Menopause Hair Loss: I Thought I Was the Only One

Apparently, this is a huge taboo.

After all, roughly half of women¹ deal with it once they’re past menopause, and yet you never hear anyone talk about it: female baldness.

I’m not saying half of all women go bald, but they do lose their hair to a greater or lesser degree. And that’s what’s happening to me now.

It’s been going on for a while, but it never really sank in until now, when it’s reached the point where I can’t look the other way anymore. I’ve developed very deep recessions at my temples. There’s still some hair there, but there’s less of it, and what’s left is thin and wispy and never grows longer than about two inches (5 cm). I have a bald spot at the back of my crown, and on top of my head I now have far fewer hairs, and the ones I do have are much finer. I often wear my hair in a ponytail, but it’s not even half of what it used to be. Before menopause, I also wore bangs a lot. I absolutely couldn’t pull that off now. I simply don’t have enough hair for it.

I’ve always had a lush head of hair. It wasn’t extremely thick, just normal, but there was a lot of it, so my hairstyles always looked full and voluminous. Now it’s mostly thin on top. And because of the deep recession, especially at my right temple, I have no choice but to part my hair on the left so I can comb it over the right side to hide it. It’s basically the female version of the male comb-over.

In that respect, too, female pattern hair loss, which is what I have, is similar to male pattern hair loss. The hair on top disappears, while at the bottom, just above the neck, it stays largely intact. My hair back there is as full as it ever was. The difference with men is that they can lose all of their hair, or most of it, at the temples and the back of the crown, and watch their hairline keep moving back. In women, the hairline usually holds up better and the loss is more diffuse.

A few months ago I was at one of Yuki’s parties, and she asked me what I’d been up to. I told her: I’m losing my hair, and I’m looking for a solution. I lifted my comb-over for a moment so I could show Yuki that awful recession. By then I’d been chatting for a while with a woman around my age, maybe a little older, who hadn’t struck me as having any hair problems at all. She suddenly lit up: “You’re losing your hair too? I thought I was the only one!” She told me she’d lost so much hair that her shiny scalp shows through what little she has left. But she uses a spray in the same color as her hair to camouflage her scalp, and that’s why nothing shows on her. I told her I wanted to look into hair transplants. She asked me to let her know if I actually went through with it, so she could maybe start looking into it too.

She and I kept talking about it for a while at the party, which was fairly crowded, mostly with women of menopausal age. Once we started paying attention, we suddenly saw it: most of the women had a relatively normal head of hair, but with a few of them you could clearly see the scalp through their hair.

A few days later, when the dog I was babysitting was dropped off and his owner and I got to talking (I don’t remember how the subject came up), she confided that she, too, had been looking into a hair transplant and had already taken some concrete steps. She always wears her hair in a buzz cut. I’d assumed she did it because she liked the look, but no, she simply has very little hair. For medical reasons, the clinic couldn’t give her a transplant, but they recommended minoxidil, a product that’s been shown to help preserve hair and promote regrowth. And it’s really working for her.

I’ve since been to the same clinic. They won’t do a transplant for me either, for a different medical reason. I started using minoxidil a month and a half ago, too. It’s a liquid you apply to your scalp every night before bed. What I can tell you is that I’ve lost even more hair since I started. But that’s apparently normal, since it’s well known that minoxidil can cause extra shedding at first.

During my intake appointment at the transplant clinic, they did recommend a PRP (platelet-rich plasma) treatment. They draw blood, put it in a centrifuge to separate out the plasma, and then inject the plasma back in, mainly in the areas where the hair loss is worst. The plasma may stimulate the growth of new blood vessels, so that the hairs that are still there get more blood flow and can grow thicker and stronger again. We’ll see. I only had my first treatment a few days ago, and you can’t expect visible results until the third one. The same goes for minoxidil, by the way: you won’t see results for a few months.

I’m hoping fervently, of course, that this can slow the hair loss and that my thinner hairs might get a little thicker again.

I have to say I had a good experience at the transplant clinic, where I got the PRP treatment. Before starting any of this, I’d also dutifully gone to my family doctor to rule out vitamin deficiencies or another condition. That was a less pleasant experience. When I told her that compared to the past, when I had a lush head of hair, I now have far fewer hairs, she said that was “unfair.” She felt I shouldn’t compare myself to how I was twenty years ago.

Personally, I didn’t really understand what “unfair” has to do with it. As a woman, I simply don’t want to go bald, and that’s why I’m hoping I can still step in in time to slow this process down as much as possible. “The fact that so many women do keep their hair could also be considered ‘unfair,’” I replied. I’m afraid my doctor and I just weren’t on the same wavelength. She approached my request for help with a moral judgment, while I was asking for help out of a very real fear of going bald.

Anyway, I’ll let you know in six months or so how my hair is doing. And of course I’m not going to ask whether you, as a woman, recognize this problem. The fact that you never hear anyone talk about it unless you bring it up yourself tells me this is a loaded subject. But if you feel free to share your own experience, you’re more than welcome to. I’d really appreciate it, because I think we women still don’t support each other enough in this. And if you happen to have tips, that would be fantastic!

Photo: Julia Vivcharyk

P.S. Every Saturday I publish a mini-magazine called SATURDAYS with Diana. You can subscribe for free. And if you’re curious, you can take a look inside a sample issue.

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1. Chaikittisilpa, S. et al. (2022). Prevalence of female pattern hair loss in postmenopausal women: a cross-sectional study. Menopause, 29(4), 415–420. In this study of 178 postmenopausal women aged 50 to 65 seen at a menopause clinic, 52.2% had female pattern hair loss. Back to text