I explained to Emily that The Iowa Writers’ Workshop wasn’t really in the business of handing out medical degrees, but that since my hair was also thinning, and since I was curious, and since I supposed we weren’t the only two women on the planet who wanted some answers, I’d do some research. This is what I came up with for how to handle hair loss during perimenopause.
The important distinction between male pattern baldness and female pattern hair loss is that, whilst men may develop absolute baldness – when the damaged follicles can no longer function so hair growth stops, and the skin takes on a smooth, shiny appearance – this is rare in women. Women’s hair loss may become advanced, but true baldness – as men experience it – is highly unlikely.
Androgens are male hormones, which are found in women as well as men, but to a lesser degree. Menopause causes androgen levels to increase, which can in turn trigger thinning of the hair on your scalp and can also cause extra facial and body hair. Androgens do not necessarily decrease your number of scalp hairs, but reduce their diameter and length. The result is a loss of volume or ‘body’. Your hair may not be falling out more, or failing to grow back - but the replacement hairs are weaker and finer.
Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.
Trichotillomania, or hair-pulling disorder, often afflicts those with Obsessive Compulsive Disorder or anxiety. According to the Mayo Clinic, anxiety attacks often result in hair-pulling episodes that can cause permanent hair loss for Trichotillomania sufferers. Those with the condition can benefit from habit reversal training, cognitive therapy, acceptance and commitment therapy, and, in extreme cases, mood-stabilizing medication, like Prozac or Paxil.

This ‘diffuse generalized hair loss’ is present in 26% of post-menopausal women over the age of 45, according to the British Association of Dermatologists’ study.  That includes hair not just on the top of your head, but also near what they term ‘androgen-sensitive sites,’ or the hair ‘down there.’ It thins out, too, even as facial hair gain takes root in most women: 40% attested to that in this particular study.  So, in essence, thick hair where you don’t want it and thinning where you want the hair to stay put and grow.


Lifestyle changes, combined with alternative medicines, are a highly effective treatment option for most women suffering from menopausal hair loss. However, for some women, the symptoms will be so severe that a more drastic treatment is necessary. Before beginning to take prescription medicine or getting surgery, a woman should consult a trusted medical professional to better understand the potential benefits and risks involved.
Minoxidil (Rogaine, generic versions). This drug was initially introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research studies confirmed that minoxidil applied directly to the scalp could stimulate hair growth. As a result of the studies, the FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is need for a woman's hair loss.
Minoxidil (Rogaine, generic versions). This drug was initially introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research studies confirmed that minoxidil applied directly to the scalp could stimulate hair growth. As a result of the studies, the FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is need for a woman's hair loss.

Research is looking into connections between hair loss and other health issues. While there has been speculation about a connection between early-onset male pattern hair loss and heart disease, a review of articles from 1954 to 1999 found no conclusive connection between baldness and coronary artery disease. The dermatologists who conducted the review suggested further study was needed.[41]
Last summer, I started visiting the Philip Kingsley hair clinic in New York City every week to strengthen the fragile wisps that were sprouting up along my hairline as a result of my prescription treatments. There, I learned that physical as well as emotional stress can cause temporary thinning and make genetic hair loss worse. Consider it something like a domino effect. When 44-year-old fitness instructor Maria Santoro was hospitalized for a severe allergic reaction to her pneumonia medication, she lost 20 pounds in 10 days, and her chestnut waves started falling out in clumps. "People assumed I was anorexic," she says. "My body was in shock, and I felt really insecure because of my weight loss and thin hair. It was devastating."
Whereas it is normal to drop between 50 plus 100 strands of hair a day, severe hair loss — medically called as alopecia — is a mark that a little is wrong with our body. As a reaction to an event of extreme mental otherwise physical stress, the body classically drops hair later than a gap of three months. For example, if you are down by food poisoning, the mal-absorption of nutrients throughout this period can guide to hair loss in the after that few months. Therefore, it’s significant to jog your remembrance to locate the reason.
Oral Medication: “In cases of androgenetic alopecia, finasteride is still the gold standard,” says Fusco. (Finasteride is the generic version of Propecia, which can be prescribed by your dermatologist and is also available via mail subscriptions.) Fusco says that even younger men can slow or delay hair loss by starting a daily finasteride prescription. “This medication works by inhibiting an enzyme that leads to hair loss,” she notes. “In clinical trials, 90 percent of the patients either gained hair or maintained their hair over a five-year period.”
Women also have more of an enzyme called aromotase, which stimulates the hormone production of estrone and estradiol; both of these hormones act against hair follicle-shrinking DHT. In most women, aromotase production is significant at the front of the hairline—meaning loss here is less common in women, but not impossible. Sometimes, conditions such as hirsutism, ovarian abnormalities, infertility and menstrual irregularities may interfere with estrone and estradiol production so that loss at the hairline occurs.
In my youth, stylists would always tell me, "Wow, you've got a lot of hair." So much so that I took my lush mane for granted—perming, straightening, and bleaching my way through my teens. But everything changed during my sophomore year of college, as I found myself pulling more and more tangles out of my brush and strands from the shower drain. The compliments stopped and the worry began. I jealously examined the girl next to me on the subway. Why couldn't I see through to the roots on her scalp, too?

