Reviewed by Dr. Kenton Bruice, MD
Reading time: three minutes
You expect the hot flashes. You expect the night sweats. But what about the hair loss? Many women in their 40s and early 50s are caught off guard by thinning hair during perimenopause. It often starts subtly, more strands in the brush, a wider part, or less volume at the roots.
This blog breaks down why this happens, how low estrogen contributes, and what you can do to support healthy hair growth.
Table of Contents
Key Takeaway
Perimenopause disrupts the hair growth cycle, often due to low estrogen and hormonal imbalance. But with the right testing, treatment, and support, it is possible to restore the health and strength of your hair.
Why Hair Falls Out During Perimenopause
Hair loss in perimenopause stems from hormonal fluctuations that disrupt the normal growth cycle.
Estrogen and progesterone help maintain the anagen phase, the active growing phase of hair. As these hormones decline, more hairs shift prematurely into the catagen and telogen phases, leading to increased hair shedding.
Here’s what contributes to the change:
- Lower levels of estrogen: Hair grows slower and becomes thinner and more brittle.
- Androgen dominance: As estrogen drops, higher testosterone levels can shrink hair follicles, a pattern known as female pattern hair loss or androgenetic alopecia.
- Chronic stress: High cortisol and disrupted sleep further push hair into shedding cycles.
- Poor nutrient absorption: Many women develop iron or B-vitamin deficiencies during this time, which affects hair strength.
- Less blood flow to the scalp: Estrogen helps maintain circulation, and without it, oxygen and nutrients have a harder time reaching the follicles.
Does Low Estrogen Cause Hair Loss?
Estrogen supports hair thickness, follicle lifespan, and scalp hydration. When estrogen declines, the growing phase shortens, and more hair enters the shedding phase.
Signs this could be hormone-related:
- Gradual thinning at the crown or part line
- Brittle strands with less shine
- Increased hair breakage during brushing
- Hair that doesn’t grow as long or fast as before
Solutions for Hair Loss During Perimenopause & Menopause
Hair thinning during this stage of life is common, but it is also treatable. Rather than relying on trial and error, we focus on identifying the root cause and creating a personalized plan for lasting results.
- Comprehensive hormone testing: We measure estrogen, progesterone, testosterone, thyroid hormones, and more.
- Bioidentical hormone replacement therapy: For many patients, HRT can extend the anagen phase and prevent further loss.
- Thyroid optimization: Even subclinical hypothyroidism can accelerate hair thinning.
- Targeted supplements: Iron, vitamin D, B-complex, and omega-3s support hair regrowth from within.
- Lifestyle adjustments: A balanced diet, physical activity, and stress management are crucial for maintaining healthy hair during hormonal shifts.
When to Seek Help
Perimenopausal hair loss is treatable, but early intervention is key. Speak with a healthcare provider if you notice:
- Thinning along your part or crown
- Brittle hair that breaks easily
- Hair fall that persists for months
- Signs of hormonal imbalance or menopausal symptoms
Book a Consultation with Dr. Bruice in Denver
If you are struggling with hair thinning and are wondering if your hormones are part of the problem, we are here to help. To book an appointment at the Denver Hormone Institute of Colorado, call (303) 957-6686 or complete the online inquiry form. We are located at 55 Madison Street, Suite 575 Denver, CO.
📍Other locations:
St.Louis Hormone Institute of Missouri
9909 Clayton Rd, Suite 225 , St. Louis, MO.
📞(314) 222-7567