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Does Low Estrogen Cause Hair Loss?

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Hadley Mendelsohn

Published 07/25/2021

Updated 07/17/2024

The short answer is yes, particularly during menopause. In fact, we can blame a lot on hormonal changes, from unexpected tears to hot flashes, sex drive fluctuations, and, you guessed it, hair loss and thinning.

Estrogen, alongside other hormones, works to optimize the efficiency of your bodily functions. But an imbalance in hormones — like low estrogen levels — can affect many things, from your sex drive to, well, your hair.

In this article, we’ll dive into the science of hair loss in women and whether estrogen causes hair loss. We’ll also provide tips on treating signs of thinning if you experience hair loss.

Yes, low estrogen might cause some hair loss and thinning, especially during menopause.

Hair loss in women is wildly common. Research has shown that up to 50 percent of females can be affected by female pattern hair loss or androgenetic alopecia.

This type of hair thinning might stem from an excessive response to androgens (another sex hormone), possibly due to genetics. But that link isn’t clearly established in female hair loss yet.

Female pattern hair loss is characterized by follicular miniaturization, which basically means shrinking hair follicles. Miniaturized follicles can result in thinner and shorter hair over time, creating the appearance of balding or thinning in females.

One potential cause of hair loss is a change in hormone levels. While the role of estrogen, the primary female sex hormone, in human hair growth isn’t totally clear, it may play a protective role against hair loss in women.

 Estradiol, a form of estrogen, plays a role in the hair cycle. It can bind to estrogen receptors and influence the process that turns androgen into estrogen — it sounds complicated, but it’s a necessary function for the hair growth cycle. This type of hair loss typically affects the entire scalp rather than creating separate, dispersed bald spots.

In one study, 20 premenopausal women with androgenetic alopecia had their serum levels tested on the first day of their menstrual cycle. The ratio of estradiol to free testosterone and the ratio of estradiol to dehydroepiandrosterone sulfate (DHEAS) was significantly lower in patients than in the control group.

The researchers concluded that the ratio of estradiol to free testosterone may be a factor in triggering female pattern hair loss in women.

Hair Regrowth

The long, short, think, and thin of it

It’s normal for female hormones to fluctuate with each menstrual cycle. Consistently low estrogen could also be a sign of an underlying issue, a side effect of certain medications, or a normal manifestation of aging.

During menopause and perimenopause (the period of transition before menopause kicks in), women’s bodies undergo many hormonal changes.

In your reproductive years, your ovaries are responsible for making the majority of your estrogen. Once you’re about 45+, menopause may set in, and your ovaries gradually decrease their estrogen production.

It’s important to note that not everyone experiences menopausal hair loss, and low estrogen can stem from factors beyond aging. Other potential causes of low estrogen include:

  • 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 healthy fat levels — but this study also concluded that women with high body fat also had low estrogen levels.

  • Exercising excessively. While moderate exercise is generally 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. Channeling some chill can do wonders for your mood, but did you know there’s a link between stress and the health of your hairline? Research shows that psychological stress may make the natural decrease in estrogen during your menstrual cycle more extreme, cranking up the hormonal imbalance — and the issues that come with it.

  • Thyroid disorders. One study found that thyroid disorders, such as hypothyroidism (low thyroid hormone production), may decrease the production of estrogen and other sex hormones. However, the above study's sample size included only 59 women.

  • Primary ovarian insufficiency (POI). This is when a woman’s ovaries stop functioning normally before age 40. This condition is often linked to genetic, metabolic, or immune system disorders.

  • Turner syndrome. This chromosomal condition can result in an early loss of ovarian function.

  • 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, other symptoms of low estrogen may include:

  • Reduced 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

  • Dry skin

  • Mood swings

  • Weight gain (especially in the belly area)

  • Fatigue

Stop Hair Loss

Want thicker, fuller hair?

So now you know the basics, but you might still wonder how to stop estrogen hair loss and regain your hair health. To be honest, there’s not a simple, straightforward answer here. Since several health issues can cause low estrogen, no one-size-fits-all medication can treat low estrogen-related hair loss.

Your healthcare provider may suggest using medication to boost your body’s estrogen production if it’s low. You may also benefit from hair loss treatments designed to promote healthier hair, prevent breakage, and improve hair growth.

Let’s dive into the various hair loss treatments that can help you stop estrogen hair loss.

Check Your Estrogen Levels First

If you’re worried you may have low estrogen levels, it’s essential to talk to your healthcare provider.

Getting your estrogen levels checked is a simple blood test. A lab will test the sample for the three different types of estrogen your body makes: estrone (E1), estradiol (E2), and estriol (E3).

If these levels are low, your provider will likely conduct additional tests to figure out what’s going on.

If your levels come back in the normal range, there may be another root cause for your hair loss. You can learn more about the causes of female pattern hair loss and treatments in our comprehensive guide.

Hormone Replacement Therapy (HRT)

If you have persistent low estrogen levels, your healthcare provider may prescribe hormone replacement therapy (HRT).

HRT is often referred to as estrogen replacement therapy. It’s commonly used to treat menopausal symptoms and involves mimicking hormones (like estrogen and progesterone) created by the human ovary.

