Hair shedding is a term for hair loss. Normal hair shedding, 50 to 100 hairs per day, replaces each lost hair with a new hair. Hair loss occurs when new hairs do not replace the lost hairs and thinning or balding takes place. Half of women experience hair loss during menopause and two-thirds of them experience it post-menopause. During menopause, shifting hormones instigate increased hair shedding. Many treatment options and lifestyle changes offer options to reduce menopausal hair shedding.
Hair Physiology
Hair is composed of a protein called keratin. Each hair is enclosed in a hair follicle just below the skin's surface. The base of the hair is fed by the blood stream and contains hormone receptors. A hormone called androgen regulates hair growth on the scalp. Every hair root has a growing cycle, which includes a growth phase, a transitional phase and a resting phase. Hair loss occurs when the follicle is stuck in the resting phase.
Hormones
A form of the male hormone testosterone, dihydrotestosterone or DHT, is the culprit in killing hair follicles. Testosterone is an androgen that both men and women produce in their bodies. As menopause progresses the level of estrogen decreases, unblocking hormone receptors and making them DHT bio-available. DHT shrinks the hair follicles causing shorter hair growth cycles, finer hair and eventually, hair loss.
Hypothyroidism
Hair shedding is a common symptom of many diseases. Incidence of hypothyroidism increases with age and women are 10 times more likely to have low thyroid hormone levels than men. Both menopause and hypothyroidism have similar symptoms, including hair loss. About 26 percent of women are diagnosed with hypothyroidism during menopausal years. Therefore, hypothyroidism may be the cause of hair shedding and should be ruled out by thyroid hormone testing.
Psychological Aspects
Female pattern hair loss increases with age and changing hormones, affecting all areas of the scalp. Such diffuse hair shedding affects a large majority of women by the time they reach the age of 80. Society regards hair loss in men as normal, but in women it's associated with sexuality and gender identity. Losing too much hair generates low self-esteem and anxiety. Combined with other symptoms of menopause, it's viewed by women as a sign of aging and declining attractiveness. Many treatment options are available for menopausal hair shedding.
Medical Treatment Options
Many pharmacological options exist for hair shedding in women during menopause. Topical treatments aim to inhibit DHT binding in the hair follicle, thus maintaining hair regrowth. Minoxidil, or Rogaine, is the most common treatment option. Others include finasteride, cyproterone acetate, spironolactone, and fluctamide. Also, hormone replacement therapy tends to decrease hair shedding in menopausal women.
Hair transplantation and scalp reduction are surgical options. One session of transplantation involves 800 to 1,200 hair grafts and one to three sessions, six months apart. Scalp reduction removes the central portion of the scalp and brings the hair-bearing skin on the sides closer together.
Non-Medical Treatment Options
Cosmetic aid options abound for dealing with hair shedding during menopause. Hairstyling techniques help manage the loss of hair. Shorter, layered sections add volume to hair. Disguise thinness with a side part or zigzag part. Use soft brushes and alternate shampoos. Also, light sprays and styling foams prevent breakage, while providing lift and volume.
Camouflaging products cover exposed areas on the scalp. Hair building fibers, made of keratin, create density in areas of thin hair. Scalp spray thickeners bond fibers to existing hairs, creating density. Hair extensions, hairpieces and wigs replace lost hair, while hair accessories cover and conceal areas of hair loss.
References
- "Clinical Interventions in Aging"; Female Pattern Hair Loss; Quan Q. Dinh, Rodney Sinclair; 2007
- American Osteopathic College of Dermatology: Female Pattern Hair Loss
- American Hair Loss Association: Causes of Hair Loss
- Follicle: Hair Structure and Hair Life Cycle
- New York Times Health: Hypothyroidism In-Depth Report
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