Hair thinning

Hair thinning is hair that grows back finer or sparser, or falls out faster than it is replaced.

The NHS website lists hair thinning or hair loss among the symptoms of menopause and perimenopause, and NHS inform, the NHS in Scotland's health site, lists it too. The Pakistan Menopause Society's 2026 recommendations put hair thinning among the longer-term changes after the menopause, alongside drier, thinner skin.

In Urdu, Roshara calls it baal girna ya patle hona, hair falling out or growing thin. Extra hair growth is a different thing, with its own words.

• hair coming out in your hands when you wash or oil it
• a wider parting, or more scalp showing at the crown
• a thinner plait or ponytail
• hair that breaks more easily or feels finer
• worry about it that you keep to yourself

The NHS hair loss page is direct about that last point. It says losing hair can be upsetting, and that for many people hair is an important part of who they are.

The NHS lists hair thinning as a menopause symptom but does not explain the mechanism, and the PMS recommendations group it with the skin and connective tissue changes that come later. Their introduction says falling estrogen may cause physical and psychological symptoms during the menopause, without singling out hair.

The NHS hair loss page also lists causes that have nothing to do with the menopause, and these are worth checking. Temporary hair loss can follow an illness, stress, cancer treatment, weight loss or iron deficiency. Female pattern hair loss is permanent and usually runs in the family. The NHS also says it is normal to shed some hair every day without noticing.

Your thyroid is worth ruling out too. The European Menopause and Andropause Society (EMAS) says thyroid disease and the menopause can bring similar symptoms, hair loss among them, and asks doctors to keep thyroid disease in mind for women of menopausal age. It also notes that many women try over-the-counter hair supplements, most of which contain biotin, and that biotin can give false results on thyroid blood tests. EMAS asks doctors to ask about every supplement you take, so mention them.

The NHS hair loss page says most hair loss does not need treatment, because it is either temporary or a normal part of getting older. Where hair loss is causing distress, it lists what can be tried, and is plain that no treatment works every time and not all are available free.

It also says to see a GP to find out what is causing your hair loss before thinking about a commercial hair clinic. That matters when clinics and products make big promises.

The NHS says minoxidil can be used to treat female pattern hair loss, and that women should not use finasteride. These treatments do not work for everyone, only work for as long as they are used, and may have to be paid for. Other options it lists include steroid injections or creams for bald patches, light treatment, and wigs.

The menopause guidelines we checked, NICE NG23 and the PMS recommendations, do not name a treatment for hair thinning. If you are discussing HRT for other symptoms, it is fair to ask what difference, if any, your doctor would expect for your hair. Keep that question open.

The NHS says to see a GP if you are worried about your hair loss. A GP may be able to tell the likely cause by looking at your hair. Tell them if it is affecting how you feel, and ask what treatments there are.

If your hair loss is causing you real distress, the NHS says your GP may be able to help you get counselling, and that support groups can help.

When your hair is covered, a change can go unnoticed by everyone but you. That privacy is a comfort, and it can also mean the worry is never spoken. Your mother, your sisters or your friends may have been through the same thing and said nothing either. Asking is a kindness to both of you.

If thinning hair on your head comes with new facial hair or irregular periods, tell your doctor about all of them together. The NHS lists both extra hair growth and hair loss among the symptoms of PMOS, the hormone condition that used to be called PCOS, and a doctor will want to rule it in or out.