Why Am I Losing My Hair in Perimenopause?
You’re brushing your hair, and—yikes—more strands are coming out than usual. Maybe your part is widening. Maybe your once-thick ponytail feels a little limp. Or perhaps you’ve noticed extra hair collecting in the shower drain, making you worry.
Hair loss during perimenopause is incredibly common, but that doesn’t make it any less frustrating or emotional. For many women, it can feel like one more thing their body is doing without their permission. The good news? You’re not stuck with it forever. Once you understand why it’s happening and what your hair needs during this transition, there’s a lot you can do to support regrowth, slow shedding, and rebuild confidence—strand by strand.
Understanding the Hair Growth Cycle
Before we dive into what causes perimenopausal hair loss, it helps to understand the natural hair growth cycle. Each strand of hair grows from a follicle and moves through three main phases:
Anagen (growth phase) – Hair actively grows during this phase, which can last for years.
Catagen (transition phase) – A short period where growth slows and the follicle begins to shrink.
Telogen (resting/shedding phase) – Hair eventually falls out to make room for new growth.
In a healthy cycle, about 85-90% of hair is in the anagen phase at any given time. But during perimenopause, hormonal shifts can disrupt this balance, pushing more hair into the resting phase prematurely. This leads to increased shedding, slower regrowth, and a thinner appearance.
Hormones and Hair Loss: What’s Really Happening?
Hormones play a starring role in hair health—and perimenopause brings big changes to your hormonal landscape. Estrogen and progesterone, two hormones that help keep hair in its growth phase, begin to decline. At the same time, androgens like testosterone and its more potent form, DHT (dihydrotestosterone), become more dominant. This shift can shrink hair follicles, slow growth, and cause finer, weaker strands.
Progesterone is essential for calming inflammation and supporting the scalp environment. As levels fall, inflammation can increase, and blood flow to the follicles may decrease. Estrogen, often called the “queen bee” of hair health, also supports fullness, shine, and overall growth. When estrogen declines, hair follicles receive less stimulation, and hair tends to grow back more slowly—or not at all.
Furthermore, high levels of cortisol—your body’s stress hormone—can disrupt the hair cycle by sending follicles into the telogen (resting) phase. This is why many women experiencing emotional stress or poor sleep during perimenopause notice a sudden uptick in shedding.
What Hair Loss Looks Like in Perimenopause
Hair loss doesn’t show up the same way for every woman. Some notice gradual thinning around the temples or crown. Others experience sudden shedding or more visible scalp. Here are the most common patterns:
Androgenic Alopecia (Female Pattern Hair Loss): This is the most typical presentation, where thinning occurs gradually across the top or crown of the head while the hairline remains intact. It’s largely driven by DHT and tends to worsen without treatment.
Hormonal Hair Thinning: Caused by declining estrogen and progesterone, this thinning often starts at the temples or part line. Hair grows back more slowly, appears finer, and lacks volume.
Telogen Effluvium: Triggered by stress or hormonal fluctuations, this condition pushes more hairs into the resting phase immediately, resulting in sudden, diffuse shedding.
Thyroid-Related Hair Loss: Hypothyroidism, hyperthyroidism, and autoimmune thyroid conditions (like Hashimoto’s) are more common during perimenopause and can lead to significant hair thinning.
Nutrient Deficiencies: If your body is low in iron, zinc, biotin, or B vitamins, your hair may become brittle, weak, and more prone to breakage or shedding.
What You Can Do to Support Hair Regrowth
Now for the good news: while hair loss during perimenopause can be distressing, there are several ways to support regrowth, protect the hair you have, and feel empowered in your routine again. Here’s how to take a holistic, multi-layered approach:
Start With Nutrition
Your hair is built from the inside out, so nourishing it from within is one of the most effective places to begin. Protein is critical—your hair is made primarily of keratin, a protein that needs regular replenishment. Aim for 20–30 grams of protein with every meal to help support regrowth.
Anti-inflammatory foods can also make a big difference. Reducing processed sugar, alcohol, and dairy may help improve the gut-skin-hair connection and reduce overall inflammation that affects the follicles. Load up on leafy greens, berries, fatty fish, nuts, and seeds.
Key nutrients to prioritize include iron (especially from red meat, organ meats, and legumes), zinc, magnesium, and B-complex vitamins. These help transport oxygen to the scalp, reduce shedding, and support follicle health. And don’t forget to stay hydrated—your hair follicles need water, too.
Try Targeted Supplements
If food alone isn’t cutting it, consider supplementing with targeted nutrients. Nutrafol, a clinically backed nutraceutical, is one of the most popular choices. It combines herbal ingredients like saw palmetto (a natural DHT blocker), ashwagandha (for stress support), and marine collagen to target the root causes of hair loss—like inflammation, nutrient deficiencies, and hormone shifts.
Other natural options include:
Biotin, a B vitamin essential for keratin production
Zinc to support scalp and follicle health
Saw Palmetto for blocking DHT
Adaptogens like Rhodiola and ashwagandha regulate cortisol and support hormonal balance
Always speak with your provider before starting a new supplement, especially if you take medications or have underlying conditions.
Support the Scalp (and Stress Less)
Don’t underestimate the power of scalp care and stress management. Regular scalp massage can improve circulation to the follicles and support healthy growth. Use a lightweight oil (like rosemary or castor oil) once or twice a week, or simply massage with fingertips in the shower.
Stress management is non-negotiable. Chronic stress increases cortisol, which disrupts the hair cycle and accelerates shedding. Incorporate calming practices like breathwork, meditation, restorative yoga, or evening walks. Aim for 7–9 hours of quality sleep to support hormone balance and recovery.
Know When to Seek Professional Help
Sometimes, even with the right diet and lifestyle changes, hair loss continues. That’s when it may be time to consult a provider or dermatologist. Here are some advanced options:
Minoxidil (Rogaine): The only FDA-approved topical treatment for women. It helps extend the growth phase and thicken hair over time.
Spironolactone or Finasteride: Oral medications that reduce androgen activity (prescribed off-label for women).
Red Light Therapy: At-home laser devices stimulate follicles and may improve density with consistent use.
Hormone Therapy: HRT can support hair regrowth for some women by addressing the underlying hormonal shifts—though it’s not typically prescribed only for hair loss.
The Bottom Line
Hair loss in perimenopause can feel incredibly personal—and disheartening. But it’s also a sign that your body is going through a major shift, and it’s asking for a new kind of support. You’re not alone. And you’re certainly not powerless.
With a little knowledge, the right nutrition, and a combination of natural or clinical tools, you can regain stronger, healthier hair—and the confidence that comes with it.
