Is It Menopause, or Is It Something Else? Hair Changes After 45.

The Menopause Edit

6 Min Read

By Nutrafol Team2026-11-04

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Key Takeaways

Perimenopause and menopause can change hair in four predictable ways: a shorter growth phase, thinner strand diameter, shifts in texture, and a widening part at the crown.
Thyroid changes, low iron reserves, certain medications, recent illness, sudden weight change, and tight styling can all cause thinning that may mimic hormonal hair thinning or even exacerbate it.
A simple blood panel may provide insight into what may be driving your hair thinning, so ask your doctor before assuming it's "just menopause."
Nutrafol Women's Balance is formulated to support hair through hormonal changes.

You notice it before you can quite name it: a part that looks a little wider than it used to, more strands on the pillow, hair that just doesn't hold a style the way it once did. If you're 45 or older, it's natural to blame perimenopause or menopause. Most of the time, you'd be at least partly right.

But hormones aren't the only explanation, and figuring out which parts are hormonal, and which aren't, is worth a real conversation with your doctor before you spend months guessing.

What Actually Happens to Hair During Perimenopause and Menopause

Estrogen does more for hair than most people realize. As it fluctuates through perimenopause and declines through menopause, hair typically changes in a few specific, well-documented ways:

A shorter growth phase. Estrogen helps keep hair follicles in their active growing phase longer. As estrogen drops, hair spends less time growing before it sheds, so strands don't get as long or as full as they used to.¹
Thinner strand diameter. Individual hairs can grow in finer, which adds up to a noticeable loss of overall volume, even if you're not seeing dramatic shedding.²
A change in texture. Hair may feel drier, coarser, or more brittle as oil production and the hair's internal structure shift alongside hormone levels.³
A widening part at the crown. As estrogen declines, androgens become relatively more dominant. Androgens can cause hair follicles at the crown to shrink, which is why thinning tends to show up there first, rather than evenly across the scalp.⁴ By some estimates, more than half of postmenopausal women notice some version of this by their late 60s.⁵

If this sounds like what you're experiencing, hormonal change is very likely part of the picture. But it's not the only variable worth checking.

Or It Could Be Something Else Entirely

Because so many midlife hair changes overlap in timing, it's easy to pin everything on hormones. A few other common contributors worth ruling in or out:

Thyroid function. An underactive or overactive thyroid can shift hair growth cycle timing across the entire scalp, not just at the part or crown. Women may have changes in their thyroid hormone levels while simultaneously experiencing fluctuating or declining estrogen and progesterone levels.
Iron levels. Low iron stores are a common, quietly overlooked driver of shedding, especially for women who've had heavier periods during perimenopause. Levels that fall within a "normal" lab range can still be too low to support healthy hair growth.⁶
Medications. Certain medications, including some blood pressure prescriptions, blood thinners, and antidepressants, list hair shedding as a documented effect, one that often doesn't show up until months after starting. If you started something new recently, it's worth mentioning to your prescriber.⁷
Recent illness or a significant weight change. Illness, surgery, and a fast or significant weight change are all physical stressors that can push a larger share of hair follicles into the shedding phase at once. This kind of shedding tends to show up diffusely across the whole scalp, and it's usually delayed by two to three months from the original trigger, which makes it easy to miss the connection.⁸
Traction from styling. Tight ponytails, buns, braids, extensions, or similar styles put repeated or prolonged tension on the hair shaft at the root. Over time, that tension can thin hair specifically along the hairline, which may resemble hormonal hair thinning.

What to Ask Your Doctor

"What we see on the outside is often a reflection of internal imbalances, most of which begin long before menopause officially sets in," says Dr. Jody Comstock, MD, a dermatologist and Nutrafol partner with 35 years of experience.⁹ Her advice: Start with bloodwork, not guesswork.

Tests she recommends asking for:

Estrogen, progesterone, and total and free testosterone, plus FSH
Thyroid function: TSH, free T3, and free T4
Ferritin and iron
Vitamin D
Fasting glucose and insulin
Inflammatory markers, like high-sensitivity CRP

If your provider doesn't typically order the full panel, it's reasonable to ask for it directly, or to see a specialist who will.

