Is perimenopause thinning your hair?
Perimenopause is the run up to menopause. It can start in your 40s, sometimes earlier, and last several years. Hair thinning is one of the changes people notice, and it’s easy to miss because your periods may still seem normal. Plenty of women spend a year wondering whether it’s perimenopause, stress, or just getting older.
Why it happens
Hormone changes are thought to play a part. The British Association of Dermatologists says female pattern hair loss is caused by a mix of genetic and hormonal factors, and the NHS lists hair thinning among the symptoms of perimenopause and menopause. In female pattern hair loss the thinning is mainly over the top of the scalp and the parting looks wider. See the female pattern hair loss guide for more.
Signs it could be perimenopause
A thinner ponytail, a wider parting, more hair in the brush or shower, and hair that feels finer, drier or slower to grow. It’s more likely perimenopause when it comes with other changes: irregular periods, hot flushes, night sweats, poor sleep, low mood or brain fog. No single sign proves it.
Other causes that look the same
Iron deficiency, thyroid problems, a recent illness or heavy stress, and PMOS. Several of these are common in the same years of life and all are treatable, so it’s worth ruling them out before assuming it’s hormonal.
What to ask your GP
Ask whether it’s worth checking your iron levels and thyroid, which are common things to rule out. NICE says that if you’re 45 or over with typical symptoms, perimenopause is identified from your symptoms and cycle changes without blood tests. For ages 40 to 45 with symptoms, a doctor may consider an FSH blood test. Also ask whether minoxidil suits you and whether HRT is worth discussing. See a dermatologist if you notice patches, a sore or scarred scalp, or thinning that keeps getting worse.
What helps
Minoxidil is the main treatment for female pattern hair loss. It usually takes at least 6 months to judge, can cause extra shedding in the first 4 to 6 weeks, and only works while you keep using it. Minoxidil should be avoided if you’re planning a pregnancy or breastfeeding. HRT is mainly prescribed for other menopause symptoms, and how much it helps hair isn’t clear, so treat it as a conversation with your GP. If iron deficiency or a thyroid problem is found, treating it matters, because shedding can come back if the cause isn’t treated. No treatment works for everyone, and the NHS says most only work for as long as they’re used.
Why tracking matters
Perimenopause symptoms come and go. You may also change several things at once, like HRT, iron, minoxidil and sleep, and without a record you can’t tell what’s working. One photo a month of your parting and crown, same light, same angle, shows the trend, and a note of what you changed shows what caused it. It also gives your doctor something concrete.