Menopausal Hair Concerns

By: Red Hot Mamas

Published: May 26, 2010

“If truth is beauty, how come no one has their hair done in a library?” – Lily Tomlin

We’ve tamed our manes in many ways throughout our lives by coloring, highlighting, bleaching, crimping, primping, teasing, perming, cutting, washing, styling, ironing, brushing and combing. Having an attractive hairstyle is important to many women and fitting into our society. A good looking hairdo is important in our culture. We see beehives, braids, afros, mullets, mohawks, long hair, short hair, straight hair, curly and pigtails as ways to express our uniqueness and individuality. What happens when we can no longer have the glamour and fun we used to in the hair stylists’ chair. Are we becoming follicly challenged at 50? We also notice our hair becoming a very blah shade, somewhat hard to describe, and turning gray, which has nothing to do with menopause, except they both tend to occur at the same time.

Menopause can affect us, however, in the strangest of ways. Just when we have overcome all of the difficult menopause obstacles, we are hit with one that affects us physically and psychologically at once. Our self-esteem can be vulnerable when it comes to our hair and it doesn’t look how we think it should. When we are confronted with the challenges of growing older and handling hairy issues, it is sometimes difficult to age gracefully. While many women worry about hair loss during menopause, many face the challenge of excess hair growth when suddenly hair disappears from our head and starts growing on our chin or upper lip. Our hair responds to hormonal changes, so let’s try to make some sense of hair changes which sometimes occur at menopause.

Lose your hair, not your mind

About 1/3 of women between the ages of 40 and 80 find their hair thinning all over the scalp. The amount of hair loss varies from woman to woman. During menopause, a concern for some women is the thinning of hair (Androgenic Alopecia or Telogen effluvium). We usually hear the term “female pattern baldness.” It is a common condition that many women experience. According to the American Academy of Dermatology, about 30 million women in the United States are affected. The causes of hair loss can be genetic (Androgenic Alopecia) or non-genetic (Telogen effluvium). Both are treatable although the genetic condition is typically permanent while the non-genetic is temporary.

The genetic version is usually determined by the androgen-estrogen ratio in our bodies. The increase of androgen to estrogen during peri-post menopausal years may contribute to this condition. In general, hair thinning begins at the crown of the head and makes its way forward (this is a different pattern than hair loss seen in men). Currently, the only available drug for this type of hair loss is Rogaine (Topical minoxidil solution). Clinical tests have shown promising results in premenopausal women but no trials have been conducted with postmenopausal women. Propecia (an androgenic alopecia treatment for men) is not recommended for women. Clinical trials have concluded the results were non-effective. Vitamins and minerals with antiandrogen components (zinc, vitamin B6, green tea, saw palmetto) are available and have proven some effectiveness1. Shampoos and other herbal therapies have worked for some women but they are not FDA-approved if you’re considering them, keep it in mind you will be using them at your own risk. If your condition is due to your genetic disposition, it is recommended you find a treatment that is approved and well established in the medical community. Your doctor can recommend hormone evaluations if you experience hair loss suddenly.

Causes for non-genetic hair loss (Telogen effluvium) can be determined by your doctor. Blood tests or physical examinations may determine the cause. Many causes include (but are not limited to) the following:

• Drug use
• Nutritional deficiencies
• Infection
• Endocrine disease
• Trauma
• Malignancy
• Thyroid or liver diseases or disorders
• Hepatic or renal failure
• Anesthesia
• Childbirth
• Drug toxicity
• Very high fever
• Severe stress
• Anemia
• Essential fatty acid deficiency
• Zinc deficiency

Many metabolic or physiologic stresses can cause the condition including menopause. There are many treatments for Telogen Effluvium that you may want to discuss with your doctor including retinoids, beta-blockers, anticoagulants, non-steroidal inflammatories, calcium channel blockers, etc. Discuss your personal options with a doctor if you are experiencing this condition because there is hope! Hair loss can be terribly unsettling. If you notice hair loss, you should consult an endocrinologist or dermatologist.

What about hair GAIN?!

…and some experience unwanted hair growth (Hirsutism). Suddenly we have an eyebrow growing on our chin. Hirsutism usually occurs on the face and is most visible in the form of abnormal, coarse, visible hair growth. The condition affects 5 to 15% of women1 and is usually associated with increased androgen levels. A doctor needs to diagnose Hirsutism because there may be some other causes for an excess of androgen. Other causes include ovulatory dysfunction, adrenal hyperplasia, diabetes and thyroid abnormalities1. Blood tests can determine hormone levels so appropriate treatment can be administered. Treatment may take time (up to 6 to 8 months) so be patient and find a quick solution for the meantime. Quick solutions include plucking, shaving, waxing, or bleaching to immediately remedy the problem. Hormone therapies can slow down the hair growth but will not change the texture or coarseness of the hair. The North American Menopause Society recommends OCs, antiandrogens and finasteride in some combination as a treatment. Electrolysis is the only permanent way to remove the hair, as well as laser hair removal treatments.

“Life is an endless struggle full of frustrations and challenges, but eventually you find a hair stylist you like.” -Author Unknown

¹ The North American Menopause Society, 2005, Menopause Practice: A Clinician’s Guide