Perimenopause Hair Loss: Why It Happens and How to Support Thinning Hair in Women Over 40

Perimenopause can be a challenging time of change – hot flashes, mood swings, and yes, even changes to your hair. If you’re a woman in midlife noticing more strands in the brush or a thinner ponytail, you’re not alone.

Hair loss during perimenopause (the years leading up to menopause) is a common experience for women over 40. In this body-positive guide, we’ll explore why hair thinning or shedding happens in perimenopause and share tips to support healthy hair.

We’ll also cover medically sound treatments for menopause thinning hair, all in an empathetic tone to remind you that your beauty and worth aren’t defined by your hair. Finally, we’ll offer a supportive call to action so you can get more help and community on this journey.

Let’s dive in.

Why Does Hair Thinning Happen During Perimenopause? Perimenopause Hair Loss Explained

Hormones on a rollercoaster:

The primary reason for hair loss in perimenopause is hormonal imbalance. As you approach menopause, your ovaries produce less estrogen and progesterone. These hormones normally help keep hair in a growth phase and contribute to hair fullness. When their levels drop, hair grows more slowly and tends to become thinner and more brittle (Hair Loss and Menopause: How to Prevent It). At the same time, lower female hormones can lead to a relative increase in androgens (male hormones like testosterone). Higher androgen activity around hair follicles can cause the follicles to shrink, resulting in thinning hair or increased shedding (Hair Loss and Menopause: How to Prevent It). In other words, as estrogen wanes, the hair follicle feels the influence of androgens more strongly, which can shorten the hair’s growth cycle.

Female pattern hair loss:

Many women have a genetic predisposition to thinning hair known as female pattern hair loss (the female equivalent of male baldness). This condition often becomes noticeable after menopause, when hormonal protective effects decrease (Androgenetic alopecia: MedlinePlus Genetics). You might see a wider part or overall diffuse thinning on the crown rather than distinct bald spots.

The follicles aren’t dead, but they produce shorter, finer hairs over time (Female pattern baldness: MedlinePlus Medical Encyclopedia) (Female pattern baldness: MedlinePlus Medical Encyclopedia).

Aging and genetics play a role here: virtually everyone experiences some hair thinning as they age. Hair has a natural life cycle that tends to shorten with age, so new growth comes in finer (Your Guide To Aging, Thinning Hair: 5 Simple Tips). Menopause is a big player in this process. As one Cleveland Clinic expert explains, when women enter their 40s and estrogen falls, the hormones that once stimulated healthy strands diminish, and there’s often a slight dominance of testosterone. This can cause some follicles to stop producing new hairs, leading to thinner hair that may not regrow (Your Guide To Aging, Thinning Hair: 5 Simple Tips).

Stress and lifestyle factors:

Midlife is stressful for many women – juggling work, family, and the physical changes of perimenopause. High stress levels can contribute to hair shedding. In fact, extreme stress (physical or emotional) can trigger telogen effluvium, a condition where hair prematurely shifts into the shedding phase a few months after a stressful event (Light Therapy — A Promising Option for Menopausal Hair Loss – Today’s Geriatric Medicine).

Many women noticed increased hair loss about 1–3 months after events like illnesses, surgery, or major life changes (Light Therapy — A Promising Option for Menopausal Hair Loss – Today’s Geriatric Medicine). While perimenopausal hair loss is usually hormonal, it’s important to consider other factors too. Health conditions (like thyroid disorders or anemia), certain medications, and nutritional deficiencies can cause hair loss or make it worse (Light Therapy — A Promising Option for Menopausal Hair Loss – Today’s Geriatric Medicine). For example, if your thyroid is underactive or if you’re low in iron, you might see extra shedding.

This is why doctors often do blood tests (thyroid panel, complete blood count) to rule out other causes (Hair Loss and Menopause: How to Prevent It). The bottom line is that a combination of aging, hormonal changes, and life stressors is usually behind perimenopause hair loss (Female pattern baldness: MedlinePlus Medical Encyclopedia). It’s not your fault, and you’re certainly not alone – by some estimates, over half of women experience hair thinning by their fifties (Women’s Wellness: Can women prevent hair loss? – Mayo Clinic News Network).

(Internal Resource: New to the terms perimenopause and menopause? Check out our guide on Menopause vs. Perimenopause for a primer on what to expect in this life stage.)

How to Support Hair Health During Perimenopause Hair Loss

The good news is that while you may not be able to totally stop hair loss during menopause, there are many gentle, healthy habits that can help maximize your hair’s strength and appearance.