Where Nutrafol Women's Balance Fits (and Where It Doesn't)

It is important to address how issues like thyroid dysfunction, low iron, and use of certain medications may be affecting your hair with your doctor. If your bloodwork comes back clear and natural hormonal change seems to be the main driver, that's exactly the need Nutrafol Women's Balance can support.*

Along with ingredients to support key root causes of hair thinning like stress, nutrition, and lifestyle, it's formulated for women 45 and older with Maca to support the hormonal transition, Saw Palmetto to help reduce the conversion of testosterone to DHT, Ashwagandha to help manage stress, and Marine Collagen Peptides for hair strength and scalp hydration.

It's also the first hair growth supplement with published clinical studies conducted specifically in menopausal women**; and in our studies, women saw improvement in hair growth and hair quality within three to six months.¹⁰

The Bottom Line

Most of the time, hormonal change will at least explain part of the story with changes to your hair after age 45. Nutrafol Women's Balance has been formulated to support visibly thicker, fuller, stronger hair specifically due to key root causes of hair thinning like stress, nutrition, or normal hormonal fluctuations during this transitional stage of life.

However, thyroid function, iron levels, medications, recent illness or weight change, and even how you style your hair can play a role. It's best to rule out any medical conditions that may be impacting your hair health with your doctor.

FAQ

Can hormonal thinning and something like a thyroid issue happen at the same time?

Yes. They're driven by different mechanisms, but they can overlap, which is part of why bloodwork is more useful than guessing based on general menopause symptoms alone.

How do I know if my hair thinning is hormonal?

Hormonal thinning tends to be gradual and pattern-based: a wider part, finer hair overall, changes concentrated at the crown that build over months or years. Sudden, all-over shedding is more often a sign of something else, like illness, medication, or a rapid weight change.

Should I stop a medication I think is causing shedding?

Talk to the prescribing doctor first. Don't stop or change a medication on your own based on a hair change alone.

Is it too late to do something about this once I notice it?

No. Whether the cause turns out to be hormonal or something else, the earlier you identify it, the sooner you can address it appropriately.

Featured Products

Women's Balance

*Nutrafol Women’s Balance does not address hair thinning that results from thyroid dysfunction, low iron, or all medications.

**Based on U.S. studies published through PubMed, Cochrane, and top Google Scholar and ScienceDirect results prior to February 2021.

References

Conrad F, Paus R. Estrogens and the hair follicle. J Dtsch Dermatol Ges. 2004;2(6):412-423. doi:10.1046/j.1439-0353.2004.04037.x
Mirmirani P. Hormonal changes in menopause: do they contribute to a “midlife hair crisis” in women? Br J Dermatol. 2011;165(suppl 3):7-11. doi:10.1111/j.1365-2133.2011.10629.x
Owecka B, Tomaszewska A, Dobrzeniecki K, Owecki M. The hormonal background of hair loss in non-scarring alopecias. Biomedicines. 2024;12(3):513. doi:10.3390/biomedicines12030513
Gupta AK, Economopoulos V, Mann A, Wang T, Mirmirani P. Menopause and hair loss in women: exploring the hormonal transition. Maturitas. 2025;198:108378. doi:10.1016/j.maturitas.2025.108378
Chaikittisilpa S, Rattanasirisin N, Panchaprateep R, et al. Prevalence of female pattern hair loss in postmenopausal women: a cross-sectional study. Menopause. 2022;29(4):415-420. doi:10.1097/GME.0000000000001927
Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol. 2003;121(5):985-988. doi:10.1046/j.1523-1747.2003.12540.x
Hill RC, Zeldin SD, Lipner SR. Drug-induced hair loss: analysis of the Food and Drug Administration’s adverse events reporting system database. Skin Appendage Disord. 2025;11(1):63-69. doi:10.1159/000540104
Malkud S. Telogen effluvium: a review. J Clin Diagn Res. 2015;9(9):WE01-3. doi:10.7860/JCDR/2015/15219.6492
Comstock DJM. A dermatologist’s guide to perimenopause. Nutrafol. 2025. Accessed September 4, 2026. https://nutrafol.com/blog/a-dermatologists-guide-to-perimenopause/
Berkowitz S. Evaluating the efficacy of a standardized nutraceutical to improve hair growth and quality in menopausal women: a nine month subjective single-blind prospective study. Presented at: American Society for Dermatologic Surgery (ASDS) Virtual Annual Meeting; 2020.