Menopause Hair Loss: Can HRT Help or Make It Worse? | Dermatologist Explains

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Hair loss during perimenopause and menopause is incredibly common, but not all menopausal hair loss has the same cause. In this video, dermatologist Dr. Dray explains the connection between menopause, hormones, HRT, and hair loss, including why thinning hair does not automatically mean that hormone replacement therapy is the right treatment.

Dr. Dray discusses the most common causes of hair loss around menopause, including female pattern hair loss, telogen effluvium, and frontal fibrosing alopecia, as well as how declining estrogen and changes in androgen activity can affect the hair follicle.

The video also explores whether HRT can help menopausal hair loss, whether HRT can potentially contribute to hair shedding, and which evidence-based treatments may actually help with thinning hair.

Dr. Dray also discusses low-level light therapy for hair loss and shares information about the iRESTORE Elite, an FDA-cleared, non-invasive, drug-free device designed to deliver low-level red light therapy to the scalp.

In this video:

00:00 Introduction
00:27 Why hair loss becomes more noticeable around menopause
01:22 Low-level light therapy and iRESTORE Elite
06:05 What happens to your hormones during menopause?
07:03 What does estrogen have to do with hair?
07:59 Female pattern hair loss
09:46 Not all menopausal hair loss is female pattern hair loss
12:18 Can HRT help with hair loss?
14:05 Can HRT actually make hair loss worse?
15:19 What can actually help menopausal hair loss?
16:29 When should you see a dermatologist?
18:33 Final takeaway

Hair loss can have many different causes, and identifying the correct type of hair loss is an important first step toward choosing an appropriate treatment. Women experiencing sudden or significant shedding, bald patches, scalp inflammation, eyebrow loss, or progressive hairline recession should consider seeing a dermatologist for evaluation.

This video is sponsored by iRESTORE.

#Menopause #HairLoss #MenopausalHairLoss #FemalePatternHairLoss #HRT #HormoneReplacementTherapy #HairThinning #HairGrowth #Dermatologist

FTC: This video is sponsored by iRESTORE

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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Content provided on this Youtube channel is for informational purposes only. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. Information on this Youtube channel should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose, treat, cure or prevent disease.

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43 Comments

    1. I recently got diagnosed as being deep into post menopause (didn’t know because I had a partial hysterectomy 10 years ago and they left an ovary), which explains so much of the changes I’ve noticed in the last 8-12 months. Will you please talk about the difference in the minoxidil applications and strengths? Why does the Costco dropper version say not for women? I have naturally curly hair so the dropper would be ideal or I would essentially be causing more damage from the breakage if I have to massage foam in 2x a day. 4:11

    1. ​@danniedebe9885I actually received 3 iron infusions. Now Im just on a daily vitamin with iron. Check out Thorne for iron supplements, I see a lot of good reviews.

  1. I lost aLOT of hair when I stopped bio identical hormones in 2011. Mayo Clinic honored the black box warning and I could not get it subscribed.
    At 68, I’m scheduling a consult to start again.
    I use the product shown daily for the past 1.5 yrs. It. Works.😊

  2. HRT did not help me even though it started thinning right at the start of perimenopause , but maybe it will help you. ❤

  3. hrt did not help my hair shedding, or re growth for that matter. the proper nutrition/electolytes/vitamins did, stress reduction ultimately. still shed but not nearly as bad 8 years peri men now post meno. Thanks for this, Dr. Dray ❤

  4. When mentioning other reasons for HRT, don’t forget the bones! estrogen is FDA approved for the prevention of osteoporosis.

    1. Yes! I didn’t realize my estrogen levels had plummeted and my bone density had gotten pretty bad. My doctor put me on alendronate and estradiol. I feel a lot better. I go back in November to check my bone density. I’m hoping it has really improved.

    2. @laurielaurie8280My osteoporosis changed to osteopenia after I added testosterone to my HRT regimen (i.e. estradiol & progesterone). 👏

  5. Thank you, Dr. Dray! I’ve been terrified to start HRT because I heard it could make shedding worse. This breakdown is exactly what I needed – clear, evidence-based, and non-scary. 🙏❤

  6. I have been on HRT my whole life because of a hormone deficiency. I am 73 and my hair is down mid-back and no bald spots yet.

  7. Been on hrt 3 years post menopause. Hrt my help with hormones, with but if your vitamin deficiencies are still prevelant, hrt wont help. Check your levels, supplement, have a hair routine on a consistent baises will help tremendously.😢

  8. HRT caused my hair loss. That’s the consequence of going to a provider that doesn’t know what she or he is doing. Helmet did nothing. Currently on Dutasteride hoping I see some of my hair grow back. I don’t trust doctors anymore.

    1. Are you also talking oral minoxidil? The combo of dutasteride and oral minoxidil has been working for me. Dutasteride killed my sex drive tho.

  9. I started using the iRestore helmet that we bought for my husband, even though I didn’t have major hair loss.. It’s been about 6 years of consistent use and it’s helped hair fullness and the quality of the hair. I tried adding topical minoxidil to part and temple areas every night about 3 years ago, and I’ve filked in my front hairline even more. My hairdresser notices 😊

  10. I started to lose my hair now that I am on HRT for 7 months I’m going to have more blood work done and meet with the doctor I love my HRT but losing my hair is super stressful

  11. Huh. Here I was thinking the scalp serum I was using was the reason my shedding slowed down drastically but now I’m thinking it was probably because I upped my estradiol (and switched to gel from patch). Or it could be both, who knows! Either way I’m pretty happy about this! I also started doing upside down head massages. Needless to stay I’m a bit obsessed 😂 Good luck everyone!

  12. I was just recently put into medically induced menopause. I’m just waiting to see what is going to happen to me if anything. My fingers are crossed.

    1. Yes, but tbf it is one of the best at-home options for the topic of the video and iRestore *is* one of the few legit red light mask/cap brands out there

  13. I had a maddening itchy scalp & excessive hair loss during perimenopause. Going on HRT, completely stopped my itchy scalp & my hair loss stopped completely! I highly, highly, highly recommend HRT. It’s a pain in the butt to get estradiol patches these days, for they are ALWAYS out of stock; but if you can get some, they could be a life saver!!

    1. @DLkindsoulstarted on 0.0375 mg patch was still experiencing symptoms so went up to 0.05 mg & have no perimenopausal symptoms now.

  14. I’ve been on HRT since 2015 and it’s the best decision I’ve made for my well being and overall good health.

  15. Hair loss in menopause starts in perimenopause which starts basically as estrogen declines at 30. It’s best to start minoxidil when you are in your 30s to save whatever you have. The longer you wait the more irreversible the hair loss is.

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