Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 7/25/2021
It’s normal to shed between 50 and 100 hairs per day, many of which end up on your pillowcase or stuck inside your hairbrush.
However, if you’re losing a lot of hair every day, there’s a chance that it’s linked to an underlying health issue.
One potential cause of hair loss is a change in your levels of certain hormones, particularly the female sex hormone estrogen.
Your estrogen levels may drop in response to a health issue, the use of certain medications or during menopause.
Below, we’ve discussed how low estrogen can contribute to hair loss, as well as the treatment options that are available if you’re experiencing hair loss and think that low estrogen levels are the cause.
Estrogen is one of the most important female sex hormones. It’s responsible for several aspects of your health, including controlling your menstrual cycle and promoting optimal brain, bone, heart and skin health.
Before menopause, your body produces three forms of estrogen: estradiol, estriol and estrone. During menopause, your body stops producing estradiol and estriol, and only produces estrone.
Some women develop menopausal hair loss as they enter menopause in their 40s, 50s or 60s. Experts believe that reduced levels of estrogen and other hormones may play a role in menopausal hair loss.
Research shows that estrogen is linked to hair growth. For example, during pregnancy, when estrogen levels are high, it’s common for hair density to increase, with a reduced level of shedding. However, pregnancy hair loss could be common as well.
Estrogen is one of several essential sex hormones in your body. During puberty, it plays a major role in starting your menstrual cycle and defining your female physical features.
Throughout your life, estrogen is responsible for maintaining healthy cholesterol levels, keeping your bones strong and healthy and affecting certain aspects of your brain function.
Although the link between estrogen and hair health isn’t completely understood, experts believe that these hormone levels do play a protective role against hair loss.
This is because most research shows that women with low levels of estrogen are more likely to develop female pattern hair loss (FPHL) as a result of the hormonal imbalance.
Female pattern hair loss is the women’s equivalent of male pattern baldness (MPB). It’s caused by a combination of hormonal and genetic factors.
Unlike male pattern baldness, which usually causes a receding hairline or bald spot around the crown, female pattern hair loss generally causes your hair to thin around your part line (the line along which your hair naturally parts from side to side).
Over time, this type of hair loss can become more severe until the hair on the top of your scalp has an almost see-through appearance.
When we talk androgenetic alopecia, we’re usually talking about men. But, believe it or not, female hair loss loss is quite common in women, especially as we age.
In fact, research shows that around 21 million women in the United States alone show some degree of female hair loss.
Several different factors can affect your estrogen levels. The most significant is age. In menopausal women, it’s normal for the amount of estrogen that’s produced by the body to decline.
In premenopausal women, the body should produce approximately 30 picograms to 400 picograms of estradiol per milliliter of blood (pg/mL).
And for postmenopausal women, it’s normal to have a blood estradiol level of 30 pg per mL or less.
Several other issues may also cause low estrogen:
Being underweight or having very little body fat. Research
has found that estrogen production is usually lower in women with very little body fat than in women with normal levels of fat.
Being overweight or obese
. Similarly, research has also found that women with very high levels of body fat are also more likely to have decreased estrogen levels.
Exercising excessively. While a moderate amount of exercise is great for your health, large amounts of high-intensity exercise
may affect your hormone production and result in lower estrogen levels.
Being under significant stress. Research
shows that psychological stress may make the natural falls in estrogen that occur during your menstrual cycle more extreme, cranking up the hormonal imbalance — and the issues that come with it.
Thyroid disorders. Research shows that thyroid disorders, such as hypothyroidism (low thyroid hormone production) may cause a reduction in the amount of estrogen and other sex hormones produced by your body.
However, it’s worth noting that the sample size for the above study included only 59 women.
Primary ovarian insufficiency (POI). Also referred to as premature ovarian failure, this condition occurs
when your ovaries stop functioning normally before the age of forty. This condition is often linked to genetic, metabolic or immune system disorders.
Polycystic ovary syndrome (PCOS). This is a common hormonal disorder that tends to affect women in their 20s and 30s. It can cause a range of symptoms, including changes to your menstrual cycle and PCOS-related hair loss
Turner syndrome. This is a chromosomal condition
that can affect ovarian development and hormone production.