Here are some tips to care for thinning hair and support new growth:

Nourish from within:

A balanced diet is one of your best defenses against hair loss. Hair is made mostly of protein, so make sure you’re eating adequate protein (lean meats, fish, eggs, beans) to provide the building blocks for growth (Your Guide To Aging, Thinning Hair: 5 Simple Tips). Include plenty of whole grains, fruits, and vegetables for vitamins and antioxidants that support hair follicles (Hair Loss and Menopause: How to Prevent It). Essential fatty acids (like omega-3s) are important for scalp health – you can get these from fatty fish (salmon, tuna) or plant sources like walnuts and flaxseed (Hair Loss and Menopause: How to Prevent It). Some evidence suggests certain vitamins (like Biotin, or vitamin B7, and B6 and folate) may help promote healthy hair growth (Hair Loss and Menopause: How to Prevent It), especially if you have a deficiency. Don’t forget to stay hydrated as well. Drinking plenty of water keeps your skin and scalp moisturized and can improve hair quality over time (Hair Loss and Menopause: How to Prevent It). On the flip side, try to limit excess sugar and processed foods, as they can contribute to hormone imbalances.

Be kind to your scalp and hair:

Treat your scalp like fertile soil for your hair. “Treat your scalp like fertilizer that you want to optimize for hair growth,” advises one dermatologist (Here’s How Menopause Affects Your Skin and Hair). This means keeping your scalp clean and balanced – but not overdoing it. If you have a very dry scalp, avoid shampooing every day and opt for gentle, moisturizing shampoos that won’t strip natural oils (Here’s How Menopause Affects Your Skin and Hair).

For an oily scalp, more frequent washing (even daily) with a mild shampoo can keep follicles clear. Regularly using a conditioner is vital to add moisture and reduce breakage (Your Guide To Aging, Thinning Hair: 5 Simple Tips). You can also look for volumizing conditioners or hair thickening products to give the appearance of fuller hair (Your Guide To Aging, Thinning Hair: 5 Simple Tips). When it comes to styling, keep it gentle. Use a wide-tooth comb or a detangling brush to avoid tugging on strands. If you use heat tools (dryers, curling or flat irons), try to limit them because high heat can cause dryness and breakage (Hair Loss and Menopause: How to Prevent It).

Embrace air-drying or use a heat protectant spray when you do style with heat. Avoid tight hairstyles that pull on the scalp – constant tight ponytails or braids can lead to traction alopecia (hair loss from tension) (Light Therapy — A Promising Option for Menopausal Hair Loss – Today’s Geriatric Medicine). It’s also a good idea to skip harsh chemical treatments during this time. If you dye your hair, consider gentler, more natural dyes and get it done by a professional who can minimize damage (Hair Loss and Menopause: How to Prevent It). Simple changes like switching to a satin pillowcase and using soft scrunchies instead of elastic bands can reduce friction on your hair, too.

Manage stress and take care of you:

We know “reduce stress” is easier said than done, but it really can make a difference for your hair (and overall health). High stress pushes more hairs into the shedding phase (Light Therapy — A Promising Option for Menopausal Hair Loss – Today’s Geriatric Medicine). Finding ways to cope with midlife stress will help rebalance your hormones and support hair growth. Exercise is a fantastic stress reliever and hormone balancer.

Whether it’s yoga, walking, dancing, or weight training, pick activities you enjoy and make them a regular habit. Staying active not only helps your mood and stress levels, but also improves circulation (bringing nutrients to your scalp) and can mitigate other menopause symptoms like weight gain and insomnia (Hair Loss and Menopause: How to Prevent It) (Hair Loss and Menopause: How to Prevent It).

(For inspiration, here are some of Menovation’s favorite exercises for tackling menopause belly – remember, exercise benefits everything, from your waistline to your hair!) Mind-body techniques such as meditation, deep breathing, or even just relaxing hobbies can also calm the stress that might be impacting your tresses (Hair Loss and Menopause: How to Prevent It). Make sure you’re getting enough sleep, since your body (and hair cells) regenerates during deep sleep. And finally, be kind to yourself – self-care isn’t selfish. Managing stress might also mean seeking support: talking to a therapist, joining a support group, or connecting with communities of other midlife women going through similar changes.

Consider your hair care routine:

Sometimes, less is more. As hair ages and thins, you might not need to wash it as frequently. Washing too often can strip away protective oils and exacerbate dryness or breakage (Your Guide To Aging, Thinning Hair: 5 Simple Tips). Many women find they can shampoo 2-3 times a week instead of daily. When you do wash, use lukewarm water (hot water can further dry out hair and scalp).

