Menopause has wide-ranging effects on a woman's body. With the attendant decrease and fluctuations in female hormones, some amount of hair loss is common and can affect hair not only on the head, but hair all over the body. Fluctuations in hormone levels can also cause an unwanted increase in facial hair.
Hair Loss
Hair loss in menopause is most often related to low and/or fluctuating hormone levels. Hormone replacement therapy (HRT) may help ease symptoms, including hair loss and unwanted hair growth. Progesterone, in particular, may be prescribed to balance the effects of estrogen and help restore some of hair's earlier fullness and strength.
Causes of Hair Loss
The fluctuations and decrease in female hormones associated with menopause typically result in hair becoming thinner, lighter and drier all over the body.
However, other kinds of hair loss can occur as well. Bald patches may occur as the result of an autoimmune condition called alopecia areata. With this condition, hair comes out from the roots and is not replaced by new growth. It may affect eyelashes and eyebrows as well as hair on the scalp.
Hair loss occurring primarily on the crown and temples is typical of male pattern baldness, a type of hair loss that affects women as well as men.
Thyroid conditions can contribute to hair loss. Other causes include infections, radiation therapy, ovarian or adrenal tumors and lupus.
Unwanted Hair
The fluctuating and decreasing hormones of menopause can result in unwanted hair. Often this takes the form of dark, coarse hair above the lip, on the chin, in nostrils and around eyebrows.
Causes of Unwanted Hair
When female hormones decrease in menopause, the small amount of androgens (male hormones) can become more predominant. This situation can lead to unwanted hair growth.
Insulin resistance also becomes more common with age and can lead to unwanted hair growth. Several other conditions may cause unwanted hair growth as well, including polycystic ovarian syndrome (PCOS), Cushing's disease, and adrenal or ovarian tumors.
Treating Hair Loss
The only Food and Drug Administration (FDA)-approved treatment for hair loss in women is two percent minoxidil (trade names include Rogaine, Regaine and Avacor). However, some physicians prescribe the stronger five percent minoxidil (typically prescribed for men) for their female patients. Minoxidil is a topical solution applied to the scalp. It produces mild to moderate regrowth of hair in only some of those who use it. Others experience no regrowth at all.
All of the other treatments for menopausal hair loss work by affecting hormone levels throughout the body. Like hormone replacement therapy (HRT), they may produce other desired effects, such as minimizing osteoporosis, but can also increase health risks, including risks related to certain cancers and cardiovascular health.
Hormone replacement therapy itself, in the form of estrogen and progesterone, often results in hair regrowth for menopausal women.
The drug finasteride (trade name Appecia) works well for many men in both preventing hair loss and triggering regrowth and may work for some women.
Cimetidine, sold under the brand name Tagamet, has been studied in women with hair loss, with promising results.
One contraceptive, cyproterone (trade names Dianette and Diane-35) is prescribed in Europe for hair loss in women. This drug must be used for about a year in order to stop hair loss and promote regrowth.
Nizoral shampoo (containing ketoconazole) is available in prescription and over-the-counter strengths, and promotes hair growth by affecting hormone levels.
Treating Unwanted Hair Growth
Techniques used to manage unwanted hair including shaving, waxing, tweezing, depilatories, laser treatments and electrolysis. Some methods last longer than others, but all must be repeated regularly to control hair growth.
According to a Mayo Clinic study of 12 woman with hirsutism (unwanted hair growth), anti-androgen drugs may be helpful in reducing hair growth for some. In this study, women took spironolactone (trade name Aldactone), flutamide (trade names include Flutamide, Flutamin and Eulexin) or finasteride (trade name Appecia) for six months or more. Some also took oral contraceptives or the diabetes medication, metformin (original trade name Glucophage).
Cimetidine, an anti-androgen sold under the brand name Tagamet, has been used to successfully treat excess facial hair growth in women.