Senescent thinning of the scalp hair, or thinning that occurs after age 60, is poorly understood, and it is unclear whether this is a distinct entity or part of the continuum of androgenetic alopecia (AGA).  In a previous study, young males age 18 to 30 with Androgenetic Alopecia had higher levels of 5a-reductase type 1 and 2, more androgen receptors, and lower levels of cytochrome P-450 aromatase in hair follicles in the frontal region of the scalp than in the occipital region.
One-fifth of men will experience significant hair loss by age of 20(!), and that percentage grows proportional to age. Bauman says that significant loss increases steadily with age: 30 percent will experience it in their 30s, 40 percent in 40s, and so on. “This math proves true for men into their 90s,” he says. “If you go unchecked but have maintained most of your hair by middle age, then your sensitivity to DHT is probably on the low side, meaning you have a slower rate of male pattern hair loss going on.”
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."

Senescent thinning was indistinguishable from androgenetic alopecia in older males. Inflammatory changes were not a significant feature. Biochemical analysis for androgen receptors, 5 -reductase type 1 and 2, and aromatase, in scalp biopsies from older males showed nearly a two fold decrease in levels compared to levels in young males with Androgenetic Alopecia.


Though not as common as the loss of hair on the head, chemotherapy, hormone imbalance, forms of hair loss, and other factors can also cause loss of hair in the eyebrows. Loss of growth in the outer one third of the eyebrow is often associated with hypothyroidism. Artificial eyebrows are available to replace missing eyebrows or to cover patchy eyebrows. Eyebrow embroidery is another option which involves the use of a blade to add pigment to the eyebrows. This gives a natural 3D look for those who are worried about an artificial look and it lasts for two years. Micropigmentation (permanent makeup tattooing) is also available for those who want the look to be permanent.
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."
Younger men and women experiencing hair loss is not a good sign if one experiences such unwanted emotions will creep in and further damage will be incurred so deal matters well talk a hair doctor. Have a proper consultation and don’t make matters worst by self-medicating yourself. Getting treatment does not mean you’re weak but a good way to deal with the problem.
An unhealthy scalp environment can play a significant role in hair thinning by contributing to miniaturization or causing damage.[citation needed] Air and water pollutants[citation needed], environmental toxins,[citation needed] conventional styling products and excessive amounts of sebum have the potential to build up on the scalp.[citation needed]. This debris can block hair follicles and cause their deterioration and consequent miniaturization of hair.[citation needed]. It can also physically restrict hair growth or damage the hair cuticle[citation needed], leading to hair that is weakened and easily broken off before its natural lifecycle has ended.[citation needed]
Localized or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). Tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
When several of my classmates back in my senior year of college went bald (one went bald in about one year) I couldn’t believe my reaction. I was envious. Unbelievably, I wanted to go bald. I wanted to lose all my hair from the top of my head, leaving just a fringe on the sides and back: male pattern baldness. I had no idea guys still in their early 20s could go bald and I was shocked. I couldn’t wait for it to happen to me. I tried to shake off the urge, but had to finally admit to myself that male pattern baldness was I really, really wanted. But not until after I was married. I was afraid that no woman would want me if I was bald. Back then, I had no idea that there are women out there who actually prefer bald men. Lucky for me, I’m married to one of those women. When my wish finally came true in my early 50s, my wife was thrilled and she urged me to just let myself go bald. I did, and it happened very quickly, as if to make up for lost time. After only two years of finding hundreds of hairs on my pillow each morning and wads of my hair plugging our shower drain I was finally bald, male pattern bald. The rapid transition to bald was a very pleasant experience for both my wife and me and I absolutely LOVE being bald. My wife loves it too and still tells me how sexy she thinks it is. I love it when she kisses me on top of my shiny bald head. What a turn on! Going bald was one of the best things that ever happened to me. I just wish it had happened immediately after my wife and I were married, 40 years ago. I wish I had started shedding hair off the top of my head on our honeymoon and had been bald by our second wedding anniversary.
