One of the most devastating health concerns that can happen with getting older is female pattern hair loss (FPHL). It is extremely upsetting, affects self image and quality of life, and should definitely not be ignored. While men may expect to lose their hair at some point, women certainly don’t and our sense of attractiveness can be strongly tied to our hair. If this is happening to you, I am sorry that you are going through this and I also understand because I’ve dealt with it too. I will discuss some possible reasons for FPHL and some potential solutions. Keep in mind that you may have more than one issue causing your thinning hair so it can take a while to see improvement while you figure out the reason, or reasons, for the hair loss. You may need to wait three or four months to start seeing results.
What you should know about hair
We have around 70,000 to 200,000 hairs on our heads, depending on your hair color. Hair grows at approximately one centimeter per month. Normally we lose about 100 hairs a day but if we shed more hairs than we are growing back, thinning hair occurs.
Our hair grows in cycles.
The anagen phase is the phase where the hair is growing. This phase can last four years or longer. When you grow a new hair, it replaces another one that was shed. This phase begins approximately three months after the previous hair was shed.
The catagen phase is also known as the resting phase and starts at the end of the anagen phase. The hair follicle shrinks, disconnects the hair from the blood supply, and pushes the hair towards the skin’s surface. The catagen takes a few weeks to complete.
The telogen phase is the shedding phase where the hair does not grow. The hairs may be still hanging on to the follicle but no longer growing and ready to fall out. You will often find these hairs on your hairbrush. Following the telogen phase, it normally takes approximately three months before the follicle re-enters the anogen phase.
Female pattern hair loss is usually spread out (also known as diffuse), and affects the front and top of the head. You may have noticed your hair part getting wider. This is very common and affects over 50% of women.
Hair loss and stress
Hair loss due to stress is known as telogen effluvium. If the body is in survival mode due to stress, growing hair is not a priority. Potential stresses could include an illness – lots of people had telogen effluvium during the covid pandemic. Other examples could include: significant weight loss or weight gain, a surgery, a death in the family, or overworking yourself. Basically, in situations where the body is under stress, it will not prioritize hair growth because hair isn’t really necessary for survival. The hair growth cycle goes into the telogen phase while the body directs its resources to its high priorities, such as the brain and heart.
If you have telogen effluvium, you might see large amounts of hair on your floor, for example, and you will most likely notice the hair loss several months after the stressor. As long as you are recovering from the stressor, your hair will most likely start to grow back within a few months later.
Some techniques to help include: meditation, light exercise, breathing exercises, and making sure you get enough sleep.
How to stop menopause hair loss using nutrition
Nutritional deficiencies can affect women in women in peri-menopause who undertake “crash diets” to lose weight. When you are in your 20s, you might able to do Crossfit while in a calorie deficit, without any ill effects. However, in your 40s, it can be simply too much stress on the body in peri-menopause. Ketogenic diets can also be problematic. The best way to lose weight without overly stressing the body, is to aim for no more than 1-1.5 pounds of weight loss per week. This also helps you sustain the weight loss without having a rebound effect and putting you into telogen effluvium.
There are several nutritional deficiencies that could cause hair loss. Iron, zinc, and vitamin D are some of the most common deficiencies that could cause hair loss in vegans.
Before taking any supplements, it is important to get tests done to see whether you have a deficiency. Taking a supplement can lead to an imbalance if you don’t have a deficiency. For example, too much iron can block your zinc absorption.
For a "food first" approach, you could try eating iron-rich vegan foods such as seaweed, pumpkin seeds, and legumes. Add lemon juice because vitamin C helps with iron absorption. Dried fruit – especially black currants – are high in both iron and vitamin C.
Foods rich in zinc include hemp seeds, sesame seeds, and cashews.
Protein deficiency is also a possibility. Vegan sources of protein are often low in the amino acid lysine, which can lead to hair loss. Soybeans and quinoa are rich in lysine, so you could try eating more of those foods if you are not currently eating them.
You may also want to investigate whether you have a food allergy. For example, if you are sensitive to wheat gluten it can irritate your scalp and inflame the hair follicles and lead to hair shedding. If you fall in this category, simply eliminating gluten may be enough to stop the hair loss.
Hair loss and hormones
After estrogen drops, hair density can decline.
This can be due to an imbalance of androgens, or male hormones. Dihydrotestosterone, or DHT, is a hormone synthesized from testosterone, that attaches to a receptor in your hair follicle and slowly kills the hair follicle.
If you have excess androgens, you will probably also notice some facial hair growth or acne, or you may have been diagnosed with PCOS.
There are hair products you can buy to help block DHT, but these will only work if you do have a hormonal issue. An anti-inflammatory diet can also help with this.
Thyroid issues can also cause hair loss. Hair loss is a symptom of hypothyroidism, which is an underactive thyroid, and many women in perimenopause are prone to hypothyroidism. PCOS is also linked to hypothyroidism. However, note that an overactive thyroid (hyperthyroidism) can also cause hair loss. Checking your thyroid is another test to request from your doctor.
Hair loss and circulation
As we get older, the hair shaft can grow thinner in diameter, leading to the appearance of less hair. This is called miniaturization. This is normal. But eventually, over time, the hair can become so fine, it doesn’t grow back.