Using certain types of medication. Some medications, including those used in breast cancer treatment and prevention, work by reducing the amount of estrogen produced by your body.
In addition to hair loss, low estrogen can cause a range of symptoms. Other symptoms of low estrogen include:
A reduced level of interest in sex
Less frequent menstrual periods, or no periods
Hot flashes (sudden, intense feelings of warmth) and/or night sweats
Difficulty sleeping or staying asleep
Vaginal dryness and thinning of vaginal tissue
Some of these symptoms may occur before and during your period. For example, some women experience menstrual migraines — painful headaches that occur before or during their period.
This is because your levels of estrogen fluctuate during your period. When estrogen levels are low, you may have a higher risk of experiencing the symptoms listed above.
If you’re worried that you may have low estrogen levels, it’s important to talk to your healthcare provider.
Getting your estrogen levels checked is a simple process. Your healthcare provider will take a blood sample or request that you provide a saliva or urine sample. This sample will be tested for estrone (E1), estradiol (E2) and estriol (E3) in a lab.
If your estrogen levels are below the reference range, your healthcare provider may request an additional test to help determine the possible cause.
Since several health issues can cause low estrogen, there’s no one-size-fits-all medication that can treat low estrogen hair loss.
If your estrogen levels are low, your healthcare provider may suggest using medication to boost your body’s estrogen production. You may also benefit from treatments designed to improve hair growth and promote healthier hair.
We’ve listed the most effective treatment options for estrogen-related hair loss below, along with information on how each treatment works
If you have persistent low estrogen levels that aren’t related to your menstrual cycle, pregnancy or medication, your healthcare provider may prescribe hormone replacement therapy (HRT).
HRT is often referred to as estrogen replacement therapy. It’s widely used to treat menopausal symptoms and involves using supplemental estrogen, either on its own or in combination with a second hormone, to manage your symptoms and improve your quality of life.
As part of HRT, you may need to take one or several tablets per day, apply a skin patch or use a vaginal cream, ring or gel.
HRT can cause side effects. As such, you may need to check in with your healthcare provider to keep track of your health and wellbeing during treatment.
If you have low estrogen levels due to a lifestyle factor — for example, excessive exercise — your healthcare provider may suggest making changes to increase your estrogen production.
You may need to adjust your activity level or diet. If you’ve experienced weight gain over time or are clinically obese, your healthcare provider may suggest losing weight. Other lifestyle changes, such as reducing your stress levels, may also help to promote optimal hormone production.
Many women with hair loss use minoxidil, a topical medication that stimulates hair growth and extends your hair’s natural growth cycle.
Minoxidil works by shifting your hair follicles into the anagen (growth) phase of the hair cycle.
It also stimulates blood flow to your scalp, which may increase the supply of nutrients to your hair, which is believed to improve healthy hair growth.
It usually takes several months for minoxidil to start working. You’ll need to use this medication daily for sustained results.
It’s important to note that minoxidil doesn’t have any known effect on estrogen levels, meaning this medication won’t treat the underlying causes of low estrogen hair loss.
Make sure to talk to your healthcare provider before using minoxidil with HRT or other treatments for low estrogen.
Our guide to minoxidil for female hair loss provides more information about how minoxidil works and how you can use it to grow full, healthy hair.
Although products like shampoo and conditioner can’t and won’t treat low estrogen, they’re still important for keeping your hair in optimal condition.
Even if you’re prescribed medication to increase your estrogen levels, it’s essential to take good care of your hair.
Low estrogen production can cause a variety of symptoms. Some of these symptoms include hot flashes, mood swings, dry skin and even possibly hair loss.
Although the link between estrogen and hair isn’t totally understood (at least, not as well understood as the relationship between low estrogen and hot flashes — ugh), experts believe that low estrogen levels may play some role in the development of female pattern hair loss, or female androgenetic alopecia.
If you’ve noticed your hair thinning and believe that low estrogen could be the cause, it’s best to talk to your healthcare provider about checking your estrogen levels.
If your estrogen levels are below the normal range, you may need to use hormone replacement therapy or make changes to your habits and lifestyle.
Hair growth treatments, such as minoxidil for women, may also help you to regrow your hair and promote consistent, sustainable hair growth.