Maybe your part looks wider than it used to, or your ponytail feels thinner. Maybe there's more hair in the shower drain. Hair changes are common in perimenopause and menopause, and they can be upsetting. There's usually more than one thing going on, and you can work on some of them with your care team, including how you're eating.
How Common Is Hair Loss in Menopause?
Very common. The most common cause of hair loss in women, called female pattern hair loss, usually starts in your 40s, 50s, or 60s, and it's more common after menopause. In one study of healthy women ages 50 to 65 seen at a menopause clinic, about half had female pattern hair loss.
Two Common Kinds of Hair Loss at Midlife
Most hair changes at midlife fall into one of two types, and a dermatologist can tell you which one you have.
Gradual thinning (female pattern hair loss). This type builds slowly. Your part gets wider, the top of your head may look thinner, and hair near your temples may recede. It runs in families, and hormones may also play a role. It tends to continue over time, so it's a good reason to see a dermatologist early on.
Sudden shedding (telogen effluvium). This type shows up as a lot more hair falling out all at once. It's usually set off by a stressor on the body, such as significant weight loss, illness, a high fever, surgery, or a stretch of intense stress. Shedding typically starts a few months after the trigger, which is why it can seem to come out of nowhere. It's usually temporary, and hair tends to return to its normal fullness within six to nine months. If the stressor doesn't let up, though, shedding can go on much longer.
Is It Hormones?
Possibly, in part. Researchers believe that losing estrogen during the menopause transition may speed up female pattern hair loss, but the exact role of hormones isn't fully understood yet. Hormones are also rarely the only factor. Genetics, other health conditions, and how well your body is fueled can all matter.
Other Causes to Rule Out
Low iron. Iron deficiency is a well-known cause of hair loss. If you're still having periods, they can become heavier or longer in perimenopause, which raises your risk of running low on iron. After your periods stop, low iron is less common, but it can still happen. Low iron can also leave you feeling tired all the time.
Thyroid problems. Hair that feels dry and thin, along with tiredness, can be a sign of an underactive thyroid. Women develop it far more often than men, especially after age 60.
Your doctor can check for both, so bring up your hair changes rather than assuming they're "just menopause."
How Food Can Help
Think back a few months. Because shedding usually shows up a few months after its trigger, the cause may not be what's happening today. Did you go through a stretch of eating much less, start a new diet, or lose weight quickly? Sudden weight loss and low protein intake are both well-known triggers. Midlife body changes lead a lot of women to cut back on food, and your hair can feel the effects long after. If that pressure sounds familiar, our post on menopause, hormones, and weight changes explains what's happening in your body and why.
Give your hair steady building material. Your body uses protein to grow hair, and when you don't get enough protein, hair can thin or shed. Spreading protein across the day is easier than trying to fit it all into dinner: eggs or a yogurt bowl at breakfast, a bean or lentil soup at lunch, salmon, chicken, or tofu at dinner, and cheese, milk, or nuts at snack time. Protein does its job best when you're eating enough food overall, too.
Pay attention to iron if your periods are heavy. Meat, poultry, and seafood provide the form of iron your body absorbs most easily. Our perimenopause fatigue post covers plant sources of iron and how to absorb more of it. Once your periods stop, your iron needs drop, so get tested before taking an iron supplement. Too much iron can be harmful.
Skip the hair, skin, and nails aisle (for now). These products promise a lot, but the research doesn't support them for people who aren't low in a nutrient. Extra supplements can even work against your hair: high amounts of vitamin A or selenium can cause hair loss. If a product you take contains biotin, mention it before any blood work, since it can throw off some lab results.
When to See a Doctor or Dermatologist
Talk with your doctor or a dermatologist if:
Your part is getting wider or your hair is thinning over time
You're shedding a lot more than usual
You notice patches of hair loss
You also feel tired, cold, or run down, or your periods are much heavier than usual
For female pattern hair loss, treatment works best when it's started at the first sign of thinning, so there's no need to wait and see. A dermatologist can figure out which type of hair loss you have and talk with you about treatment options.
When Eating Feels Complicated
Midlife body changes can stir up old struggles with food, or start new ones. If you find yourself skipping meals on purpose, feeling guilty after eating, or caught in cycles of restricting and then feeling out of control around food, you deserve support with that, too.
Want Support With Menopause Nutrition?
At Wilfong Nutrition, our registered dietitians help women in perimenopause and menopause eat in a way that supports their energy, hair, and long-term health, using a weight-neutral, non-diet approach. We see clients in person in Austin and by telehealth across Texas, and we're in-network with BCBS, Aetna, Cigna, United, and Curative.
Frequently Asked Questions
Does menopause cause hair loss? Hair loss is common around menopause. Female pattern hair loss is more common after menopause, and hormones may play a role, along with genetics. Shedding can also be triggered by stressors like illness or significant weight loss, and low iron or thyroid problems can cause hair loss at any age.
Will my hair grow back? It depends on the type. Sudden shedding (telogen effluvium) is usually temporary, and hair tends to return to its normal fullness within six to nine months once the trigger has passed. If the trigger continues, shedding can last longer. Female pattern hair loss tends to continue over time, but treatment works best when it's started early, so talk with a dermatologist sooner rather than later.
What vitamins help with menopause hair loss? The ones that help are the ones you're actually short on, and a blood test is how you find out. Iron is a common one to check, especially if your periods have been heavy. Vitamins you don't need won't grow more hair, and too much vitamin A or selenium can cause hair loss.
Does biotin help menopause hair loss? Probably not, unless you're low in it, and true biotin deficiency is rare. If you take it, mention it before blood work, since it can throw off certain lab results.
Can low iron cause hair loss? Yes. Iron deficiency is a well-known cause of hair loss, and heavier periods in perimenopause can raise your risk. A blood test can tell you whether you're low.
Should I see a dermatologist for thinning hair? Yes, especially if your thinning is gradual and ongoing. A dermatologist can tell which type of hair loss you have, and treatment for female pattern hair loss works best when started early.
