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Hair Loss in Older Women: Causes and Treatment Options

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 6/29/2021

Aging gracefully is everyone’s goal. Often, the things we worry about — skin, gray hair, heart and mental health — get the most attention. 

But for women, one of the less talked about aging concerns is something traditionally associated with men: hair loss. 

Hair loss is not something normally associated with women, and yet for many older women it becomes a (not) growing reality as they lose more through their later years. 

As women age, the condition known as androgenic alopecia — more commonly known as female pattern hair loss — can affect hair density and contribute to thinning. 

But it’s not the only reason a woman out of her younger years might be losing hair. 

Before we discuss reasons women might lose hair as we age, it’s important to understand some basics about how hair grows, and why it may stop growing.

Why You Lose Your Hair

As you might suspect, hair loss is completely normal at every age when it happens within certain parameters. Children lose hair every day after all, and the same is true for normal adults.

You can shed about 100 hairs a day as an adult without falling outside normal parameters. The average human head has about 100,000 hairs, and 100 is just a small fraction compared to what (should be) growing every day.

In fact, every one of your hair follicles can be in a slightly different position on the circle that represents your hair’s three life cycle phases — the anagen phase, catagen phase and telogen phase.

Hair grows in the anagen phase, rests in the catagen phase and falls out in the telogen phase before the whole cycle starts again. 

Up to 10 percent of your hair is typically in the telogen phase at one time, with about 90 percent  of your hair growing in the anagen phase.

What we understand as “hair loss” is really “excessive” hair loss — the shift from normal percentages to an imbalance of follicles that are remaining in the telogen phase and not regrowing.

Hair might end up stuck in the telogen phase for a variety of reasons — autoimmune diseases, stress, trauma to the scalp or body generally. 

It may also be due to genetics or hormones. Depending on the cause, hair loss will be characterized as a different condition or disorder.

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Causes of Hair Loss in Older Women

Despite a focus on certain types of hair loss, women can see thinning or balding from a number of conditions and disorders. 

Here’s a brief look at the most frequently seen causes of hair loss in older women.

Telogen Effluvium

Telogen effluvium is a condition in which more than 10 percent of your hair follicles become locked into the telogen phase, causing a disproportionate amount of your hair follicles to be dormant. 

It typically appears as even thinning across the scalp, rather than spotty, patchy loss. Typically, telogen effluvium is caused by a stressor like major surgery, trauma, illness, giving birth or radiation. 

It’s thought to be common during stressful events like high fever, after an operation or when someone has lost a significant amount of weight.

Typically, it will resolve itself after several weeks or months.

Traction Alopecia 

Traction alopecia is hair loss due to follicle and scalp injuries, and is sometimes referred to as traumatic alopecia. 

But unlike a blow to the head, this is typically related to hair styles that stretch, pull or strain the follicle repeatedly. 

Bleaching, straightening and other stylistic manipulations can cause traction alopecia. It’s best treated preventatively — when you remove the strain, the damage generally stops. 

Alopecia Areata

The condition commonly referred to as alopecia areata is not so much a type of hair loss as it is a term for hair loss due to autoimmune diseases. 

Alopecia areata is the name given to hair loss due to your immune system erroneously attacking your scalp or follicles as if they are foreign bodies. There are two types of alopecia areata: alopecia totalis and alopecia universalis, which describe hair loss in the scalp or over the whole body respectively. 

Autoimmune conditions typically don’t have a cure — the best treatment will be set out by your healthcare provider once they’ve diagnosed your larger condition and its issues.

Androgenic Alopecia

Androgenic alopecia is typically discussed by its more common names: male pattern baldness or female pattern hair loss. 

It is caused by fluctuations in hormones, and typically manifests as men and women age. 

While most people will assume that later in life changes cause this kind of hair loss, the fact is, hormone fluctuations may begin as early as a woman’s twenties. 

Still, it’s true that the most common time for it to begin is at the outset of menopause, or during what is known as perimenopause

Women experience androgenic alopecia similarly to men, but with a few key differences.

The hair loss appears as thinning all over, rather than on the crown. Likewise, women do not typically experience a receding hairline.

The hormones that cause hair loss for men and women are called androgens, but not all women show an increase in circulating androgen levels as they hit menopause — or as they begin to lose their hair — suggesting that a more complicated mechanism may be involved. 

Unfortunately, science does not yet understand that mechanism.

Hair Loss Treatment Options

Whether the cause of your hair loss is determined to be androgenic alopecia or another condition, there are a variety of topical and oral medications that can reduce, halt or reverse thinning in your scalp. 

Some are better and safer than others.

Finasteride is one of the oral medications that fights the effects of androgenic alopecia, though it’s typically prescribed for men for a variety of safety reasons. 

It does this by balancing your levels of the hormone DHT. Studies show finasteride is effective for men. 

For women, it’s not such a safe bet.

While the efficacy of finasteride for women is less clear than for men, the most important concern is that finasteride can also carry serious risks for pregnant women, as it can cause a male fetus to develop ambiguous genitalia. 

Even if you’re not pregnant, side effects can include sexual dysfunction and cancer risks. 

Antiandrogens like spironolactone or cyproterone acetate are a better and safer bet for most women, though a healthcare professional will help you make the final decision.

Perhaps most commonly used in women is topical minoxidil, which is believed to increase blood flow to hair follicles to encourage hair growth. 

A study of men using minoxidil over a 48-week period showed up to an 18 percent increase in hair growth — and women can expect similarly effective results. 

Aside from traditional medications, there are herbal options to consider, including saw palmetto: a popular shampoo ingredient for fighting DHT. 

And there are lifestyle and dietary treatments that a healthcare provider might want you to consider as part of a holistic treatment.

Increasing key vitamins and reducing your intake of processed foods can help — particularly if you’re deficient in any of them. 

Vitamin A, vitamin D and biotin (like the stuff found in hers’ Biotin Gummy Multivitamins) can also help.

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Treating Hair Loss: Take Control

If you’ve begun to see more of your scalp than you’d like, the first step you should take is to speak with a healthcare professional about your observations and concerns. 

Proper attention to hair health makes all the difference, particularly if you’ve already started seeing signs of thinning. 

Whether you suspect your hair loss might be genetic or the result of another factor, a healthcare professional will be able to give you more information. 

They’ll also be able to guide you to the best treatment options, lifestyle changes or diagnoses that could help you retain your mane. 

Androgenetic alopecia may indeed be what’s causing your thinning, but there are other issues you might not even be aware of — a healthcare professional will be able to give you the proper guidance on your own needs.

Hair loss and hair thinning don’t have to be permanent, but time is not necessarily on your side.

If your hair loss is sudden, you can find out more about sudden hair loss with our guide. We also have products to help you treat many hair problems in our selection of hair care products—you can also purchase them together in our Complete Hair Kit.   

13 Sources

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.

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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.

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