What You Need to Know About Perimenopause and Hair Loss
Perimenopause is a natural yet often misunderstood transition in a woman’s life. Its impact on hair and scalp health is one of the most overlooked symptoms of all. While hot flashes, mood swings, and irregular cycles are often talked about, many women are blindsided by another frustrating change: hair loss.
If you’ve noticed your hair isn’t growing like it used to, the texture has changed, seems thinner around the crown or temples, or you’re shedding all over diffuse effluvium, this blog could be for you. These changes you’re experiencing might very well be tied to hormonal shifts that happen during perimenopause. Let’s break down what’s happening from a trichological perspective and how you can take action to manage it.
What Is Perimenopause?
Perimenopause is the transitional phase before menopause, typically starting in a woman’s 40s, and it happens to every woman. During this phase, hormones such as estrogen, progesterone, the follicle-stimulating hormone, and the luteinizing hormone become unbalanced, affecting nearly every system in the body, including the hair and scalp. According to a study published in The Journal of Dermatology, hair thinning and hair loss become more common as women age. By age 60, around 80% of women will experience some form of hair loss. My first recommendation is to see a hormone specialist
Unfortunately, though a large number of women are experiencing symptoms of perimenopause, very few are actually being diagnosed. Evernorth Research Institute stated that of 1.5 million women they analyzed, only 8% were diagnosed with either perimenopause or menopause. This is a problem in and of itself.
Hormones and Hair: What’s the Connection?
Your hair health is directly tied to your hormonal health, and your hormonal health changes during perimenopause. Estrogen and progesterone, in particular, help keep hair in its growth (anagen) phase longer, supporting hair growth and regulating androgen levels. As these hormones decline, the effects of androgens (male hormones like testosterone) become more pronounced, even in women.
When estrogen and progesterone drop, this hormonal imbalance may:
Shorten the hair growth cycle
Increase hair shedding
Cause thinning at the crown, temples, or front hairline (classic signs of female pattern hair loss)
Lead to a change in texture, meaning the hair may feel more brittle, dry, or coarse
Reduce overall density
Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) also play a role here. FSH and LH fluctuate during perimenopause as the body tries to keep hormone levels balanced. As the ovaries become less responsive, estrogen and progesterone drop, and androgens take over—leading to increased shedding, thinning, and changes in hair texture.
Other Contributing Factors of Hair Loss During Perimenopause
While hormones are the main drivers, they aren’t the only reason hair starts to thin during perimenopause. Several other triggers can worsen the issue:
Stress
Stress is a powerful but often underestimated factor in hair loss, especially during perimenopause. When stress becomes chronic, it elevates cortisol, the body’s primary stress hormone. High cortisol levels can disrupt the natural hair cycle, pushing follicles into the resting (telogen) phase too early. This results in increased shedding, a condition known as telogen effluvium.
Emotional stress, life transitions, poor sleep, and even physical stress from illness or overexertion can all contribute to this shift. For many women, the added mental and emotional load of perimenopause, on top of everyday responsibilities, can silently take a toll on the scalp and hair.
Nutrient Deficiencies
Your body needs the right nutrients to support healthy hair growth. Perimenopause often coincides with nutritional gaps that can exacerbate hair loss, including:
Iron and ferritin: Low levels can impair hair follicle function
Vitamin D: Helps modulate the hair cycle and reduce inflammation
Zinc: Supports hair tissue growth and repair
Vitamins B6 and B12: Aid in red blood cell production and oxygen delivery to follicles
Protein: Essential for the building blocks of hair
Underlying Health Issues
Hair loss can also be triggered or worsened by certain medical conditions and treatments, even in otherwise healthy individuals. These could include:
Autoimmune disorders: Conditions like thyroid disease can cause the immune system to attack hair follicles, leading to thinning or patchy loss.
Chronic illness: Long-term illnesses such as diabetes or PCOS can affect hormones and nutrient absorption, both of which impact hair growth.
