Hair, Hormones, and Aging: What’s Normal — and What Actually Helps

Hair is one of the most emotional parts of aging — and one of the least talked about.

In a recent podcast conversation with Dr. Day, we unpacked something many women quietly notice:

Your hair ages too.

And no, you’re not imagining it.

What Happens to Hair as We Age?

You are born with a fixed number of hair follicles. That number does not change.

What does change?

• Follicles become smaller and thinner
• Hair strands become finer
• Texture shifts (curly becomes frizzy, straight becomes wiry)
• Color fades or coarsens

Many women notice an initial shift in their 30s — and then a more significant change in their 50s and 60s around menopause.

Estrogen plays a protective role in hair growth. As estrogen declines during perimenopause and menopause, thinning can accelerate.

You can lose up to 40% of your hair before you even notice it.

Female Pattern Hair Loss Is Different Than in Men

In women, thinning typically appears as:

• Widening of the part
• Diffuse thinning at the crown
• Overall decrease in volume

Causes can include:

• Hormonal shifts
• Aging
• Stress
• Autoimmune conditions
• Inflammation
• Genetic predisposition

Dramatic or sudden shedding deserves evaluation.

Is Your Scalp the Real Issue?

Your hair shaft is dead tissue.
Your scalp is living, aging tissue.

Signs your scalp may be contributing:

• Shedding that won’t slow down
• Strands becoming thinner and weaker
• A widening part
• Slower regrowth

Emerging research suggests the scalp microbiome plays a role in inflammation and follicle health. Inflammation at the base of the follicle is thought to drive many hair concerns.

For many women, the issue isn’t just the hair — it’s the environment the follicle lives in.

Does Hormone Therapy Help?

We do not yet have strong evidence that menopausal hormone therapy (MHT) reverses hair loss.

However, starting MHT earlier in perimenopause or early menopause may help slow progression in some women by stabilizing hormonal fluctuations.

It is not a guaranteed hair-restoration strategy.

Medical Treatments for Alopecia (Hair Loss)

Alopecia simply means hair loss.

Minoxidil (Androgenic Hair Loss)

Topical minoxidil 2–5% (5% tends to perform best) significantly outperforms placebo for improving hair density in female pattern hair loss.

It helps stimulate hair follicles and prolong the growth phase.

Important nuances:

• It can stimulate hair growth anywhere it is absorbed
• Oral versions may increase facial or chin hair
• Topical application is often preferred if unwanted hair growth is a concern

These treatments target the follicle — not the scalp environment.

What About Supplements?

A 2022 systematic review (Drake et al., JAMA Dermatology) examined 30 trials and found potential benefit for several branded complexes, including:

• Viviscal
• Nourkrin
• Nutrafol
• Lambdapil
• Omega-3/6 + antioxidants
• Pumpkin seed oil
• Zinc
• Tocotrienols

However, studies were often small and variable in quality.

Many menopausal hair formulas rely on phytoactives that influence estrogen/androgen pathways (e.g., saw palmetto, soy isoflavones, pumpkin seed oil).

Benefits appear modest and product-specific.

Pumpkin Seed Oil

A small randomized controlled trial comparing topical pumpkin seed oil to 5% minoxidil found improvement in both groups over three months. Promising — but more research is needed.

Biotin

Most people are not biotin deficient. It rarely improves hair unless deficiency exists.

Rosemary Oil

Recent small studies using rosemary-containing blends (often combined with lavender, castor oil, or other actives) show improvements in density and shedding over 90–120 days.

However:

• Most studies are small
• Often not rosemary alone
• Primarily in androgenetic alopecia

Evidence remains limited.

Collagen & Protein

Collagen peptides and adequate protein intake may support hair structure indirectly.

Hair itself is dead — nutrition supports the follicle and scalp, not the shaft.

A Note on Marketing

There are many products on the market. Some have limited evidence. Some rely heavily on branding.

Nutrafol, for example, is currently facing a class action lawsuit related to marketing claims. There are clinical studies showing reduced shedding and improved density in specific populations, but bold promises should always be viewed critically.

Discuss supplements with a clinician — especially if you have breast cancer risk or take medications.

Red Light Therapy

Low-level light therapy (LLLT) is a generally safe option with moderate evidence supporting modest increases in density and thickness in pattern hair loss.

Best results occur with:

• Consistent use
• Several months of treatment
• Often combined with other therapies

Optimal dosing parameters are still being refined.

Practical Prevention & Scalp Care

Your scalp is living tissue. Your hair shaft is not.

Hydrating your hair will not reverse thinning. Supporting scalp health might.

Practical strategies:

• Avoid phthalates in hair products
• Limit over-processing and excessive heat
• Protect hair when coloring
• Shampoo your scalp (that’s where buildup and inflammation occur)
• Condition the ends only
• Be gentlest when hair is wet — it is most fragile
• Brush from the ends upward
• Use a brush designed for wet hair
• Switch products if irritation occurs

Scalp health also connects to:

• Adequate protein intake
• Balanced gut health
• Reducing systemic inflammation

Over-processing and heat damage are cumulative. Balance matters.

The Big Takeaway

Hair changes are a normal part of aging.

Estrogen depletion accelerates the process.
Inflammation contributes.
Genetics matter.

There is no single magic product.

Hair health — like menopause care — lives in the grey.

If you’re experiencing rapid shedding, scalp symptoms, or dramatic changes, seek medical evaluation.

Otherwise, focus on scalp health, gentle care, and realistic expectations.

Your hair is changing.

That does not mean you are failing.

—

Natalie Perkins, PhD
Founder, PAUZ Health
Host, Grab Life by the Ovaries

Selected Research

• Sinclair R. Female pattern hair loss: Pathogenesis and treatment. Journal of Clinical Investigation.
• Olsen EA et al. Guidelines for management of androgenetic alopecia. Journal of the American Academy of Dermatology.
• Messenger AG et al. Alopecia in women: Pathophysiology and management. British Journal of Dermatology.
• Drake L et al. Evaluation of nutritional supplements for hair loss: A systematic review. JAMA Dermatology (2022).
• Burns L & Senna M. Supplement use among women experiencing hair loss. International Journal of Women’s Dermatology (2020).
• Rubaian N et al. Natural alternatives for androgenetic alopecia, including rosemary oil. Clinical, Cosmetic and Investigational Dermatology (2024).
• Research on scalp microbiome and inflammation in hair disorders. Experimental Dermatology.