Your Complete Hair Care Guide for Perimenopause

When your hair starts to feel different

Maybe your ponytail feels thinner than it used to. Or you are finding more hair in the shower drain and on your pillow. Or the texture has shifted, from shiny and smooth to dry and coarser, and products that used to work have stopped making a difference.

Hair changes during perimenopause are among the most emotionally significant shifts women describe. Hair is deeply tied to identity, and watching it change can feel unsettling. You are not alone in this, and there are real, evidence-based steps you can take.

What perimenopause does to your hair

Hair growth happens in cycles: a growth phase (anagen), a transition phase (catagen), and a resting phase (telogen) where the hair falls out before a new one grows. Estrogen keeps hair in the growth phase longer. As estrogen levels fluctuate and decline, more hairs shift into the resting phase at once, leading to increased shedding.

Androgens (including testosterone and its derivatives) also play a role. During perimenopause, the ratio of estrogen to androgens shifts. This can contribute to a pattern similar to female androgenetic alopecia: thinning at the part line and crown rather than a receding hairline.

DHEA, cortisol, and thyroid hormones all interact with hair follicles too. Thyroid changes are common during perimenopause and can independently cause significant shedding, which is why getting thyroid levels checked is part of any thorough evaluation of hair loss.

Why it matters beyond appearance

Hair thinning and shedding during perimenopause can signal broader nutritional or hormonal shifts that are worth addressing for overall health. Iron deficiency, for example, is a common and correctable cause of hair loss that overlaps with perimenopause in timing.

Significant shedding also affects scalp health. The scalp is skin, and it needs its own care, particularly as sebum production changes. Scalp health supports follicle health, which matters for the hairs that are still growing.

Address hair changes early. The longer a follicle remains dormant, the harder it can be to reactivate. Acting on supportive habits now protects more of what you have.

The foundations: what your hair needs most

Nutrition is the most impactful foundation. Hair follicles are among the fastest-dividing cells in the body and need a consistent supply of protein, iron, zinc, biotin, and B vitamins. Inadequate protein intake is one of the most common drivers of hair loss that gets overlooked during perimenopause, when calorie intake may decrease.

Aim for adequate dietary protein, generally 0.7 to 1 gram per pound of body weight, from whole food sources like eggs, fish, legumes, Greek yogurt, and lean meats. These also provide many of the co-nutrients hair follicles need.

Hydration affects hair shaft quality directly. Chronically dehydrated hair becomes brittle and breaks more easily, which adds to the appearance of thinning even when the follicle itself is healthy.

Your hair care action plan

Step one: Get blood work done. Ask your doctor to check ferritin (stored iron), thyroid function (TSH, free T3, free T4), and vitamin D. Low ferritin, even within the normal lab range, can cause significant shedding. These are fixable.

Step two: Handle your hair more gently. Heat styling, tight hairstyles, chemical processing, and harsh brushing all cause mechanical breakage that worsens the appearance of thinning. Air-dry when possible, use a wide-tooth comb on wet hair, and consider a silk or satin pillowcase to reduce overnight friction.

Step three: Switch to a scalp-supporting shampoo. Look for formulas that are sulfate-free or low-sulfate, and consider adding a scalp massage to your routine. Even two to three minutes of firm but gentle scalp massage daily has been studied for its effect on hair thickness, with some promising results.

Step four: Assess your styling products. Heavy silicones and waxes can clog follicles over time. Lighter formulas, or occasional clarifying washes, help keep the scalp environment healthy.

Step five: Protect against environmental damage. UV exposure and pollution affect hair shaft integrity. Protective styles, hats in strong sun, and UV-protective hair products reduce cumulative damage.

What makes hair changes harder to manage

Stress is a significant driver of hair loss on its own, separate from hormonal changes. Telogen effluvium, a sudden increase in shedding triggered by stress, illness, or nutritional depletion, can layer on top of perimenopause-related changes and make the total loss feel alarming.

Sleep deprivation impairs the body's overnight repair processes, including those that support follicle cycling. Poor sleep during perimenopause, driven by night sweats or insomnia, compounds hair-related stress.

Crash dieting is particularly damaging during this period. Rapid calorie restriction shocks follicles into the resting phase. If weight management is a goal, slow and steady approaches protect your hair.

Supplements and treatments: the honest evidence

Minoxidil (Rogaine) is the only topical treatment approved by the FDA for female hair loss, and it works by extending the growth phase of hair follicles. A 2 percent or 5 percent solution applied to the scalp can slow shedding and promote regrowth for many people. It requires consistent use and takes four to six months to show results.

Biotin supplements are widely marketed for hair growth, but most research shows they only help if you are actually deficient in biotin, which is relatively uncommon with a varied diet. That said, they are generally safe.

Iron supplementation should only happen if your ferritin levels confirm a deficiency. Excess iron has its own risks. Work with your doctor on this one.

Spironolactone, a prescription medication, is sometimes used off-label for hormonal hair loss because it blocks androgens at the follicle level. Platelet-rich plasma (PRP) injections are a newer treatment with growing evidence. Both are worth discussing with a dermatologist specializing in hair.

Track your patterns

Hair shedding is highly cyclical and often correlates with hormonal fluctuations. Many people notice more shedding in the weeks following an estrogen drop, or during high-stress periods. Without tracking, these patterns blend together into a constant sense of worry.

Logging your shedding level, energy, sleep, and cycle phase in PeriPlan over time can reveal whether your hair changes follow a pattern, which helps you and your doctor have a much more informed conversation.

When to see your doctor or a dermatologist

Your hair is not done growing

Hair changes during perimenopause can stabilize and, for many people, improve with the right support and time. The transition period is often the most difficult, and it does not necessarily reflect how your hair will look in five years.

Being consistent with the basics, addressing any nutritional gaps, and treating your hair more gently creates the best environment for your follicles to do what they were designed to do. The growth is still there.

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