Give yourself a gentle scalp massage with your fingertips while shampooing – this can boost blood flow to hair follicles and feels relaxing. After washing, handle your hair gently: blot (don’t rub) with a towel or use a soft t-shirt to squeeze out water. If you notice your hair is particularly fragile, avoid brushes on wet hair, as wet hair is more elastic and prone to snapping – use a wide comb instead.

Also, protect your hair from environmental damage. Sun exposure and chlorine from swimming pools can dry and weaken hair. Wear a hat when you’re out in strong sun, and use a swim cap or rinse hair immediately after swimming in chlorinated water (Hair Loss and Menopause: How to Prevent It). All these little steps add up to healthier locks.

By adopting these lifestyle and hair care habits, you create a healthier environment for your hair to grow. Remember, new hair growth is a slow process measured in months, so consistency is key. Think of it as a long-term investment in your hair’s future. And regardless of what your hair is doing, embrace a positive mindset: midlife changes are natural, and you are beautiful at every stage.

Treatments and Options to Consider for Perimenopause Hair Loss

If supportive care and lifestyle changes aren’t giving you the results you want, don’t worry – there are additional treatments that many women in menopause use to address hair thinning. It’s always a good idea to consult with a dermatologist or healthcare provider (many are very familiar with hair loss in women over 40). They can help determine if your hair loss is primarily hormonal or if other factors are involved, and guide you to effective treatments (Perimenopause Hair Loss – Can You Prevent It? ).

Here are some medically-sound options worth considering:

Topical minoxidil (Rogaine):

Minoxidil is one of the most widely recommended treatments for female pattern hair loss. It’s available over the counter in 2% or 5% formulations (5% is often labeled “for men” but many women use 5% foam or solution as well). Minoxidil helps improve hair follicle function and can slow or stop hair loss for many women, and even stimulate regrowth in some areas (Women’s Wellness: Can women prevent hair loss? – Mayo Clinic News Network). You apply it directly to the scalp once or twice daily.

Patience is important: it usually takes at least 3–6 months to start seeing results, and about a year to know how much it’s helping (Women’s Wellness: Can women prevent hair loss? – Mayo Clinic News Network). In fact, dermatologists often recommend a trial of 6 to 12 months on minoxidil to gauge effectiveness (Women’s Wellness: Can women prevent hair loss? – Mayo Clinic News Network). If it works for you, you’ll need to keep using it to maintain the benefits (if you stop, the hair you’ve gained or preserved will gradually shed).

Some women experience an initial shedding increase in the first few weeks of use – this can be alarming, but it’s usually a sign the old hairs are making way for new growth. Side effects are generally minimal (some scalp irritation or dryness). Minoxidil has the most research backing it and is considered safe for long-term use in women (Women’s Wellness: Can women prevent hair loss? – Mayo Clinic News Network). It can be a game-changer for menopause-related thinning, helping hair follicles stay in the growth phase longer. If you have questions about how to use it or which strength is right, talk to your doctor or pharmacist.

Low-Level Light Therapy (LLLT):

You might have seen high-tech looking laser combs, caps, or helmets marketed for hair growth. These use low-level red light lasers to stimulate hair follicles. Interestingly, low-level laser therapy has FDA clearance as a treatment for pattern hair loss in both men and women (Low dose laser therapy for hair loss). The therapy is thought to work by improving scalp circulation and cell metabolism in hair follicles, encouraging them to shift into a growth phase (Laser Treatment for Hair Loss: Does It Work?). The good news is LLLT is non-invasive and painless, with virtually no side effects reported (Laser Treatment for Hair Loss: Does It Work?) (Laser Treatment for Hair Loss: Does It Work?).

Home devices (like laser combs or caps) are widely available, or some dermatology clinics offer in-office laser treatments. Does it work? Studies show mixed results – some users see thicker, fuller hair, while others don’t respond as much (Laser Treatment for Hair Loss: Does It Work?). A 2014 study did find LLLT safe and effective for stimulating hair growth in women and men (Laser Treatment for Hair Loss: Does It Work?).

So, it’s a promising option to consider if you’re looking for extra help beyond topical treatments. The downside is that it can be costly and requires ongoing use to maintain results. If you go this route, be prepared to stick with regular sessions (a few times a week) for several months to see improvement (Laser Treatment for Hair Loss: Does It Work?). Many women use laser therapy in conjunction with other treatments like minoxidil for an additive effect.

