Menopause, skin and common dermatoses. Part 1: hair disorders

Abstract

Menopause, which usually occurs between the age of 45 and 55 years, is associated with falling oestrogen levels due to ovarian follicle depletion. The impact on the cardiovascular system and bone density are well documented; however, further research required to establish the impact on the skin and hair. In this first part of a four-part review, we examine the effect of menopause on the hair. We performed a literature review on dermatology and hair in menopause. Androgens and oestrogens are involved with regulation of the hair cycle, with a reduction in anagen hairs seen in postmenopausal women. Female pattern hair loss and frontal fibrosing alopecia have both been associated with the perimenopausal and postmenopausal states. It is clear that menopause and the change in hormone levels have an impact on the hair cycle and common hair conditions. However, further research is required, particularly to understand the therapeutic targets and role of hormonal therapy.

Frontal Fibrosing Alopecia and Reproductive Health: Assessing the Role of Sex Hormones in Disease Development

“…This phenomenon is diminished by progesterone, which has been shown to inhibit 5-α reductase, thereby decreasing dihydrotestosterone production. However, the gradual decline in the body hair score with aging implies that changes in scalp hair are not exclusively associated with the endocrine shifts associated with menopause [99][100][101][102]. This might be also possible since the skin is a factory for synthesizing numerous chemicals, most of which have autocrine or paracrine functions, in addition to being affected by various hormones [103].…”

The Hormonal Background of Hair Loss in Non-Scarring Alopecias

“…Various conditions can result in hypoestrogenism, including menopause (the most common cause), premature ovarian failure, and other causes of hypogonadism [ 57 , 58 , 59 ]. In previous studies, the relationship between menopause and hair loss has been studied and described in particular [ 60 , 61 ]. Estrogens in premenopausal non-pregnant women are mainly synthesized in the ovaries.…”

Diagnostic Evaluation of Hair Loss: A Narrative Review

“…Decreased oestrogen secondary to menopause often results in changes in hair quality and structure, with hair becoming thinner and drier, and patients often report hair loss. 20,21 Additionally, female PHL commonly presents in menopause, with weakening of the hair shaft and a wider part due to reduced hair density. 21,22 Compared with females who are pre-menopausal, there is an increase in frequency of male pattern changes in females ACE: angiotensin-converting-enzyme; DMARD: disease-modifying antirheumatic drug; SNRI: serotonin and noradrenaline reuptake inhibitors; SSRI: selective serotonin reuptake inhibitor.…”