Menopausal Hair Changes

We know that just about everyone loses some hair as they age. But we also know that estrogen promotes hair growth and density. So it’s not really clear if any hair changes you’re having are because of the drop in estrogen from menopause or simply part of the aging process.

Estrogen affects the growth cycle of your hair, your scalp and follicle health, and the natural oils that keep hair smooth and lustrous. So, when estrogen levels go down as you move through menopause, your hair may shed, thin, lose density, change texture, and become dry.

If you notice more strands of hair in the shower or bathtub drain, you’re not alone. A 2022 study  ¹ found that 200 out of 200 women participating had menopausal hair loss.

Low estrogen levels also can affect the growth cycle of your hair, shortening the growth phase and delaying the stage when the hair regrows. Your hair follicles also get smaller as you age, so the strands coming out of them are finer, causing an overall lack of density. 

For mild to moderate hair loss, dermatologists often recommend topical minoxidil, an over-the-counter medicine that promotes hair growth. It’s safe for people with a history of breast cancer and moderately effective. Look for products labeled “5% minoxidil foam” that you apply to your scalp when your hair and scalp are dry. It’s ok for women to use minoxidil products labeled for men. Minoxidil is thought to stimulate hair growth by, among other things, improving blood flow to the scalp and prolonging the growth phase of each hair follicle.

Doctors also may prescribe oral minoxidil to help regrow hair, especially if your hair loss is due to breast cancer treatment.

Ketoconazole shampoo (brand name: Nizoral) also can help stimulate hair growth by lowering androgen levels. As estrogen levels go down, androgen, which is considered a male hormone, is more active in the hair follicles. Using ketoconazole shampoo two to three times a week lowers androgen levels and helps regrow hair. 

Just as your skin gets drier during menopause, your scalp and hair do, too. Lower estrogen levels mean less sebum is produced. Sebum is the oil that lubricates the scalp. The result is dry skin and a flaky scalp. If there is less sebum on your scalp, there is less to infuse itself into your hair, so your hair is also drier, duller, more brittle, and more prone to breakage. 

If your scalp is dry, use a gentle, moisturizing shampoo and wash it less frequently.

Lightweight scalp serums can provide moisture that won’t clog the follicles or leave your roots feeling greasy. Look for those with collagen-stimulating ingredients such as niacinamide and moisturizers such as ceramides.

As you get more gray hair, you may find that your hair feels wirier or is suddenly curly in places. Hormones can affect the shape of some hair follicles, changing them from circle-shaped follicles that produce straight hair to oval-shaped follicles that produce curly hair.

The coarse, wiry feel is from lower sebum levels. Sebum helps to maintain hair’s pH in a healthy acidic range. Acidity keeps the hair cuticle cells lying tightly against each other. Lower sebum levels change the pH balance so it’s less acidic; the cuticle cells begin to lift up and pull apart, leaving hair looking dull and feeling rough.

At-home smoothing treatments and deep conditioners with nourishing oils such as coconut and avocado can help soften coarse, brittle hair and help tame frizz. It also can help to avoid using hot styling tools, like hair dryers, hair straighteners, and curling irons because they dry out your hair.

If you’ve been diagnosed with breast cancer, learn more about how to prevent and manage hair loss from treatment.