Certain medications: Drugs for blood pressure, depression, or hormonal conditions can have hair loss as a side effect by disrupting the hair cycle. Speak to your doctor.
How to Manage Hair Loss During Perimenopause: A Trichologist’s Perspective
As a trichologist, I view perimenopausal hair loss as more than just a cosmetic issue. It’s a signal that the body, scalp microbiome, and hair ecosystem are out of balance. That’s why I take an individualized approach and offer personalized, homeopathic solutions for hair loss with every client I see. I don’t believe in quick fixes or one-size-fits-all routines. Instead, I focus on uncovering the root causes—whether hormonal, nutritional, lifestyle-related, or medical—and creating a well-rounded plan that addresses those needs from the inside out.
This may involve reviewing lab work and dietary patterns, supporting the scalp with the right products, or simply having honest conversations about daily habits and lifestyle changes that can help reduce stress. The work is always personal because the path to healthier hair is never just about hair. It’s about supporting the whole body. My goal is to help clients regain not just hair growth, but clarity in how to care for themselves during this transitional time.
Managing perimenopausal hair loss requires a comprehensive strategy. Here’s how I help my clients navigate this complex stage with knowledge and care:
Nutritional Support
My favorite saying is “ We are what we eat.” Before recommending supplements, I assess diet, health history, and bloodwork. But here are general guidelines that support hair and scalp wellness:
Polyphenol-rich foods: According to the Cleveland Clinic, polyphenols—found in colorful fruits, vegetables, and teas—support inflammation reduction, healthy aging, and hair integrity. They noted, “Polyphenols are simply a category of phytonutrients… that help protect your body from the root causes of many chronic illnesses.”
Curcumin, berries, dark chocolate, green tea, oily fish, nuts, seeds, parsley, celery, chamomile
Iron and ferritin testing: Aim for ferritin levels above 70 ng/mL
Lean red meat, lentils, spinach, pumpkin seeds, tofu, fortified cereals
Omega-3s and zinc: Reduce inflammation and nourish follicles
Omega-3s: salmon, sardines, flaxseeds, chia seeds, walnuts.
Zinc: oysters, pumpkin seeds, chickpeas, cashews, eggs, whole grains.
Vitamin D: Many studies have shown that low vitamin D levels contribute to hair shedding.
Fatty fish (like salmon, mackerel, and sardines), egg yolks, fortified milk or plant-based milks, mushrooms exposed to UV light, cod liver oil.
Hair and Scalp Care
Gentle, intentional care is essential during this time. My trichological hair and styling tips include:
Avoid high-heat tools; use lower temperatures and heat protectants
Take organized sections before you blow-dry your hair. This avoids over-dyeing a large section.
Skip tight ponytails or braids that can cause traction alopecia
Reduce harsh chemical treatments (like relaxers or bleach)
Use high-quality shampoos and conditioners that nourish, not strip, the hair, such as the Oribe Serene Scalp Densifying Collection, a product I helped @Oribe create
Incorporate scalp massages with nutrient-rich oils or creams to stimulate circulation, reduce inflammation, and slough off buildup and dandruff
Collaborative Hormonal Support
If perimenopause is suspected, I always recommend that clients work with a hormone specialist. I’m fortunate to collaborate with Dr. Elana Buruiana, a Hormonal expert who takes the time to thoroughly assess hormone levels and create targeted, individualized treatment plans.
Final Thoughts on Perimenopause and Hair Loss
Perimenopausal hair loss is real, and it’s something we need to talk about more often. If your hair has changed and you're unsure why, it’s not vanity. It’s a valid health concern that deserves attention and care. With the right support, you can uncover the root cause, nourish your scalp from the inside out, and restore confidence in your hair journey.
If you want to know if perimenopause could be affecting your hair, book a consultation with me at my trichology center, and let’s explore your scalp health together. I do not pretend to be a doctor and will recommend you to a specialist when needed.
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