particularly the decline in estrogen and progesterone, which normally help keep hair thick and in its growth phase. As these hormones fall, the relative influence of androgens (male hormones present in small amounts in women) increases, which can shrink hair follicles and lead to thinner, finer hair.
Other contributing factors include age-related slowing of hair growth, genetic predisposition, stress, nutritional deficiencies, and certain medical conditions or medications. Together, these shifts often result in more hair shedding, reduced volume, and changes in texture that many women notice during the menopausal transition.
As a hormone specialist, I explain to patients that menopause-related hair changes are often subtle but noticeable. The hair itself may become thinner in diameter, giving it a finer, more fragile texture. Many women experience increased shedding, a widening part, or overall reduced volume rather than patchy bald spots. The hair can also feel drier, more brittle, and less shiny because of decreased oil production from the scalp.
In some cases, women notice more breakage or slower growth, and a few may develop mild thinning around the temples or crown due to increased androgen sensitivity. Altogether, menopause hair tends to look less full, with changes in both density and quality.
Menopause hair is typically drier rather than oily. This happens because estrogen levels drop, leading to reduced activity of the sebaceous (oil) glands on the scalp. With less natural oil production, the hair often loses some of its shine, feels more brittle, and may be more prone to breakage.
That said, a small subset of women may notice areas of increased oiliness if androgens stimulate the scalp’s oil glands, but the more common pattern is dryness and loss of luster.
As a hormone doctor, I explain to women that reducing hair loss in menopause requires addressing both the hormonal changes and the overall health of the hair follicle. Restoring balance through bioidentical hormone therapy—such as carefully tailored estrogen or progesterone support—can help protect hair follicles from the effects of declining hormones and excess androgen activity. Optimizing thyroid and adrenal function is also important, as imbalances can worsen shedding.
Beyond hormones, I recommend a nutrient-rich diet with adequate protein, iron, vitamin D, and omega-3s to support healthy growth, and targeted supplements like biotin or collagen when appropriate. Scalp health can be improved with gentle hair care, medical-grade topicals such as minoxidil, and in some cases, low-level laser therapy or platelet-rich plasma treatments. The key is a root-cause, individualized approach that supports both hormonal health and the hair growth cycle.
As a hormone-focused physician, here’s how I guide patients in choosing the right shampoo:
Look for glycerin, hyaluronic acid, and plant oils to counteract reduced sebum output and dryness.
Ingredients such as niacin (vitamin B3), caffeine, peptides, biotin, and saw palmetto support hair resilience and volume.
After menopause, ingredients like caffeine and saw palmetto may help reduce androgen-related hair thinning.
Consider sulfate- and fragrance-free formulas, especially for thin or irritated scalps. A dermatologist or trichologist can guide the choice if conditions like dandruff or dermatitis are present.
During perimenopause and menopause, supporting hair health requires both essential vitamins and targeted supplements that nourish the follicle from the inside out. Key vitamins include vitamin D, which regulates follicle cycling and is often deficient in women at midlife, as well as the B-complex vitamins—particularly biotin, B12, and folate—which are critical for red blood cell formation, oxygen delivery, and keratin production. Vitamin C supports collagen synthesis and iron absorption, while vitamin E and trace minerals like zinc and selenium protect follicles from oxidative stress and structural damage.
Beyond vitamins, collagen peptides provide the amino acids needed to strengthen hair shafts and improve scalp health, and daily protein intake ensures the raw materials for keratin growth. Creatine, though best known for muscle support, also enhances cellular energy in follicle cells, promoting stronger, thicker hair when combined with protein. Omega-3 fatty acids help reduce scalp inflammation and improve circulation, while botanical extracts such as saw palmetto or pumpkin seed can counteract androgen-related thinning.
Taken together, a foundation of hormone balance, nutrient optimization, collagen, protein, creatine, and targeted supplementation creates a powerful strategy to reduce shedding and restore fuller, healthier hair in menopause.
In my practice, I use a multifaceted medical approach to stop or reverse hair loss in menopause by addressing the hormonal root causes and supporting follicle health directly. Bioidentical hormone therapy, including carefully tailored estrogen and progesterone, can help protect hair follicles from the effects of declining hormones, while optimizing thyroid and adrenal balance is equally important.
For prescription therapies, I often recommend topical or oral minoxidil to stimulate follicle growth, spironolactone or other anti-androgen medications to block the effects of DHT on the scalp, and in select cases, finasteride or dutasteride for women with significant androgen-driven thinning.
This combination of hormone optimization, prescription therapy, and regenerative treatments allows me to both slow shedding and encourage healthier, thicker hair growth in my patients.
