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Guide to Menopause
|Are You Losing Hair?
Some women notice hair loss during menopause. Hair turning gray is nothing to do with menopause, this is a natural process of aging. But menopause can cause hair to thin, and between the ages of 40 and 80 about 30 percent of women display signs of androgenetic alopecia (AGA), a male pattern of thinning on the crown of the head. To make matters worse, menopause hormones can cause hair to grow where you do not want it, like the face and chin. However if you are shedding more than 150 strands of hair a day, you are losing too much and this should be checked by a doctor.
See an overview of all symptoms of menopause as well as the effects of menopause on the body.
What Causes Hair Loss?
Hormone fluctuations are the primary culprit. Hair follicles are highly receptive to hormone levels and balance. Testosterone is the main hormone responsible for hair growth, but the other male hormone called DHT which comes from testosterone is responsible for controlling excess growth. Although DHT is produced by testosterone, it is actually controlled by estrogen. So as estrogen and testosterone levels fall during perimenopause, DHT production is left unchecked. This can lead to excess hair loss.
AGA is genetically transferred to both men and women. Any genetic predisposition to AGA can worsen in menopause due to hormone fluctuations.
Medications used for treating certain conditions can cause hair loss:
• Heart disease meds.
• Hypertension drugs.
• Chemo medications and radiation therapy used for cancer.
The following conditions, unrelated to menopause, can cause hair loss:
• Polycystic Ovary Syndrome.
• Thyroid Disorders.
• Pituitary Tumors.
• Unusually high levels of iron, proteins or vitamin A in the blood can also cause hair loss.
If you are losing hair at an alarming rate, do report it to your doctor. But sure if your symptoms are menopause related? Read about getting a menopause test.
It is worth locating a doctor who is interested specifically in female hair loss; this may be a hormone specialist or a dermatologist. During a consultation they will evaluate of your hair, skin, diet, hormones and any medical conditions. Based on their evaluation they may recommend any of the following treatments:
Estrogen Hormone Therapy
One of the advantages of estrogen replacement therapy (ERT) is that it can help protect skin and hair from the ravages of menopause (see also menopause skin problems). This is because it increases the liver's production of the sex hormone-binding globulin (SHBG). Studies shows that women with AGA typically have lower levels of SHBG in their blood. Soy isoflavones and green tea may also raise SHBG levels. More recently some women have been prescribed another hormone replacement pill called ANGELIQ which contains estradiol and DRSP (a form of progestogen called drospirenone).
A potassium-sparing diuretic called spironolactone is often prescribed to women suffering hair loss. It not only blocks the effects of DHT on the hair follicles it also reduces episodes of hormone related acne and facial hair growth. It is only available on prescription under the brand name Aldactone. However it has been associated with menstruation disorders in premenopausal and perimenopausal women, so it is often prescribed in conjunction with either an oral contraceptive or ERT. Some doctors will prescribe it in combination with YAZ. YAZ is a lower dosage of the popular contraceptive pill YASMIN.
Shampoos like Nizoral can block DHT production in the hair follicle and promote hair growth as a result. It should be used twice a week between regular shampoos. Although it is marketed as an anti-fungal, anti-dandruff shampoo it also acts as an anti-inflammatory on the scalp. Many people who develop hair loss also experience and itchy, tingling scalp. This irritation is caused by inflammation which can speed up hair loss. It is worth considering using this shampoo in combination with other treatment options. Another alternative is Rogaine HP (Minoxidil), a solution which is applied directly to the scalp. In fact Rogaine is the only FDA-approved topical solution for hair regrowth.
Where all treatment options become exhausted and the loss of hair remains extensive, the only other final option is hair transplantation. Performed under local anesthesia, it involves moving healthy plugs of scalp from one area and transplanting to the hairless area. It is worth asking for the advice of a dermatologist first rather than going directly to a hair clinic. This is considered a cosmetic procedure so it will not be covered on health insurance.
How To Look After Your Hair
Use brushes with soft bristles and only brush your hair it if it is necessary. Avoid tying your hair back tightly.
Avoid using heavy conditioners more than once a week as they tend to drag hair down and emphasize thin hair.
Work with your stylist to create a flattering look for thinner hair. Shorter is always better than longer and soft layering can give the appearance of more fullness.
For more, see treatments for female hair loss.