Hair loss can be very upsetting, impacting your self-esteem and confidence to an extreme level. While hair loss is often considered a male problem, it’s very common among women around the menopause. The NHS estimates that around 50 percent of women over 65 experience female-pattern baldness. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out why hair loss happens as women age and what you can do about it. Does HRT really fix menopausal hair loss?
As women age, it’s all too common to find they are losing their hair.
There are many different types of hair loss, but most of the time hair loss is due to female pattern hair loss (FPHL).
Dr Lee explained: “Hair loss causes untold misery for women, and some become so distressed that they develop an unhealthy obsession with their body image and appearance.
“Many women start to avoid social gatherings and find this has a negative effect on their social life.
“In one survey 40 percent of women with hair loss complained of marital problems, and 63 percent had work-related issues.
“In another study, 55 percent of women with FPHL were diagnosed with clinical depression, and in a further study.
“However, in the same study 89 percent of these women showed improvements in their depressive symptoms when their hair loss was treated.”
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The exact nature of hormones and hair growth and the cause of FPHL is still not fully understood, but it is thought that FPHL might be caused by high levels of the male hormones – testosterone and androstenedione.
However, the situation is complex, because most women with FPHL do not have raised blood levels of androgens or suffer from hyperandrogenic symptoms.
Dr Lee said: “In men, male pattern baldness has been clearly linked to testosterone metabolism.
“This responds to antiandrogen therapy, using the drug finasteride – a 5-alpha-reductase type two inhibitor, but this is not licensed for use in women to treat FPHL.
“However, some antiandrogens do appear to be effective in FPHL, for example, the diuretic, spironolactone, and the progesterone, cyproterone acetate.”
In one research study, 75 percent of women treated with spironolactone reported improvements in the thickness of their hair.
Dr Lee said: “The usual dose is 100 mg – 200 mg per day. Unfortunately, this is not the answer for many women, as it can cause side effects such as nausea, vomiting, dizziness and low blood pressure.”
Other options are spironolactone, cyproterone, a combined oral contraceptive pill containing estrogen and cyproterone acetate or hormone replacement therapy.
Alternatively, hormone replacement therapy (HRT) can help reduce hair loss, as estrogen is believed to promote hair growth.
Does HRT fix menopausal hair loss?
Hormone replacement therapy can help reduce hair loss, as estrogen is believed to promote hair growth.
Women choose to take HRT at menopause for a variety of reasons, most often to try and control unpleasant hot flushes and night sweats.
However, HRT helps many other menopausal symptoms too, including insomnia, tiredness, joint pains, irritability, low mood, and vaginal dryness and soreness.
One of the lesser-known benefits of HRT is that it stimulates the production of collagen – the main matrix protein (scaffolding) in skin, bone, cartilage, hair and nails.
There is little published research on which HRT preparation to recommend for treating hair loss, however.
Dr Lee added: “The most antiandrogenic progesterones are likely to have the best effects at reducing hair loss.
“These include medroxyprogesterone acetate – for example, found in Indivina, and drospirenone, for example, found in Angelique.”
The risks and benefits of HRT must always be carefully assessed with your GP or menopause specialist, but for most women, the benefits of taking HRT will outweigh the risks.
Dr Lee warned: “Women need to be fully informed about the possible small increased risk of breast cancer from taking combined HRT, versus the protective benefits from HRT on the cardiovascular system, bone health, and the other possible protective aspects against other medical conditions such as dementia and colon cancer.
However, wanting to take HRT to improve their hair is a good enough reason to take HRT if hair loss is causing distress and affecting their quality of life. Taking HRT is always a personal decision.”