Menopause and Hair Health

Does Menopause Cause Hair Thinning or Hair Loss?

Hair can be an important part of our appearance and even our identity. It symbolizes vitality. Hair can thin or fall out due to the hormonal changes of menopause. 52% of women over the age of 50 experience female pattern hair loss (Chaikittisilpa S, 2022).

In this blog you will learn:

• How menopause affects hair health 
• How you can improve your hair health while going through menopause

Menopause & Hair Loss

The 2 most common types of menopausal hair loss are (Chaikittisilpa S, 2022):

• Female pattern hair loss or FPHL (androgenic alopecia)
• Telogen effluvium or TE

In FPHL the drop in hormones, specifically estrogen and progesterone, is the issue. Estrogen and progesterone help promote healthy hair growth. The decline in hormones can cause the hair follicles to shrink and weaken, potentially leading to thinning hair. 

TE can be caused by fluctuating hormones or stress. Many women experience TE during menopause. Telogen effluvium often occurs in conjunction with an iron deficiency in pre-menopause women. TE is usually not permanent.

Other factors like family history, other medical issues, diet, stress levels and lifestyle can contribute to hair thinning or hair loss (Chaikittisilpa S, 2022).

How does Menopause Affect Hair Health?

In menopause, the decline in estrogen can cause hair follicles to become thinner and more likely to shed. High estrogen levels before menopause helps keep hair in the growth phase and stops it from shedding quickly. With menopause, estrogen levels decrease significantly and disrupt the hair cycle. Hair follicles can become thinner and weaker, resulting in hair loss or thinning. 

There is an increase in androgen, or male hormones, during menopause which can contribute to hair loss. Testosterone itself isn’t the problem. It’s a hormone called dihydrotestosterone (DHT), which is derived from testosterone. The conversion of testosterone to DHT and its interaction with hair follicles can cause a problem. In some women, DHT can attach to hair follicles and shrink them over time. This is known as miniaturization and can cause thinner finer hair and possibly hair loss. It is similar to male pattern baldness but can happen to a woman going through menopause. 

• Androgens, estrogen and progesterone have all been shown to affect the hair cycle.
• Increased estrogen levels can promote the anagen or growth phase in hair follicles.
• FPHL commonly presents in menopause (Kamp E, 2022)

What are Other Causes of Hair Thinning or Loss in Women?

• A poor diet low in iron 
• Other nutrient deficiencies
• Excessive stress
• Hormonal changes including pregnancy, post-partum & menopause
• Damaging products & over styling

How to Optimize Hair Health during Menopause?

Hair loss during menopause can be distressing. The good news is that hormonal hair loss can grow back after menopause. In order to help, it is important to get the basics right. We can support hair growth with a hair-promoting diet, the right supplements, stress reduction and other good lifestyle habits. 

Eat a Hair-Healthy Diet

Diet is essential for hormone balance, hair health and good overall health. A balanced whole foods diet can prevent deficiencies in the important vitamins or minerals essential to the hair building process.

Prioritize protein and iron. 

Protein is extremely important for hair health. We should aim to consume between 1 to 2 grams of protein per kilogram of body weight. Your weight in kg’s is about half of that in pounds. So, a 120 lb. woman weighs about 55kg and should be eating 55-110 grams of protein. 55 grams of protein is not the same as the weight of your food. This is actual grams of protein per egg (5 grams of protein are in 1 egg) or chicken breast (1 medium breast weighing 120 grams has 37 grams of protein). 

Use an app like Cronometer, My Fitness Pal or others to track grams of protein. Protein should be consumed mainly at breakfast and lunch, with smaller portions in an afternoon snack and at dinner (Goluch-Koniuszy, 2016). Good sources of protein for women include cottage cheese or Greek yoghurt if you tolerate dairy, fish, meat (veal, beef), poultry (turkey, chicken), legumes (lentils, beans, peas, broad beans), seeds (pumpkin, sunflower, sesame), nuts (pistachio, almonds, walnuts), whey protein smoothies and eggs.