Stress management and overall health:

This was covered in the tips section, but it bears repeating as part of your “treatment” plan. Because hair loss during menopause is not just a cosmetic issue but often a reflection of internal changes, taking care of your overall health will reflect in your hair.

Some doctors even include stress-reduction techniques and scalp massage as part of hair loss treatment plans because they can improve circulation and counteract the effects of stress hormones on hair follicles (Here’s How Menopause Affects Your Skin and Hair) (Here’s How Menopause Affects Your Skin and Hair). So consider yoga, mindfulness, or other therapies as part of your hair wellness regimen – these have no downside and can improve your quality of life in many ways.

Other medical options for Perimenopause hair loss:

Depending on your specific situation, a healthcare provider might discuss additional treatments. For example, if lab tests show a thyroid issue or iron deficiency, treating those can significantly improve hair density. In women who have signs of excess androgens (like unwanted facial hair or acne along with thinning scalp hair), doctors sometimes prescribe medications such as spironolactone (an oral anti-androgen diuretic) to block the effect of male hormones on hair follicles – this is an off-label treatment that can help in certain cases under medical supervision.

If you’re also experiencing many other menopause symptoms, you might ask your doctor if menopausal hormone therapy (HRT) is appropriate for you; while HRT is primarily for symptom relief like hot flashes and bone health, some women feel it helps their skin and hair by partially replacing estrogen (though HRT is not a guaranteed hair loss remedy and not suitable for everyone). Another emerging option is platelet-rich plasma (PRP) therapy, where a doctor injects growth-factor-rich platelets (drawn from your own blood) into the scalp.

Early evidence suggests PRP injections can improve hair thickness in women with androgenic hair loss (Hair Loss Got You Down? Platelet-Rich Plasma May Regrow It), but this procedure can be expensive and typically done by specialists.

Hair transplant surgery is also a consideration for some, though women with diffuse thinning are usually not ideal candidates compared to men with receding hairlines. Generally, it’s best to start with the least invasive options (like topical treatments and lifestyle changes) and consult a dermatologist if you’re considering prescription or procedural therapies.

Above all, remember that treating hair loss is often a gradual process. There is no instant cure, but many women see meaningful improvement over time by combining a healthy lifestyle with one or two targeted therapies. And if one approach doesn’t work, another might – so stay hopeful.

(External Resources: For more detailed information on treatment options, see the Cleveland Clinic’s guide on female hair loss treatments or this Mayo Clinic article on women’s hair loss which includes expert tips.)

Embracing a Positive Mindset and Next Steps

Facing menopause thinning hair can be emotionally difficult – our hair is tied to our identity and seeing it change can be scary. It’s completely understandable if you’re feeling self-conscious or frustrated. Please know that you are not alone and that hair loss does not diminish your femininity or beauty. Millions of women go through this, and more and more of us are speaking openly about it, which helps break the stigma.

There are even communities and support groups where women share their hair journey and uplift each other.

It might help to reframe the way you think about your hair. Rather than viewing it as a loss of youth or femininity, try to see it as a natural part of midlife – a phase that can be managed with care and patience. Focus on what you can control: nourishing your body, pampering your scalp, and exploring treatments if you want to. Many women find that once they start taking action (like improving their diet or using a treatment), their sense of control and confidence increases, even before any physical results show up. Every small step you take is a win for your wellness.

Lastly, don’t hesitate to seek support. Talk to your friends or family about what you’re experiencing – you might be surprised how many have their own hair thinning stories. If you need expert guidance, reach out to a dermatologist or trichologist (hair specialist). Sometimes, just having a professional confirm that “yes, this is a common issue and here’s what we can do” provides great relief.

You’re Not Alone – We’re Here to Help

At Menovation, we believe menopause and perimenopause are journeys no woman should have to navigate alone. We’re building a community and resources to help women thrive in midlife – from fitness and nutrition to beauty and emotional well-being. If you’re looking for more support and expert-backed advice on changes like hair loss during perimenopause, join the Menovation waitlist today.

By joining, you’ll get early access to our upcoming app and a supportive network of women and specialists (plus some perks like 20% off as a founding member!). This is your invitation to put yourself first and invest in your well-being. Remember: You are strong, you are still you, and you’ve got a whole community ready to uplift you. Your perimenopause hair loss is just one chapter in your story – and together, we’ll help you face it with confidence and grace.

Join the Menovation Waitlist – Empower yourself with knowledge, support, and sisterhood as you embrace this new chapter. You’ve got this, and we’ve got you!