair health. Which is why we developed a gentle programme that takes only 42 days / 6 weeks to guide you back to your hair health. It’s completely free and aims to support women in their journey of regrowing their hair – due to hair shedding in menopause, illness, stress episodes and various health conditions.

Who we are:

The Hair Fuel is an all-natural hair growth mask created by Laura Sagen, who lost a third of her hair after a terrible visit to a hairdresser while suffering from a life-long condition of PCOS associated with androgenic hair thinning. She developed the formulation rooted in the science of scalp blood flow, which has become The Hair Fuel growth mask. Since then, her company has helped thousands of people like you to start growing healthy hair.

We work closely with our lab and manufacturers to ensure the highest quality product. But a product alone is never enough – so we hold your hand throughout your own, unique hair growth journey. Our flagship product, The Hair Fuel mask coupled with tailored advice, digital tools, and online support is there to help you grow the best hair you can. It’s a big claim – but we’re unafraid to make it. Check out our starter bundles >>


Effect of estrogens on skin aging and the potential role of SERMs, (1)

Estrogens Induce Rapid Cytoskeleton Re-Organization in Human Dermal Fibroblasts via the Non-Classical Receptor GPR30, (2)

A potential association of meditation with menopausal symptoms and blood chemistry in healthy women, (3)

Estrogen Supplementation Decreases Norepinephrine-Induced Vasoconstriction and Total Body Norepinephrine Spillover in Perimenopausal Women (4)

Hormonal effects on hair follicles, (5)


Drinking water for hair growth: does it help your hair?


What do dead hair follicles look like?

Leave a Comment