Another of the key clues is a feeling that the hair is not as thick as usual – for instance when putting the hair into a ponytail, it may seem less dense. Although this may make it difficult for any obvious changes to be observed, many women intuitively know when something is different – and this would be a good time to see a hair loss expert to ascertain exactly what is going on.
Follicles grow in cycles (growing – resting – falling out). Therefore, not all follicles grow at the same time and they have periods of rest. During the rest period the hair may remain in the follicle for some time or it may fall out. This cycle repeats itself for the whole of your life. It takes 8-12 weeks for a hair to grow from the base of the follicle to the surface of the skin. This means that if you remove a hair, you may have to wait 8-12 weeks for it to grow again. Hairs you see growing a few days later in the same area are from different follicles.
The psychology of hair thinning is a complex issue. Hair is considered an essential part of overall identity: especially for women, for whom it often represents femininity and attractiveness. Men typically associate a full head of hair with youth and vigor. Although they may be aware of pattern baldness in their family, many are uncomfortable talking about the issue. Hair thinning is therefore a sensitive issue for both sexes. For sufferers, it can represent a loss of control and feelings of isolation. People experiencing hair thinning often find themselves in a situation where their physical appearance is at odds with their own self-image and commonly worry that they appear older than they are or less attractive to others. Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.[11]
As a last resort—or in extreme cases—you may want to consider a hair transplant. This process involves a surgeon removing either an entire strip of hair from your scalp, sewing the scalp closed, and then separating that strip of hair into thousands of tiny grafts, or shaving the scalp and removing only the hair follicles from the area. Both styles of hair transplant end in the follicles (or grafted hair strands) being placed inside tiny holed created in the scalp inside the balding area. New hair should grow naturally in the area. However, this process can be costly and there is always a chance that the transplant will fail and the follicles will not set and begin to produce new hairs. Your doctor will be able to discuss with you the chances of success based on your medical history and the severity of your hair loss.
The main type of hair loss in women is the same as it is men. It's called androgenetic alopecia, or female (or male) pattern hair loss. In men, hair loss usually begins above the temples, and the receding hairline eventually forms a characteristic "M" shape; hair at the top of the head also thins, often progressing to baldness. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald.

Topical chemical treatments are used by many to help stimulate regrowth, although some believe that blood flow and circulation to old or weak hair follicles can be stimulated with only the fingertips and some common vitamin-rich items. Popular remedies for encouraging new hair follicle growth include combining a rich carrier oil like jojoba, coconut or olive oil with agents like vitamin-dense or mineral-dense aloe vera gel, potato juice, cinnamon, neem leaves or certain essential oils.
Hi David, I understand where you are coming from. Losing hair at a young age is not a nice experience. Luckily, there is a lot more you could be doing besides the shampoo. Honestly I don’t know how much this will help in the long term. To get you started, you’ll probably have to adjust a few things in your diet and lifestyle to stop further loss/ regrow lost areas. A simple thing to get started would be to use a dermaroller (or even better a dermastamp) along the hairline. Remember though, pattern baldness starts from the inside out. It’s basically a sign that your body is out of balance. So try to sort that out as well.
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.

