April 2011

With menopause, the ovaries cease producing estrogen, the female hormone. This leads to many changes in the body including both increased and decreased hair growth. Hair growth, whether more or less, can impact self esteem due to the effect on one's appearance. It is important to be aware that excessive hair growth, both pre-menopausal and post-menopausal, can also signal abnormal endocrine function or a tumor, although most changes are normal and not worrisome.

Seven hundred and fifty-eight post-menopausal females aged 45 years or older were studied for the changes in their hair patterns. They were all of northern European origin.Twenty-five percent experienced generalized scalp hair loss. Nine percent found that they lost hair on the front of their scalp. In all, forty-one percent of women experienced some form of hair loss. As they continued to age, there was more hair loss over the entire body. Only 39 percent noted excessive growth on their chin and upper lip.

In men, the male hormone, testosterone, has its greatest effect on facial hair. Secondarily, it causes male-pattern baldness. Women make testosterone from the ovaries and the adrenal gland throughout their life. However, prior to menopause estrogen seems to have the stronger effect in women, limiting facial hair growth and maintaining scalp hair. Once the estrogens are lost, it would appear that the testosterone they continue to make causes hair growth on the face along with male-pattern baldness, similar to that in men.

Other body hair is not as sensitive to testosterone. Consequently, overall, women lose sexual and body hair (arm pits, abdomen, chest, pubic, leg and thigh areas, and around the nipples) after menopause.

In this study, the post-menopausal effects on hair changes appeared to be consistent whether or not the woman was on hormone replacement therapy. Post-menopausal women also reported increased dryness of their hair (35 percent) while 3 percent noted more greasiness. The sixth decade of life was the most frequent period for the onset of hair loss. However, 19 percent of women in the 45 to 54 age group had already noted some generalized thinning of their hair.

Several methods are now available to treat both excessive hair growth and hair loss. When women experience excessive hair, the most common treatment is laser. Laser therapy can provide consistent, permanent hair reduction. There may always be a few hairs that continue to sprout back, but the majority of the hair will be destroyed. There are also oral medications that can be used and are quite effective if started early, such as spironolactone (which is primarily used as a diuretic), and finasteride (which is normally used for men who have prostate problems). Both of these medications are male hormone blockers.

The treatment of hair loss is more difficult. There are topical creams that can be used daily, but as soon as they are stopped, hair loss frequently recurs.

In summary, post-menopausal women do experience changes in their hair patterns. As a generality, there is less overall hair on the body. Areas that are more sensitive to testosterone, such as the upper lip and chin, will have increased hair while other areas, such as the front of the scalp, will have less hair. Although many oral and topical treatments are available to treat these conditions, they are minimally helpful at best. Increased hair growth is easier to treat than hair loss. If hair growth is excessive, there may be a need for lab tests to be sure there are no tumors or gland problems.

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