Menopause And Our Hair

The perimenopause and menopause phases of our lives can be very confusing as we don't always recognise the early symptoms. For many years it has been such a taboo subject that we never really knew where to turn or who to talk to. It's not always something for which we feel we can visit a GP.

Often, we can feel like symptoms that we are experiencing are all in our mind and we're not quite sure how to put them into words. We don't really know how we’re feeling or what we're experiencing regarding changes our  bodies are going through. 

Until recently you would have thought that there were only a few symptoms such as hot flushes, irregular menstrual cycle, mood swings and hair loss, but the fact is there are a plethora of symptoms that don’t just stop once we are considered ‘post-menopausal’. These symptoms can last for many years thereafter.

There are three stages of the menopause. They are known as perimenopause, menopause and post menopause.

The perimenopausal stage can happen many years before the menopause begins. It is during this first stage that our oestrogen and progesterone levels are beginning to decrease, and it is this decrease that triggers symptoms.
The continued decline of these hormones throughout all of the stages of the menopause is what causes some or all of the symptoms listed below.

• Hot flushes
• Cold flushes
• Night sweats
• Breast tenderness
• Breast enlargement
• Palpitations
• Headaches
• Vaginal dryness, itching or pain
• Bladder weakness
• Bladder infections
• Low libido
• High cholesterol levels
• Fatigue
• Mood swings
• Anxiety and Panic Attacks
• Insomnia
• Dry and Itchy skin
• Bloating and Digestion issues
• Brain fog
• Lack of concentration
• Slow metabolism leading to weight gain
• Hair texture changes

Women are post-menopausal after a full 12 months without a menstrual cycle. Some women enter menopause abruptly due to surgery (surgical menopause) or medication. Most symptoms will generally start to ease, but some women may have symptoms of the menopause for many years.

What changes may I notice with my hair?

The stages of the menopause can trigger 2 main types of hair loss. A reflective type of non-permanent hair loss called Telogen Effluvium and a genetic type of progressive hair loss called Androgenic Alopecia, also known as female pattern hair loss.

During the early stages of perimenopause, the fluctuating oestrogen can cause changes to hair. Other stressors that can exacerbate or cause hair loss during the menopause are mineral or vitamin deficiency, heavy menstrual bleeding and stress.

These changes in the hair can present a lack of density, hair shaft diameter changes, and brittle and dry hair which can result in hair breakage. Curls can change and lose definition; ponytails feel lighter and a shortening of the hair growth cycle results in slow and stunted hair growth.

The hair growth cycle has four phases which are: Anagen (Growing phase), Catagen (Transition phase), Telogen (Resting phase) and Exogen (Shedding phase).

Everybody’s hair grows for a set period of time. This time is genetically predetermined. If the hair growth cycle is behaving normally a hair will grow for a set time, then transition its way through the hair growth cycle to be replaced by a new hair and the entire process starts again.

It is very normal to lose between 50 and 100 hairs a day but in the case of Telogen Effluvium the hair growth cycle is interrupted by one or more of the stressors. This then causes more hairs to transition faster through the hair growth cycle resulting in an increase in the daily hair shedding. This shedding will continue until the stressors have been removed.

Some menopausal women who are genetically predisposed to female patten hair loss find that the menopause will trigger this process. This is due to the decrease of their female hormones. This decrease in oestrogen and progesterone allows androgen hormones (male hormones) to become more prevalent, triggering the process of hair follicle miniaturisation. This results in a reduction of hairs emerging from the follicular units. This in turn causes the mid frontal, vertex and crown area of the scalp to thin in a diffuse pattern. Female pattern hair loss is genetically inherited. It can be passed down from either the maternal or paternal parent or both. It’s a progressive type of hair loss that can lead to permanent thinning in the affective area. If you have concerns about hair thinning you may want to visit a trichologist to find out what treatments and advice are available to help.

It’s really important to choose good hair care products and accessories that can strengthen the hair, and don’t contribute to its fragility.

The right products can really help with the health and look of hair during the menopause. Hair is dead once it emerges from the scalp so it has always been susceptible to weathering, even more so during the stages of menopause. Special care must be taken when dealing with it. Make sure to regularly use hair masks as these will help to strengthen weakened hair fibres. Cleansing of the hair and scalp is really important as this can help alleviate irritation, inflammation, increase volume, remove product build up and moisturise the hair.

Using an organic jersey cotton towel can help prevent breakage.

What treatments are available to ease the symptoms of the menopause?

Hormone replacement therapy (HRT)
This comes in the form of tablets, skin patches, gels and implants.
It’s really important if you are experiencing hair loss to choose hair friendly HRT. Your GP will be able to advise you on which ones are most suitable.

Non-hormone treatment: complementary and alternative therapies
You will read a lot about alternative treatments that help to alleviate the symptoms of menopause but many of these have not been proven to work and some have safety concerns. When seeking complementary and alternative treatments it’s always best to speak to a registered nutritionist. They will be able to advise you on the safest options.

Lifestyle changes, such as a healthy balanced diet
Include foods that are rich in omega 3, vitamin D, B vitamins and calcium, and iron (when needed). Upping your dietary intake of proteins, cutting back on alcohol and giving up smoking, exercising regularly and reducing stress where possible can all help reduce the severity of symptoms.

Omega 3 rich foods such as_
Salmon, sardines, mackerel
Flax and chia seeds

High calcium rich foods such as:
Kale, spinach, collard greens
Figs, oranges, kiwi, pineapple
Poppy, chia, sesame seeds
Milk, yoghurts, cheese (there are lots of fortified non-dairy alternatives available)

Good sources of protein
Fish, poultry, eggs, nuts and seeds, beans, pulses and grains.

What supplements help to treat the symptoms of the menopause?

It’s really important to take the right supplements at the right time during these changing menopausal times

Iron
During your perimenopausal years, you may require additional iron. This mineral is responsible for the production of haemoglobin. Haemoglobin is a protein in your red blood cells that carries oxygen to your body’s organs and tissues. Every cell in our body needs iron for growth and development. It helps your immune system function. Prolonged and heavy periods can cause low serum ferritin. A low serum ferritin result can indicate that the body's stores of iron are low. Good sources of iron are: red meat, sardines and mussels, fortified cereals, pulses, nuts and seeds, quinoa, wholegrain bread and dried fruit.

Post-menopausal iron supplementation is not required as the need for systemic iron reduces.

According to www.nhs.uk women aged 19 to 50 require 14.8 mg per day dropping to 8.7 for women over 50. This is based on the woman no longer having a menstrual period.

Vitamin D
This is a key vitamin for all, but it’s especially important during the menopausal phase. Oestrogen weakens our bones and the decrease that happens during perimenopause and the menopause can have long term effects on them. Vitamin D is essential for the absorption of calcium. There are also many studies that have found that optimal levels of vitamin D can help reduce some menopausal symptoms. Good sources of Vitamin D are: oily fish, eggs and fortified breakfast cereals. We also get Vitamin D from sunlight.

Vitamin B
B vitamins are essential for cellular function. They can improve brain function, help reduce stress and improve sleep as they increase the body’s production of melatonin. They also help to stabilise your mood and support feelings of wellbeing. There are 8 essential B vitamins and ensuring the body has a healthy balance of these can help with the management of some symptoms during the menopause. Vitamin B7 (biotin) is especially important for hair health.

You can read more about vitamins and their benefits in this BBC Good Food article.

Samantha Stewart MIT, Consultant Trichologist at The Spencer Clinic, and co-founder of CURL iD.