Why does hair loss happen during perimenopause (and what can you do about it)?

If you’ve noticed more hair in the shower drain or on your brush than usual, you’re not imagining it. Thinning hair is a common, though rarely talked about, symptom of perimenopause. For many women, it comes as a shock - especially when we already have enough to deal with between mood swings, hot flushes, and unpredictable cycles. The truth is: perimenopause hair loss is real, it has hormonal roots, and there are steps you can take to support your hair and confidence.

Table of contents

1. Why does perimenopause cause hair loss?

2. What does perimenopausal hair loss look like?

3. Everyday ways to support your hair

4. Treatments and professional support

5. When to seek medical advice

Why does perimenopause cause hair loss?

Perimenopause is a time of hormonal transition, and one thing hormones influence are your hair. Oestrogen and progesterone - two hormones that start to decline - usually act like protective factors for your hair, keeping strands in their growth phase for longer. As their levels drop, hair may grow more slowly and fall out more easily.

At the same time, androgens (male hormones that women also produce) can become more dominant. Higher sensitivity to these hormones can shrink hair follicles, leading to finer, thinner hair. Genetics also play a role: if your family members experienced hair loss during midlife, you may be more likely to notice it too.

Symptoms of hair loss in perimenopause

Hair loss linked to perimenopause doesn’t usually happen overnight. Instead, it tends to creep in with subtle but noticeable changes:

• Gradual thinning: You may feel like your hair isn’t as full as it once was, especially around the crown or temples.

• Wider parting: Many women notice their part looks more visible as hair density decreases.

• Shedding: Finding more strands in the shower drain, on your pillow, or in your brush can be an early sign.

• Texture changes: Hair may feel finer, more brittle, or prone to breakage.

• Slower growth: New hair may take longer to grow back, making overall volume feel reduced.

It’s important to remember that these changes vary from person to person. Some women see only mild thinning, while others notice more significant shedding. Stress, illness, or nutritional gaps can also make symptoms more noticeable.

Everyday ways to support your hair

While you can’t fully stop hormonal changes, small daily habits can help protect your hair health:

• Gentle care: Avoid harsh brushing, tight hairstyles, and excessive heat styling. Your hair is more fragile now, so treat it kindly.

• Balanced nutrition: Protein, iron, vitamin D, and omega-3s are especially important for hair growth. Think eggs, lentils, leafy greens, and oily fish.

• Stress management: High cortisol (the stress hormone) can accelerate shedding. Yoga, meditation, or even a daily walk can make a difference.

• Scalp health: A healthy scalp is the foundation for stronger hair. Simple scalp massages can improve blood flow and stimulate follicles.

Treatments and professional support

If everyday care isn’t enough, there are treatments that can help. Topical solutions like minoxidil are often recommended for female-pattern hair loss. Some women also explore low-level laser therapy or prescription medications, though these should always be discussed with a doctor first.

For a more natural approach, some supplements claim to support hair growth, especially those with biotin, zinc, or collagen. While evidence varies, they may help if you have deficiencies. It’s always best to consult with a healthcare provider before adding new supplements.

When to seek medical advice

Hair loss can sometimes signal more than just hormonal change. If shedding is sudden, patchy, or accompanied by symptoms like fatigue, skin changes, or irregular heartbeat, it’s important to get checked for conditions like thyroid disease or anaemia. Even if it is “just” perimenopause, speaking to a doctor or women’s health specialist can give you tailored options and peace of mind.

Key takeaways

• Hair loss during perimenopause is common and linked to declining oestrogen and progesterone, alongside increased sensitivity to androgens.

• It usually appears as gradual thinning rather than sudden bald patches.

• Nutrition, gentle care, stress reduction, and scalp health can all help slow hair loss.

• Treatments like minoxidil and certain supplements may support regrowth, but professional guidance is best.

• If hair loss feels extreme or comes with other health symptoms, seek medical advice.

References:

Karishma Desai, Bianca Almeida, Mariya Miteva; Understanding Hormonal Therapies: Overview for the Dermatologist Focused on Hair. Dermatology 31 August 2021; 237 (5): 786–791. https://doi.org/10.1159/000512888

Mirmirani, P. (2011), Hormonal changes in menopause: do they contribute to a ‘midlife hair crisis’ in women?. British Journal of Dermatology, 165: 7-11. https://doi.org/10.1111/j.1365-2133.2011.10629.x

Levy, L. L., & Emer, J. J. (2013). Female pattern alopecia: current perspectives. International journal of women's health, 5, 541–556. https://doi.org/10.2147/IJWH.S49337

Olsen, E. (2008). Female Pattern Hair Loss. In: Blume-Peytavi, U., Tosti, A., Trüeb, R. (eds) Hair Growth and Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-46911-7_10