How to Keep Your Hair Healthy and Strong During Perimenopause

We understand how important your hair is to you. It's not vanity; it's part of how you present yourself to the world. When you start going through perimenopause, and you start finding more hair in the drain, less hair in your thinner ponytail, and a widening center part, it can be a significant blow to your self-image and confidence.

Lucky for you, it's never too late to begin taking steps to prevent and even reverse hair loss.

The Role of Hormones in Hair Health During Perimenopause

Hormonal fluctuations during perimenopause are a primary reason you’re noticing changes in your hair. While shifts in sex hormones like estrogen and progesterone are considered the main culprits behind these changes, minute fluctuations in a number of critical hormones cause imbalances that can have widespread consequences for your hair's health. Let’s break down the key hormones involved and how they impact hair health:

Estrogen & Progesterone

Estrogen and progesterone are essential for keeping hair thick and vibrant. During perimenopause, as these hormones begin to wane, many women observe reduced hair density and increased shedding. Estrogen’s role is particularly vital, as it keeps hair in the growth, or anagen, phase longer. When estrogen declines, hair may shift to the shedding, or exogen, phase more rapidly, causing noticeable thinning.[1]

Progesterone acts as both a hair-loss inhibitor and a hair-growth promoter. Progesterone inhibits hair loss by preventing the conversion of testosterone into DHT, a hormone that can shrink follicles. By stimulating hair follicle growth and reducing scalp inflammation, progesterone helps promote your hair's growth and overall health.[1]

Testosterone & Androgens

Testosterone is often misunderstood in the context of hair loss. While elevated levels of testosterone can lead to hair thinning, testosterone therapy has not been found to cause hair loss in menopausal women; the hormone can sometimes even help improve hair health in women with androgen deficiency.[1,2]

Instead, women with female pattern hair loss, also known as androgenetic alopecia, generally have higher ratios of androgens than ovarian hormones. Progesterone, for instance, regulates testosterone’s conversion into dihydrotestosterone (DHT), an androgen that contributes to thinner hair and hair loss.[1,3] The relatively quick drop in progesterone during perimenopause can play a significant role in hair loss through this pathway as the ratio of androgens to ovarian hormones increases.

Cortisol

Cortisol, the stress hormone, can impact your overall hair health. Perimenopause can be a stressful time, but your body will also naturally begin producing more cortisol with age.[4]

High levels of this hormone in the scalp and hair are directly associated with the degradation of important modulators of hair health. In addition to disrupting other hormones like progesterone, increased cortisol levels can cause increased stress-induced hair shedding, known as telogen effluvium.[5]

Understanding the intricate web of hormonal interactions during perimenopause can help you navigate your hair changes with greater insight and control.

Common Hair Changes During Perimenopause

As hormones fluctuate during perimenopause, it’s natural to experience shifts in hair health. Here are a few common changes you might notice:

• Thinning Hair: As hormone levels change, hair growth cycles shorten, leading to thinning hair. Many women may notice smaller ponytails or more hair left behind in brushes and drains.
• Hair Loss (Alopecia): Increased ratios of androgens like DHT can lead to hair thinning or loss at the temples or crown. Genetic predisposition plays a large role in pattern hair loss, so family history is worth considering.[6]
• Dryness, Brittleness, and Texture Changes: In addition to thinning, you may notice that your hair feels drier, more brittle, or has a different texture as your scalp starts producing less oil. You also may find that products that once worked for you no longer provide the same benefits.[7]
• Accelerated Graying and Oxidative Stress: Oxidative stress can increase during perimenopause, impacting melanin-producing cells in hair follicles and contributing to cellular aging and increased graying.[8,9]
• Increased Senescence: Diffuse age-related hair thinning, even in individuals without a family history of hair loss, is termed age-related thinning, and it’s due to increasing levels of senescence in the body with age, particularly affecting the cells in hair follicles. In many people, age-related hair thinning can co-exist with pattern balding, and research indicates that senescence may also contribute to pattern balding.[10]

Scalp Changes During Perimenopause

The scalp may also change during perimenopause, contributing to hair health challenges as it affects your hair follicles. Here are some of the more common scalp issues that may arise:

• Scalp Sensitivity and Dermatitis: During perimenopause, hormonal fluctuations, especially progesterone and its anti-inflammatory effects, can trigger scalp sensitivities and conditions like dermatitis. This inflammatory response often results in redness, itching, and flaking.[7,11]
• Sebum Production: Decreased estrogen levels can also affect sebum production in the scalp, leading to dryness and potential dandruff. An overly dry scalp may lead to itchiness and discomfort, creating a cycle that makes it challenging to maintain healthy hair.[7]
• Scalp Inflammation: Greater sensitivity and inflammation during perimenopause may aggravate scalp issues like eczema or psoriasis.[11]

Recognizing these changes as a natural part of aging is essential, but understanding how to address them can significantly affect how you feel about your hair and scalp during this time.

