I’m 61 Losing My Hair – What Do You Think About HRT For Menopause and Hair Loss?

by Geoffrey Redmond, MD

Question:
I am 61 and had been on HRT for 12 years for menopause. The Dr. took me off of it 6 months ago and within 3 months the hair loss started. I went to a Dermatologist who then directed me to a female Gyn. She ran many tests and found that my testosterone was low and estrogen extremely low. I had been on a combi patch for the last 6 years but new Gyn put me on a low dose Prometrium (progesterone) and vivelle dot (estradiol) which I’ve been taking now for 2 weeks. Still my hair loss seems to be getting worse. This is all very distressing to me as my hair was on the thinner side to begin with. I would be interested in hearing any comments you might have on HRT for menopause and hair loss.

Answer:
Menopause is a major event in a woman’s life and in spite of all the media coverage, there is still much confusion about it. While menopause has effects on a woman’s hair, these tend to be ignored both by the medical establishment and by writers on women’s health.

The effect of estrogen is to make hair grow faster and stay on the head longer. Basically more estrogen means more hair. That is why when women are pregnant, hair gets fuller. Turning this around, anything that produces a drop in estrogen can induce shedding. This happens after giving birth, sometimes after stopping birth control pills, and with menopause.

Not all women are equally vulnerable to estrogen drops but most women begin to have thinning hair sometime after age forty-five or fifty, because that is when the ovary slows down and produces less and less estrogen.

Hormone replacement helps hair but hair often needs more estrogen than the rest of a woman’s body. The emphasis now is on using mini-doses of estrogen. While these may help bones and reduces symptoms such as hot flashes, they may not be enough for hair. Using more estrogen generally helps menopause related hair loss but whether estrogen therapy is a good idea depends on a woman’s particular situation.

It is also important to know that after starting any treatment for female alopecia, it takes a minimum of 2 to 4 months to see any improvement in shedding, Regrowth is possible but takes longer.

Patches such as Vivelle dot or gels are the best way to use estrogen.

Estrogen safety issues are important. These are addressed in detail in Chapter 22 of my recent book, It’s Your Hormones.

I hope this makes things a little clearer for you.

About the author: AHLA Contributing Editor Geoffrey Redmond, M.D., is an endocrinologist specializing in female hormone problems. His primary focus for more than twenty years has been conditions in which hormones adversely affect women’s well-being, particularly those which affect appearance. Learn more about Dr. Geoffrey Redmond.

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