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For most women it's relatively mild: you might notice more hair in the plug hole, thinning around the temples or a reduced pony tail volume.
Understanding why this hair loss may be happening is important, because there are things you can do to support imbalances or nutrient deficiencies, to enable your hair's natural growth cycle to improve. Here, we'll focus specifically on two key nutrients which are sometimes overlooked when it comes to hair loss: vitamin B12 and iron.
There are so many reasons why hair loss can happen leading up to and during menopause, including the effect of hormonal changes, genetic predisposition or thyroid health. Very often nutrient deficiencies are overlooked, particularly in regard to iron and vitamin B12 levels, because as women stop having periods it's less likely they'll be deficient in these nutrients.
The fact is that many women can have increased menstrual blood flow leading up to and during menopause, due to cycle changes, and mid cycle or heavy bleeding. This can lead to an increased risk of B12 or iron deficiency, both of which are known to contribute to hair loss.
Many women also find it difficult to lose weight during menopause, so make changes to their diet, which can lead to nutrient deficiencies. It can also take several years post menopause for a woman's iron levels to reach those of a man the same age, particularly if she's always had heavy or long periods.
When looking at iron deficiency and hair loss, it's important to recognise the difference between iron levels in haemoglobin and iron stores, also known as ferritin. Ferritin is the protein which stores iron in our body, and low levels are one of the most common causes of hair loss: without it, the growth cycle of hair is reduced. It's possible to be low in ferritin without being iron deficient, which is why if your GP is checking your iron it's vital they also check your ferritin levels too. This can all be done with a blood test.
The reference range for ferritin in the UK is typically anything under 22 ug/L being classified as low, however optimum levels could be considered to be anywhere over 50. Every person is different, with some women still feeling tiredness and other symptoms when their ferritin is under 30. You should be sure to carefully check the units of measurement being used in relation to your ferritin levels, as sometimes this differs between health authorities and countries.
If you discover that your iron levels or iron stores are low, make sure you include plenty of iron rich food in your diet. This includes liver, red meat, fish, nuts, green leafy vegetables, blackstrap molasses, dark chocolate and even the odd glass of Irish stout. Combine these with vitamin C rich foods such as berries, kiwis, red peppers, parsley, and greens to support absorption of the iron.
If you need to supplement iron, do take some vitamin C alongside your iron tablets to support absorption. 500mg up to three times per day with every iron tablet is usually advised.
Another simple nutrient deficiency that is easy to test for, and manage, when it comes to menopausal hair loss is vitamin B12. Risk factors include heavy or prolonged periods, as well as gastric surgery, use of acid reflux medication, and vegan or vegetarian diets. Alongside hair loss, symptoms of B12 deficiency include mouth ulcers, palpitations, low appetite, poor memory and tingling hands or feet.
Vitamin B12 supports the maintenance of normal bones, teeth, hair, skin and nails. Animal foods are the only sources of B12, including meat, fish, eggs and dairy. Vegans need to rely on fortified foods (such as cereals, yeast extract, soya products) and B12 supplements. The recommended daily amount for B12 in the UK is 1.5mcg per day, however this is not enough to correct a deficiency.
If you have a blood test and find you are deficient in B12, your GP may discuss B12 injections with you. Alternatively, a sublingual B12 supplement of 1000mcg is advised, alongside a diet rich in B12 foods or fortified foods.
If you do discover you are low in iron stores or B12, it can take some time to correct these deficiencies. Try to be patient, because once these levels are corrected, you may find your hair begins to thicken and regrow after several months.
For more advice and information about the menopause, select Menopause on the Your health menu above.
Catherine Jeans DipION mBANT CNHC is a nutritional therapist and founder of The Family Nutrition Expert. She has a special interest in women’s health, supporting hormonal balance and optimal wellbeing in women of all ages, through the use of food, nutrition and functional health.
Find out more about Catherine Jeans.
Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.