A medication that is prescribed for this is called minoxidil (or Rogaine), which helps with vascularization or bringing more blood to the hair follicle. Minoxidil can have the side effect of skin irritation or dandruff, or growth of facial hair.
Another option that has been studied is red light laser treatment. This can be done at home using low-level laser caps. The caps would be worn for about 30 minutes, 3 times a week. These have been studied and show that they work in 40% of people, without side effects. However, you would need to continue treatment on an ongoing basis. That means, if you discontinue, then the hair loss would reoccur.
You could also try scalp massage to bring more blood to the tissues, using your fingertips or a scalp massager that you can buy. Scalp massage is also very relaxing so this can be part of your daily stress reduction practice.
Another thing you could try is using peppermint oil, which also helps with blood flow. Peppermint oil can be used directly on the skin without needing to be diluted in a carrier oil. There are “pens” you can buy for headaches that allow you to dab oil on your scalp, or you could also try adding peppermint oil to a natural unscented shampoo. Peppermint oil can also help with itchiness, which can be associated with hair loss if there is an underlying inflammation. So, note that you would also want to work on eliminating the inflammation.
Melatonin and hair regrowth
There was a double blind, randomized study which showed that topically applied melatonin significantly increased hair growth in women with alopecia, compared to placebo. In the study, the women applied melatonin to their scalps once daily for six months. It is thought that the melatonin stimulates the anogen phase.
Hair loss and insulin resistance
Another issue that is strongly tied to hair loss, that actually surprised me a bit, is insulin resistance. It’s known that a whole foods plant based diet can reverse type 2 diabetes. However, it’s still very possible to be vegan and have insulin resistance. If your waistline is greater than 35 inches, you should pay attention to this one because that is one of the signs of insulin resistance. You can also check your BMI (body mass index) using a calculator online and entering in your height and weight to see if your BMI is above 25, which is another risk factor for insulin resistance. There have been studies linking female pattern hair loss to metabolic syndrome, which is another term for insulin resistance. If you don’t have diabetes it is still worth looking into – people can have insulin resistance for over a decade before developing type 2 diabetes.
Insulin resistance happens when your cells store fat – not from eating fat but from having glucose spikes throughout the day from sugar consumption. Your cells can’t handle all of the excess energy so they store it as fat. This can lead to damage of your capillaries, including blood flow to your scalp. If your scalp can’t receive enough blood flow, which brings oxygen and nutrients, your hair will be affected.
You can decrease your insulin resistance by reducing your sugar intake, increasing your fiber intake, and eating your carbohydrates along with a protein. Exercise will also help to reduce the fat in the cells and bring more circulation to your scalp. Exercising 10 minutes after a meal, such as taking a light walk or doing some bodyweight squats, also can reduce your glucose spikes by sending that glucose into your muscles and giving it a place to go.
Summary
I hope you have found this information useful to stop your menopause hair loss. As I’ve mentioned, you may be dealing with multiple reasons for hair loss and it can take some time to figure out the issues. As you can see, improving your overall health will benefit your hair health in many ways. If I can give you just four takeaways, they would be:
Start a stress reduction practice, if you don’t already have one. Meditation will improve your overall health, as well as increase your capacity to deal with stress.
Ask your doctor about necessary tests, including thyroid, iron, zinc, and vitamin D. Bonus points if you get tested for food sensitivities.
Find ways to increase the blood flow to your scalp, such as scalp massage, peppermint oil, or possibly trying a low level red light laser.
If your waist measurement is greater than 35 inches, that is one of the signs of insulin resistance. This can have a major effect on your hair health, but you can get it under control through dietary changes and exercise.
References
Female Pattern Hair Loss - A Comprehensive Review. Bertoli et al. Dermatologic Therapy. 2020.
Association of metabolic syndrome with female pattern hair loss in women: A case-control study. El Sayed et al. Int. J. Dermatol. 2016. PMID: 27060965.
A Cross-Sectional, Observational Study of the Clinico-Epidemiological Profile of Female Pattern Hair Loss in Western India and its Association with Metabolic Syndrome. Singh S. et al. Indian Dermatol Online J. 2023. PMID: 37089856.
Melatonin increases anagen hair rate in women with androgenetic alopecia or diffuse alopecia: results of a pilot randomized controlled trial. Fischer et al. Br J Dermatol. 2004. PMID: 14996107.
Low-Level Laser (Light) Therapy (LLLT) for Treatment of Hair Loss. Avci et al. Lasers Surg Med. 2013.
Artemis, Nadine (2017). Renegade Beauty. North Atlantic Books. Holford, Patrick (2004). The New Optimum Nutrition Bible. Crossing Press.
Means, Casey (2024). Good Energy: The Surprising Connection Between Metabolism and Limitless Health. Penguin Random House.
Staveley, Bambi (2022). Hair Loss in Women. Green Hill Publishing.
Further help for Menopause
My free Vegan Menopause 3-Day Meal Plan is packed with plant protein to help you feel full longer, stabilize your blood sugar, protect your bones, boost your mood, and feel better overall during perimenopause!
In my free guide, Five Action Steps to Elevate Your Vegan Menopause Experience, I share five simple steps you can implement immediately, to feel more calm, more positive, and less affected by menopausal symptoms.
DISCLAIMER: This podcast’s information is general in nature and for informational purposes only. It does not constitute medical advice and is not intended to substitute for professional medical advice, diagnosis, or treatment.
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