Hair Loss in Women: Exploring the Role of Hormones in Hair Health

Our hair often plays a significant role in expressing our personality and overall health. Changes in hair structure and density can be attributed to various factors. Today, we're delving into the fascinating connection between hormones and the health of our hair, especially in women.

The Impact of Aging on Hormones

As women age, they undergo a natural process known as menopause. This life stage comes with hormonal changes. While the production of male hormones gradually decreases, the decline in estrogen during menopause isn't as sudden.

With the drop in menopausal estrogen, the production of Sex Hormone-Binding Globulin (SHBG) in the liver decreases, leading to an increase in the free androgen index. This means that androgens relatively predominate in the perimenopausal and postmenopausal periods. This hormonal excess may be associated with symptoms such as increased facial hair and thinning of scalp hair in otherwise healthy menopausal women.

Hair Cycle and Estrogens

Estrogens play a key role in regulating the hair cycle. They promote the anagen phase (growth phase) of our hair. Among postmenopausal women, a reduction in the proportion of hairs in the anagen phase has been observed, particularly in the frontal area compared to the occipital region.

The precise role of menopausal estrogen decline and the relative androgen imbalance in the development of androgenetic alopecia (female pattern hair loss = FPHL) during menopause is not yet clearly established. It's assumed that FPHL during the reproductive stage (for example, in the case of polycystic ovary syndrome) and FPHL in postmenopause are distinct entities.

Identifying Causes of Hair Loss

It's essential to emphasize that hair loss in menopausal women is not automatically linked to hormonal changes. Many hair and scalp conditions should be ruled out by a dermatologist. The loss of eyebrows and/or eyelashes is not characteristic of FPHL and menopausal symptoms.

Possible Solutions and Treatments

In addition to traditional approaches such as topical treatments (e.g., minoxidil) and systemic anti-androgen therapy (e.g., off-label anti-androgen hormone therapy, anti-androgenic progestins, spironolactone), various dermatological approaches and numerous over-the-counter (OTC) products for oral consumption or topical application are available. These products follow different therapeutic approaches, including hair growth stimulation, inhibition of the 5-alpha-reductase enzyme, anti-inflammatory effects, and enhancement of perifollicular circulation.

We hope that this exploration of the complex topic of hair loss in menopausal women has been helpful. If you are dealing with hair problems, it's highly recommended to consult a healthcare professional to find the best solutions tailored to your individual needs.

Your health is our priority, and we are here to address your questions.

Warm regards,

Dr. Sandra Yene Amougui

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