There are various ways HRT can be delivered: orally, and through the skin (transdermally) with patch, vaginal inserts, cream, or subdermal pellets.

HRT can cause side effects like the risk of stroke or heart disease, so it’s important to talk to your healthcare provider to ensure this treatment is right for you.

Natural Remedies

You can take certain holistic measures to help naturally increase estrogen, including trying supplements (like biotin), getting enough sleep, reducing stress, and maintaining a healthy body weight. Here’s how these factors can help:

  • Work towards a healthy body weight. Being underweight or very overweight could cause lower estrogen levels. Speak with a dietician to ensure to make sure you’re getting all the nutrients, vitamins, and minerals essential for healthy hair growth.

  • Exercise in moderation. Avoid overdoing it since over-exercise can mess with hormone levels.

  • Reduce stress levels. Too many stress hormones (like cortisol) can throw everything out of balance. Try practices like meditation or yoga to help channel some zen and reestablish hormonal balance. And make sure you’re getting enough sleep.

Hair Growth Medication

Many medications treat female pattern hair loss. Here are some hair loss treatments you may want to consider:

  • Minoxidil. This medication has been used for decades and is an FDA-approved topical treatment for female pattern hair loss. A review of clinical trials showed that patients with androgenetic alopecia treated with 2% or 5% minoxidil had major improvements in hair growth and less hair loss. These topical formulations may have fewer side effects than other treatments like spironolactone. They’re also available over the counter, so adding them to your cart is easy. Hers offers both minoxidil drops (2% strength) and minoxidil foam (5% strength).

  • Topical finasteride and minoxidil spray. This two-in-one spray combines 0.3% finasteride and 6% minoxidil for a powerful formula that can help promote new hair growth for post-menopausal women. Topical finasteride has not been approved by the FDA to treat female pattern hair loss but has been used off-label for this condition.

  • Oral minoxidil. This once-daily prescription pill may be good if you haven’t responded well to topical minoxidil. While the FDA hasn’t approved oral minoxidil for hair loss, clinical trials have shown it’s quite effective for hair growth at various doses (0.25 to 2.5 mg daily).

  • Spironolactone. For those with signs of hyperandrogenism (excessive androgen hormones) and other hormonal imbalances, spironolactone may be an effective treatment for female pattern hair loss. Spironolactone stops androgen from binding to receptors, which reduces testosterone and DHT levels and decreases hair loss. Women who are pregnant or trying to get pregnant shouldn’t take spironolactone.

Hair Loss Treatment

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Estrogen may play a role in how lush your hair is, but there are steps you can take to get healthy hair, even if you have low estrogen. Maintain thicker, healthier hair by:

  • Checking in with your healthcare provider. A medical professional, like a primary care doctor or dermatologist, should determine whether you have estrogen hair loss.

  • Boosting your estrogen levels. Whether you try natural measures like getting exercise or opt for hormonal replacement therapy, boosting your estrogen levels may help your hair feel fuller again.

  • Trying a hair treatment option. From minoxidil to spironolactone, various effective hair loss treatments can help kick-start hair growth.

While losing hair is not fun, remember that you’re not alone.

And you’re one step closer to coming up with a treatment plan. The right hair loss treatments may help reverse hair loss and restore your confidence (but we think you’re pretty either way).

Start your hair consultation today if you’re interested in figuring out a routine that’s right for you.

14 Sources

  1. American Academy of Dermatology. (n.d.). Do you have hair loss or hair shedding? Retrieved from https://www.aad.org/public/diseases/hair-loss/insider/shedding
  2. Assad SA, et al. (2017). Role of Sex Hormone Levels and Psychological Stress in the Pathogenesis of Autoimmune Diseases. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498122/
  3. Grymowicz MO, et al. (2020). Hormonal Effects on Hair Follicles. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/
  4. Ho CH, et al. (2024). Androgenetic Alopecia. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430924/
  5. National Library of Medicine. Finasteride - Mother To Baby | Fact Sheets. (2022). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK582707/
  6. National Library of Medicine. Turner syndrome. (2023). Retrieved from https://medlineplus.gov/genetics/condition/turner-syndrome/
  7. Patel PR, et al. (2024). Minoxidil. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
  8. Peacock KI, et al. (2023). Menopause. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507826/
  9. Reidel-Baima, B, et al. (2008). Female pattern hair loss may be triggered by low oestrogen to androgen ratio. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18333699/
  10. Rinaldi FA, et al. (2023). The Menopausal Transition: Is the Hair Follicle “Going through Menopause”?. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669803/
  11. Saran SA, et al. (2016). Effect of hypothyroidism on female reproductive hormones. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743370/
  12. Shannon FA, et al. (2016). Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573453/
  13. Suchnowanit PO, et al. (2019). Minoxidil and its use in hair disorders: a review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
  14. Ziomkiewicz A, et al. (2008). Body fat, energy balance and estradiol levels: a study based on hormonal profiles from complete menstrual cycles. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18641044/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board-certified dermatologist specializing in hair loss. Dr. Beasley obtained his Bachelor of Science from the United States Military Academy at West Point, NY, and he subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military in San Antonio, TX, helping to diagnose dermatologic conditions in soldiers all over the world. Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen, of course) with his wife and two children in his spare time.

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