Hormonal Changes and Hair Loss: What Happens During Perimenopause and Menopause

Hair changes during midlife are extremely common, yet many people feel unprepared for how confronting they can be. Shedding, thinning, and changes in hair texture often appear gradually, leaving individuals unsure whether what they’re experiencing is “normal,” temporary, or something that needs professional attention.

Hormonal change plays a significant role in many of these experiences. Understanding how perimenopause and menopause affect the body – and how those changes can influence hair growth – helps set realistic expectations and reduces unnecessary fear.

This article explains what happens to hair during hormonal transition, why changes vary from person to person, and when assessment and support may be helpful.

Understanding hormonal change during perimenopause and menopause

Perimenopause refers to the transitional phase leading up to menopause. It can begin several years before menstrual periods stop and is characterised by fluctuating hormone levels rather than a single hormonal “drop.”

Oestrogen and progesterone levels rise and fall unpredictably during this time. These fluctuations affect multiple systems in the body, including the skin and hair.

Menopause itself is defined as the point when menstrual periods have ceased for 12 consecutive months. After menopause, oestrogen levels stabilise at a lower baseline.

According to Healthdirect Australia, hormonal changes during this transition affect people differently, both in timing and severity. Hair changes are one of many possible symptoms, alongside hot flushes, sleep disruption, and changes in skin texture.

Healthdirect Australia – Menopause

How hormones influence hair growth

Hair growth is regulated by the hair cycle, which includes growth, transition, and resting phases. Hormones influence how long hairs remain in each phase and how robustly they grow.

Oestrogen supports the growth phase of the hair cycle. When levels fluctuate or decline, hairs may spend less time growing and more time resting. Over time, this can result in increased shedding, reduced density, or slower regrowth.

It’s important to note that hormonal change does not affect everyone in the same way. Genetics, overall health, nutritional status, stress levels, and existing hair conditions all influence how hair responds.

Why hair shedding can increase during hormonal transition

One of the most common hair-related experiences during perimenopause and menopause is increased shedding rather than immediate thinning.

Hormonal fluctuation acts as a physiological stressor. In response, a higher number of hairs may shift into the resting phase of the hair cycle. Several months later, those hairs shed – a process known as telogen effluvium.

This mechanism is well documented in dermatological literature and is discussed in detail in clinical reviews published through the National Center for Biotechnology Information.

Telogen Effluvium and Physiological Stress – PubMed

For a deeper explanation of this process, see our related article:
Menopause and Telogen Effluvium: When Hormonal Change Triggers Temporary Shedding

Shedding versus thinning: understanding the difference

Shedding and thinning are often used interchangeably, but they describe different processes.

Shedding refers to an increased number of hairs falling out. Thinning refers to a gradual reduction in overall hair density, often related to changes in follicle size or growth duration.

During hormonal transition, shedding is often temporary and related to telogen effluvium. Thinning, however, may reflect longer-term changes in hair growth patterns.

This distinction is explored further in:
Hair Thinning During Menopause: Temporary Shedding or Ongoing Change?

Hormonal hair changes and pattern hair loss

Hormonal changes can also interact with genetically influenced hair loss patterns. This does not mean that menopause causes pattern hair loss, but it can make existing tendencies more noticeable.

Authoritative dermatology resources such as DermNet NZ explain that pattern hair loss involves gradual miniaturisation of hair follicles rather than sudden shedding.

DermNet NZ – Female Pattern Hair Loss

Understanding these differences is essential for appropriate support and is discussed in:
Hormonal Hair Changes vs Pattern Hair Loss: How They’re Different

Why hair density may change during perimenopause

Perimenopause is marked by ongoing hormonal fluctuation rather than stability. This can result in repeated cycles of shedding and regrowth, which may gradually affect perceived hair density.

Changes in hair texture, slower regrowth, and reduced volume can all contribute to the feeling that hair is becoming thinner, even when follicles remain active.

This stage-specific experience is explored further in:
Why Hair Density Changes During Perimenopause

How The Hair & Scalp Clinic supports hormonal hair changes

The Hair & Scalp Clinic does not diagnose medical conditions or advise on hormone therapy. Our role is to assess hair and scalp health, identify patterns consistent with known conditions, and support recovery where appropriate.

A professional Hair & Scalp Analysis allows us to examine shedding patterns, hair density, scalp condition, and contributing factors.

Support may include:

• Targeted Scalp Treatments to maintain a healthy scalp environment
• Supportive Hair Loss Treatments where appropriate
• Ongoing care through Personalised Treatment Plans & Follow Up Care
• Long-term support via Preventative & Maintenance Care

When hormonal hair changes should be assessed

Not all hair changes require intervention. However, assessment may be helpful if shedding is prolonged, density continues to decline, or changes are causing distress.

Clear guidance on this topic is provided in:
When Hair Changes During Menopause Should Be Assessed

Key takeaway

Hormonal changes during perimenopause and menopause can influence hair growth in multiple ways. These changes are common, varied, and often manageable with the right understanding and support.

Clear assessment, realistic expectations, and evidence-informed care help ensure that hair changes are addressed calmly and appropriately – without unnecessary fear or assumptions.