Ferritin

Ferretin is the stored form of iron in the body. Ferritin is measured in a blood test. At ferritin levels less than 40 ng/ml, we see hair loss. But at levels between 40 ng/ml and 70 ng/ml, we may also see hair loss (Goluch-Koniuszy, 2016). So, aim for a ferritin level of just over 70. 

The best sources of iron are animal products which contain the better absorbed form of heme iron so eat beef, pork, poultry, lamb, fish. But plant products such as white beans, pistachio nuts, parsley, dried apricots and figs are also rich in iron.  

Other nutrients needed for hair health include:

B Vitamins and especially B12: 

• Low vitamin B12 is linked to excess hair loss in women with B12-deficiency anemia. Sources of B12 are animal products: meat, fish, eggs, milk and dairy products and seafood.
• Folate helps tissues to build hair. Good sources of folate are kale, brussels sprouts, green peas, white beans, asparagus, beets, kohlrabi, halibut, cod.
• Pantothenic acid (B5 vitamin) is responsible for hair growth. Food rich in B5 vitamin are mushrooms, cauliflower, liver, eggs, beans, milk and green leafy vegetables.
• Biotin (B7) is a vitamin whose deficiency can lead to hair loss. Biotin is found in largest amounts in milk products and in vegetables.
• Niacin is necessary for hair. Good sources of niacin are meat, legumes, seeds, milk, green leafy vegetables, fish, peanuts, shellfish.

Vitamin C 

Vitamin C is found in plants and increases the absorption of non-heme iron. Eat vitamin C-rich vegetables (parsley, kale, horseradish, peppers, Brussels sprouts, broccoli, cauliflower, spinach) and low-sugar fruit (black currants, strawberries, kiwi, red currants and citrus fruit).

Vitamin D is important for hair so eat fatty fish (mackerel, wild salmon, sardines, tuna) and mushrooms. Also be sure to get some safe sun exposure so your body can manufacture vitamin D. 

Vitamin A protects hair from being too fragile. However, in excess from animal products, it can also cause hair fall. A good safe source is from carotenoids present in vegetables and fruit.

Minerals are also critical for hair growth. These include zinc, iron, copper, selenium, silica, magnesium and calcium:

• Zinc concentration in blood should be 70-250 µg/dl (Goluch-Koniuszy, 2016). Zinc is plentiful in oysters. Other good sources are other kinds of seafood, red meat, poultry and nuts.
• Iron is found in animal products especially beef, chicken, fish, but also in greens like spinach or nuts such as almonds.
• Copper is necessary in balance with zinc. Good sources of copper include dark chocolate, organ meats, shellfish and nuts.
• Selenium is found in Brazil nuts, seafood and meat.
• Silicon is responsible for growth and shine of hair. It can be found in grains like rice or oatmeal, green beans, garlic, chives and seafood.
• Magnesium is found in cacao, nuts and legumes. 
• Good sources of calcium include dairy products, parsley, hazelnuts, white beans, kale, walnuts, fish and cabbage.

Flavonoids are polyphenols, an important type of antioxidant. Flavonoids found in herbs contribute to faster hair regrowth (Goluch-Koniuszy, 2016). A high level of flavonoids is found in dark chocolate (minimum 70% cocoa), vegetables (onions, tomatoes, peppers, broccoli), fruit (apples, berries, black currant, citrus fruits and grapes), lentils, spices, green tea, coffee and tea.

Fats are necessary too. Focus on foods with essential fatty acids, like flaxseeds or flaxseed oil, wild salmon, tuna, nuts (walnuts, almonds), poultry, eggs and olive oil.

Too many carbs in the form of ultra processed foods high in simple sugars can indirectly cause excess hair loss (Goluch-Koniuszy, 2016). A diet of excessive sugar causes blood sugar dysfunction, high blood sugar and insulin resistance. High insulin increases androgen hormones. In the hair follicle, insulin increases DHT concentration which leads to miniaturization and hair loss as mentioned above (Goluch-Koniuszy, 2016). A healthy hair diet should be low in simple carbs and high in complex carbohydrates with fiber and a low glycemic load. Good types of carbs to eat are rice, vegetables and fruit with a low glycemic load.