Hair loss can be scary and frustrating, especially when you don’t know why it’s happening or what to do about it.

Our hair is part of how we express who we are. Whether wavy or straight, bobbed or buzzed, polished or natural, our hair is part of our identity and how the world sees us.

It can be distressing then, when there are changes to our hair that we don’t choose.

Not just the wily grays that can sneak up on us, alluding to the loss of youth, but more serious changes that broadcast health challenges and loss of vitality.

We may bring up our concerns with our hairdresser or in hushed conversations with friends, but hair loss just isn’t something women typically talk openly about, so it can be easy to feel alone.

The truth is, if you’re experiencing thinning hair, you’re in good company.

A recent study found that nearly 1 in 5 women experience hormonal hair loss.[i]

An Australian study broke that down into age groups, with 25% of women aged 40–49 affected, 28% of women 50–59, 41% of women 60–69, and 56% of all women older than 69 experiencing hair loss.[ii]

Why is this so common, and why isn’t anyone talking about it? Especially since there’s much that can be done.

Many women fear the worst, when in reality hair loss can be a sign that something is awry hormonally — that can very often be helped.

There are key hormone imbalances that contribute to thinning hair in women:

  1. High Testosterone — whether due to other hormone problems such as insulin-resistance, adrenal insufficiency, or estrogen dominance, a woman with high testosterone is also likely to be dealing with hair growth on her face, neck and chest, weight gain, and painful, cystic acne along her jawline.
  2. Low thyroid — again…often resulting from prolonged stress and adrenal insufficiency. Some of the most common symptoms are weight-gain, cold hands, fatigue, depression, and loss of the outsides of eyebrows, lashes and scalp hair.
  3. Excess estrogen — related to excess body fat, peri-menopause, and chemical endocrine disruptors in pesticides on food, plastics and “anti-aging” skincare products.[iii] [iv] In addition to hair loss, too much estrogen causes weight gain across the hips, and increases a woman’s risk for developing certain types of breast cancer.[v]

Hormones dip out of balance after periods of prolonged stress, physical over-exertion, lack of sleep, or giving birth.

Unless the cause is corrected, hormones will continue to become more and more dysregulated over time — and the secondary effects such as hair loss, only snowball.

Out-of-balance hormones can be the result of an over-stimulated nervous system from constantly living in “overdrive” mode. 

One patient describes this as “running on fumes”.

The clinical term is neuro-endocrine dysregulation, and it is one of the most common underlying causes of hormonal hair loss.

With chronic stress, our hormone system has to constantly operate from emergency mode, and our body becomes over-taxed, depleting mineral reserves.

Smartly, our body re-routes its limited nutrients and hormonal resources to only the most essential functions to get us through another day.

Iron is a good example of this. While it’s important for building shiny healthy hair, it’s also crucial for transporting life-giving oxygen to our cells.

If iron is scarce, our health will always be prioritized over strong, silky locks.

Our thyroid is largely responsible. During tough times, this powerful little controller of out metabolism re-routes iron and other important minerals away from hair to more essential body processes.

The same goes for our hormones. Under prolonged stress, our body will make more cortisol to get us through, wreaking havoc on thyroid hormone and others like estrogen, progesterone and testosterone.

These shifts are necessary…but the secondary effects — like hair loss — are frustrating nonetheless.

So, what’s a girl to do?

First — get to the root cause of mineral depletions and hormone imbalances.

Have you (and your body) been
overdoing things or “running on fumes” for too long? Have you experienced a
major life change — a move, job or relationship
change, or a loss that’s thrown you off center?

If so, consider that your nervous and endocrine system may be overwhelmed, dysregulated, and depleted.

In my practice, we assess for the presence of neuro-endocrine dysregulation through a detailed health history and physical exam, and specific lab tests including cortisol, thyroid, and familiar hormones such as estrogen, progesterone and testosterone.

If the objective signs for neuro-endocrine dysregulation are present, we have some work ahead of us.

Lifestyle changes and re-introducing key nutrients in the right order will be necessary to give your body the opportunity to reset and rebuild hormone health — so biology can do its job without sacrificing your healthy, shiny hair.

Even before testing, there are some simple ways you can begin supporting healthy hair immediately:

  1. Get enough high-quality protein. The amount you need is based on your metabolism, muscle mass and activity level. When possible, choose grass-fed and pastured sources of meat, and combine veggie sources for complete proteins.
  2. Optimize iron levels. Get a daily source of steamed or lightly sautéed leafy greens and cruciferous veggies such as spinach, kale, broccoli and Brussels sprouts. Lightly cooking and adding a squeeze of lemon and black pepper and some healthy fat increases iron absorption. Consider a grass-fed source of red meat a few times weekly, and remember that caffeine can deplete iron.
  3. Cover your head in the sun. A 1950’s bandana, or sassy 1920’s-style cloche or turban can be quite chic. They key is to cover your scalp, but also protect your hair from drying and breakage. Research has shown that sun exposure for more than 16 hours a week can increase hair loss.[vi]
  4. Minimize sugar. The same study found that a fasting glucose level >110mg/dl was associated with worse hair loss in women. [vii] Insulin-resistance, or pre-diabetes increases your risk.

Taking good care of your hormones now will not only protect your hair, but bolster your metabolism and soften the hormonal shifts that come with peri-menopause and menopause.

If you’re already experiencing hair loss, seek the help of a skilled functional medicine professional to test for signs of neuro-endocrine dysregulation, and get on a path to rebuilding your hormone health — and your lovely locks!

When hair loss is no longer a mystery, we can feel empowered with choice. It need not be a stigma causing so many women to feel alone.

Dr. Kimberly Higney assists patients in looking and feeling their best by helping them reset their hormone health and metabolism through lifestyle. She has a private practice on the Seacoast of New Hampshire. For more information visit

[i] PM Ramos, HA Miot. Female Pattern Hair Loss: a clinical and pathophysiological review. Anais Brasileiros de Dermatologia. 2015;90(4):529–543.

[ii] DC Gan, RD Sinclair. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc. 2005;10:184–189.

[iii] C Gasnier, C Dumont, N Benachour et al. Glyphosate-based herbicides are toxic and endocrine disruptors in human cell lines. Toxicology. 2009 Aug 21;262(3):184–91.

[iv] SL Myers, CZ Yang, GD Bittner et al. Estrogenic and anti-estrogenic activity of off-the-shelf hair and skin care products. Journal of exposure science & environmental epidemiology. 2015;25(3):271–277.

[v] SS Tworoger, BA Rosner, WC Willett et al. The combined influence of multiple sex and growth hormones on risk of postmenopausal breast cancer: a nested case-control study. Breast Cancer Research 2011 Oct 21;13(5):R99.

[vi] LH Su, LS Chen, HH Chen. Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol. 2013;69:556–577.

[vii] LH Su, LS Chen, HH Chen. Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol. 2013;69:556–577.

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