Some hair loss is associated with stress although male pattern baldness is a genetic condition found in many men. If you find your hair is falling out in clumps or at unpredictable times, it is most likely to be the symptom of something else. This could be stress related but is unlikely to be caused by sexual frustration. The best thing to do is to see your GP for a check up.
Some medications have side effects that include hair loss. Talk to your doctor if you are experiencing significant hair loss and you think that your medication might be the cause. Your doctor might be able to switch you over to another type of medicine without any reported side effects. Don’t stop taking your medications until you’ve spoken with your doctor, as this could be dangerous for your health.
Consider consulting a nutritionist to see if you might be deficient in certain nutrients that are vital to hormone balance and hair health for example B Vitamins, Zinc, Omega-3 fatty acids. Consider using Viviscal, a natural supplement containing Amino-Mar which is shown to promote hair growth. Viviscal Shampoo and Conditioner can also be used to ensure hair health inside and out.
I posted some pictures because I am not sure if I am loosing my hair. I have recently noticed some thining in the front and back but I am not sure if I am really loosing my hair or if it recently has just been looking different. I also notice when I stroke my hand through it a lot of strands are easy to pull out. What can I do? Progaine? Rogaine? I am 22. Thanks! READ MORE
Loose anagen syndrome, which most commonly presents in young children, occurs when hair that is not firmly rooted in the follicle can be pulled out easily. Most of the time, hair falls out after it has reached an arbitrary maximum length. Children with loose anagen syndrome often cannot grow hair beyond a relatively short length. The condition more commonly affects girls with blond or brown hair.
I’m glad to hear that wearing hats does not cause hair loss. I heard one of the biggest reasons for hair loss for men is from hats. I wear a hat almost everyday so I was pretty nervous. I think I will eventually be bald but I didn’t want to speed up the process. I think I would probably still wear hats even if it did cause hair loss. But it’s nice to know it doesn’t. Thanks for debunking some hair myths for me!

Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can't restore the full density of the lost hair. It's not a quick fix, either for hair loss in women . You won't see results until you use the drug for at least two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you'll need to keep using it to maintain those results. If you stop, you'll start to lose hair again.
When several of my classmates back in my senior year of college went bald (one went bald in about one year) I couldn’t believe my reaction. I was envious. Unbelievably, I wanted to go bald. I wanted to lose all my hair from the top of my head, leaving just a fringe on the sides and back: male pattern baldness. I had no idea guys still in their early 20s could go bald and I was shocked. I couldn’t wait for it to happen to me. I tried to shake off the urge, but had to finally admit to myself that male pattern baldness was I really, really wanted. But not until after I was married. I was afraid that no woman would want me if I was bald. Back then, I had no idea that there are women out there who actually prefer bald men. Lucky for me, I’m married to one of those women. When my wish finally came true in my early 50s, my wife was thrilled and she urged me to just let myself go bald. I did, and it happened very quickly, as if to make up for lost time. After only two years of finding hundreds of hairs on my pillow each morning and wads of my hair plugging our shower drain I was finally bald, male pattern bald. The rapid transition to bald was a very pleasant experience for both my wife and me and I absolutely LOVE being bald. My wife loves it too and still tells me how sexy she thinks it is. I love it when she kisses me on top of my shiny bald head. What a turn on! Going bald was one of the best things that ever happened to me. I just wish it had happened immediately after my wife and I were married, 40 years ago. I wish I had started shedding hair off the top of my head on our honeymoon and had been bald by our second wedding anniversary.

"Macafem nutrients help restore natural hormones in women. Unlike hormone drugs, which override your body's natural endocrine functioning with synthetic hormones, Macafem acts totally different in your body. It nourishes and stimulates your own natural hormone production by inducing the optimal functioning of the endocrine glands." Click on the following link to discover more about Macafem.
Nutrition can play a part. If you're not eating a well-balanced diet or are severely dieting or anorexic, it will affect your hair. However, if it is nutritional, it will be a temporary hair loss. Return to a well-balanced diet and hair should return in 4 – 6 months. Supplements must be used with caution and women must understand that vitamins in excess, even those purported to help grow hair, can be detrimental and have an adverse affect. In this day and age, people are rarely deficient in the hair loss vitamins folic acid and biotin. There would be other symptoms beyond hair loss. A B-vitamin rich supplement can help grow hair, but it might not make more hair. I advise using any supplement with caution and eating vitamin-rich foods instead. And ALWAYS tell your physician the vitamins, herbs, and medications (over the counter and prescription) you are using.
"Macafem nutrients help restore natural hormones in women. Unlike hormone drugs, which override your body's natural endocrine functioning with synthetic hormones, Macafem acts totally different in your body. It nourishes and stimulates your own natural hormone production by inducing the optimal functioning of the endocrine glands." Click on the following link to discover more about Macafem.

Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.)
In males over 60, androgen receptor and aromatase levels were low and comparable in scalp with and without thinning in both frontal and occipital regions. The 5a -reductase type 1 and 2 levels were only slightly higher in males with thinning hair in both frontal and occipital regions, but the differences were not significant. Histologic and hormonal findings suggest that senescent thinning is a diffuse process that is histologically similar to Androgenetic Alopecia, but hormonally different and may not be entirely androgen dependent.
It seems more than a little unfair, doesn’t it? You’d think the one thing we could count on was that hair loss or male or female pattern balding was an older person’s game. No way would hair loss occur as early as the mid 20s, right? Well, unfortunately for some of us, we may start seeing hair loss as early as our late teens and 20s, making for a very distressing discovery so soon after finishing school. Approximately 25 percent of men begin balding by age 30 and there are a great many theories as to why hair loss in mid 20s might happen.
If hair loss is genetic or an autoimmune condition, available treatments night not be effective for regrowth, but there are hair systems that look like your own hair that can help. The hair is attached using surgical glue and the hair can be blow dried, dyed, straightened. You can swim, shower etc with it. While not your own hair, they can be truly wonderful. I met several young women who wore them and you couldn’t tell. Are they difficult to deal with? Yes. But at the very least they help. I interviewed several women who were fine with not covering their bald heads, but who felt compelled to do so for work and society in general. One woman, a teacher, told me she covered up because her student’s parents complained to the administration, concerned that she was ill.
Going bald was one of the best things that ever happen to me. I thoroughly enjoyed finding hundreds of hairs on my pillow every morning and wads of hair clogging the shower drain. My wife loves it as much as I do and she loves kissing me on top of my smooth head. What a turn on! For me, male pattern baldness is a normal, natural inherited trait and not a disease in need of a cure. I have been bald for almost 20 years and I love it more than ever. Perhaps it’s because I lost hair later in life and married a woman who adores bald men like me.
Unfortunately for men, there’s a four in seven chance of receiving the baldness gene which means hair loss could occur for you really at anytime during adulthood. Many of our clients have recognised that their fathers or their mothers if the balding is on the female side, started at a certain point in their lives and that the time-scales are similar or identical.
Loose anagen syndrome, which most commonly presents in young children, occurs when hair that is not firmly rooted in the follicle can be pulled out easily. Most of the time, hair falls out after it has reached an arbitrary maximum length. Children with loose anagen syndrome often cannot grow hair beyond a relatively short length. The condition more commonly affects girls with blond or brown hair.
One of the most common yet least talked about symptoms of menopause, hair loss can be devastating for the millions of women who suffer from it. Americans spend upwards of a billion dollars per year on hair loss treatments. According to the American Hair Loss Society, 99% of these treatments are unfortunately ineffective. Most women do not want to sit back and let their hair fall out slowly without taking action. Luckily, there are alternative solutions that are safe and effective for the multitudes of women experiencing hair loss.
Menopause is a natural biological process that all women experience at some point in their lives. During this time, the body goes through numerous physical changes as it adjusts to fluctuating hormone levels. Many women have unpleasant symptoms during menopause, including hot flashes, mood swings, and insomnia. Hair loss is another common occurrence.
In men, finasteride (originally marketed as Proscar) is approved for hair loss associated with androgens. In one study, 62% of women also taking oral contraceptives containing the synthetic progestin drospirenone reported improvement. So it may be effective for female hair loss in the setting of increased androgen. But studies are limited and it is harmful to the male fetus so should not be used by women thinking about becoming pregnant or who are pregnant.

Unfortunately for men, there’s a four in seven chance of receiving the baldness gene which means hair loss could occur for you really at anytime during adulthood. Many of our clients have recognised that their fathers or their mothers if the balding is on the female side, started at a certain point in their lives and that the time-scales are similar or identical.
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