Does melatonin help with hair thinning during perimenopause?

Hair thinning during perimenopause is distressing and very common. The primary driver is androgenic alopecia, a pattern of hair loss triggered by the relative rise in androgens as estrogen and progesterone decline. Other contributors include elevated cortisol from chronic stress and poor sleep, nutritional deficiencies (particularly iron and ferritin), and thyroid changes. Melatonin's relationship to hair thinning is more specific than you might expect, and it is one of the more interesting areas of melatonin research outside of sleep.

Melatonin receptors have been identified in human hair follicles. This discovery opened the door to research examining whether melatonin plays a role in the hair growth cycle. Hair follicles cycle through phases of active growth (anagen), regression (catagen), and rest (telogen). Research in both animal models and small human studies suggests melatonin may help shift follicles toward the anagen (growth) phase and prolong the time they spend in active growth. Fischer et al. (2004) conducted one of the early studies in this area, applying topical melatonin solution to women with diffuse hair loss or androgenic alopecia. After six months of use, they found a significant increase in the proportion of follicles in the anagen phase compared to baseline. The results were promising, but the study was small and used a topical formulation rather than oral supplementation.

The evidence for oral melatonin specifically improving hair thinning in perimenopause is limited. The mechanisms for topical versus oral melatonin acting on follicles differ, and it is not established that oral supplementation delivers meaningful concentrations to the follicle level in the scalp. Most of the direct hair research has used topical preparations.

That said, oral melatonin may contribute indirectly through two other pathways. First, its antioxidant properties, reviewed by Rossignol and Frye (2011), may protect follicle stem cells from oxidative damage. Oxidative stress has been implicated in follicle miniaturization and the progression of androgenic alopecia. Whether systemic melatonin supplementation reduces oxidative stress at the follicle is not directly established, but the antioxidant capacity is real. Second, the sleep pathway matters: poor sleep raises cortisol, and sustained cortisol elevation is associated with a shift of follicles into the telogen (shedding) phase. Women with significant sleep disruption sometimes notice increased hair shedding. By improving sleep quality, melatonin may reduce cortisol-driven telogen effluvium.

Bellipanni et al. (2001) reported general improvements in wellbeing in perimenopausal women taking 3 mg of melatonin nightly for six months. Hair condition was not a primary outcome, so this study does not provide direct evidence. Still, improvements in sleep and hormonal balance may create a more favorable environment for hair retention.

Research has examined doses ranging from 0.3 mg to 3 mg for systemic effects. Talk to your healthcare provider about the right dose for your situation, particularly if you have underlying health conditions or take medications.

Safety: melatonin is generally well tolerated for short-term use. Higher doses can cause next-day drowsiness. It may interact with blood thinners, immunosuppressants, and some diabetes medications. Autoimmune conditions require medical guidance before use.

If you are tracking symptoms in PeriPlan, noting your sleep quality alongside how your hair is feeling can help you build a clearer picture over time. Hair changes are slow to show improvement, so a consistent three to six month period is usually needed to assess any intervention fairly.

When to see a doctor: If hair thinning is significant, rapid, or occurring in patches, see your provider before starting any supplement. Blood tests for ferritin, thyroid hormones (including TSH and free T3/T4), and androgens can identify treatable causes. Low ferritin is one of the most common and correctable drivers of hair loss in perimenopausal women. Alopecia areata, an autoimmune form of hair loss, can also emerge during periods of hormonal or immune change and requires specific treatment. Do not assume hair thinning during perimenopause is purely hormonal without appropriate testing.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.