How to Care for Hair During Perimenopause

Now that you know how perimenopause affects hair health, you’re ready to take action. Here are some science-backed strategies to help keep your hair healthy and strong:

Maintain a diet that helps your hair.

With hormonal changes during perimenopause, shifts in your gut microbiome can make it harder to absorb nutrients, so a well-balanced diet becomes even more critical for keeping your hair healthy.[12] Even if you’re eating a balanced diet, deficiencies in nutrients like iron, healthy fats, biotin, and vitamin D can cause your hair to thin or your scalp to dry.

Here are some of the best sources of each:

• Iron: Found in leafy greens, legumes, tofu, and red meats–high in heme iron, which is more easily absorbed by the body–iron supports hair growth and strength by enhancing oxygen flow to follicles.[13]
• Healthy Fats: Omega-3-rich foods like fatty fish, avocados, nuts, seeds, and olive oil help promote scalp health and reduce inflammation.[14]
• Biotin: Eggs, nuts, sweet potatoes, spinach, and bananas are rich in biotin, essential for hair strength and growth.[15]
• Vitamin D: In addition to sunlight, fatty fish, mushrooms, egg yolks, and fortified foods contain vitamin D, a nutrient that is essential for hair growth.[16]

To support deficiencies, look for high-quality supplements targeting hair health.

Take care to avoid damaging your hair.

If you want to extend your hair's longevity and prevent unnecessary hair loss through perimenopause, a few small habits make a big difference:

• Limit sources of dryness: Limiting heat exposure or using a sulfate-free shampoo can keep dryness and hair loss at bay.
• Get frequent trims: Regular trims every few weeks help fend off split ends and keep your hair healthy.
• Prevent breakages: Be gentle when brushing, especially on wet hair. A wide-tooth comb or detangling brush is perfect for this, ensuring your hair stays smooth and resilient without unnecessary breakage.

Professional Treatments

If you’re noticing more severe hair loss during perimenopause, a visit to a dermatologist or trichologist might be worth considering, as they can offer a range of effective options:

• PRP Therapy: Using the power of your own platelets, PRP injections can help rejuvenate hair growth naturally.[17]
• Laser Therapy: Low-level laser therapy stimulates your follicles, helping boost hair thickness without invasive procedures.[18]
• Microneedling: By creating tiny channels, microneedling promotes collagen production, enhancing the impact of growth serums.[19]

A specialist can help you navigate these treatments to give you the best chance for fuller, vibrant hair as you move through perimenopause.

Topical Treatments

Topical treatments can make a difference for your hair and scalp during perimenopause. Here’s what to try:

• Minoxidil: Minoxidil is one of the more common hair loss treatments. It works by increasing blood flow to hair follicles, stimulating hair follicle growth, and combating thinning. Although it's considered a gold standard for hair regrowth, it's not safe for pregnant women and can sometimes cause hair loss if the treatment is stopped too suddenly. [20]
• Fiansteride/Dutasteride: Finasteride and Dutasteride are oral 5-alpha reductase inhibitors that lower DHT, the hormone linked to pattern hair loss. Finasteride blocks Type 2 5-alpha reductase, while Dutasteride blocks Type 1 and 2, making it stronger but prescribed off-label. Both can slow hair thinning and preserve density but won’t address non-hormonal hair loss. Neither is safe for pregnant women.[21,22,23,24]
• Ketoconazole Shampoo: Ketoconazole is an antifungal shampoo that may reduce scalp DHT and improve hair thickness by promoting follicles in the growth phase. Though promising, more research is needed to confirm long-term benefits. It’s often part of hair loss routines but should be avoided during pregnancy or if the scalp is damaged.[25,26]

While results may vary, using one or more of these treatments may help restore lost hair.

Can OS-01 HAIR Help With Perimenopausal Hair Loss?

Although the relationship is not fully understood, estrogen acts as a mediator of senescence throughout the body. Emerging research suggests that as these cells slowly build up they can disrupt hair growth and play a role in age-related hair loss, pattern balding, and stress-induced hair loss.[27]

By directly reducing levels of cellular senescence in the scalp, OS-01 HAIR helps revitalize aging hair follicles, improve scalp health, and extend the growth phase. For hair follicles struggling to produce healthy hair, OS-01 HAIR can turn back the clock on the growth cycle, reversing follicle miniaturization.[27]

With OneSkin’s science-backed approach to perimenopausal hair loss, you don’t have to accept it as inevitable.