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[Mariegil]

Hi, first time posting. I’m 7 weeks into starting Oestrogel and ultrogestan. I’m 46 and the reason I asked to try HRT was because my hair had been thinning so much over the last couple of years and I wanted to see if this would help. Since starting however the hair loss has increased dramatically!! It is coming out at an alarming rate and I’m not sure if I should stop asap or should I keep going in the hope that this shedding will soon stop and new hair will grow? Has anyone any experience of pushing on through this stage of hair loss? I could brave it out another couple of weeks (although it is getting very thin) if I thought it was for the greater good. Please help!!

[CLKD]

  sorry I can't help with hair loss though there are several recent threads about the problem.  Browse round. Hopefully some1 will be along.

[Taz2]

Hi Mariegil. What treatment or tests have you had so far to try to get this sorted? Mine was due to low vitamin D.

You will find lots of help on this forum and as CLKD says there are threads about hair loss on here. You can find them by using the search facility.

Taz x 

[CLKD]

I've bounced one thread, there are several.  Browse round.

[Mariegil]

Thanks for your reply. I’ve had a quick look on the forum and saw that lots of posters experienced hair loss and subsequently stopped their hrt. I’m hoping to hear from people who persevered with the treatment despite the hairloss and if so did their hair eventually improve? I’m worried that the hair loss will continue indefinitely and if so maybe I’m better stopping now.

I’ve had a FBC done along with thyroid, ferritin, b12, folate, FSH and oestradiol checks. All have come back within the normal range

[CLKD]

Hi do U have thyroid problems?  Many GPs won't investigate further if results are returned 'within normal limits' even when patients continue to complain of symptoms.  Something to bear in mind, perhaps.

Which symptom did U want to ease first?  mayB visit a salon who specialise in hair restoration and hair loss conditions.  Let us know how you get on.

[Bandango42]

Hi Mariegil

I have been on HRT for almost 15 months now and my hair loss hasn't got any better, in fact it's got worse with each increase of oestrogen.

I didn't have any excessive hair loss before starting HRT.

Sorry, I know that's not what you wanted to hear. Hopefully other ladies on here will have more positive stories, I just wanted to let you know my experience x

[Mariegil]

Thanks for sharing. Sorry to hear you are having the same problem. I was shocked at how quickly it caused my hairloss. Literally within the first 2 weeks of use 😔

[Cara999]

Hi sorry to say my hair loss seemed to get worse when I started HRT, I lasted 5 months on it then stopped because of that reason, i have thin hair anyway. Its now starting to look better after 12 months off it. We're all different so please don't let this put you off. Best of luck, it's awful xxx

[Ana21]

Hi Mariegil!

You need to see a dermatologist to determine the cause of your hair loss.  There are many different types of hair loss.  You need a diagnosis in order to determine appropriate treatment options.  Unless you know your hair loss is caused by low estrogen, the HRT may not help.  For example, if you've recently had covid or experienced another stressful event, you may be experiencing telogen effluvium and your hair will grow back in time without any treatment.  Taz's hair loss was caused by a vitamin D deficiency.  More estrogen would not have improved her hair growth.  She needed to increase her vitamin D level.

I'm postmenopausal and was already on MHT (Estradot 50 + Prometrium) when I experienced sudden hair loss and other symptoms.  My meno doc suspected low estrogen and blood tests confirmed I wasn't absorbing the patch.  He switched me to oral estrogen to get my levels up.  At the same time, my GP referred me to a dermatologist but the pandemic was in full swing and I would have to wait 6 months for an appt.  She recommended that I start using minoxidil 5% foam (Rogaine) right away.  It was excellent advice.  By the time I saw the dermatologist and rec'd a diagnosis of female pattern hair loss (aka androgenetic alopecia), it was clear that I needed more than minoxidil.  I was able to start an anti-androgen right away.  As with my MHT, it's been a process of trial and error.  My current regimen is minoxidil foam 5% and 2.5 mg finasteride, a DHT blocker.  That combination is working well for me.  My hair looks normal now.  Most of my density has returned.

At the height of my hair loss, I could not leave the house without some sort of head covering.  My hair loss is male pattern, central front hairline and temples.  It's very obvious as I have dark hair and light skin.  Because my front hairline was not preserved, products like Toppik hair fibres did not work for me.  They work well for other hair loss patterns.

My type of hair loss is very common.  By age 50, about 35% of women have this form of hair loss.  It's hallmark is miniaturization of the hair follicles.  All that was required for my diagnosis was an examination of my follicles using a determatoscope, as well as additional blood tests to rule out other factors. 

Hair loss can be multifactorial and you need to address all the underlying issues.  Some types of hair loss require a biopsy before a diagnosis can be made.  Some types are scarring and lead to permanent hair loss, so you want to start treatment ASAP.

Different types of hair loss:
https://donovanmedical.com/types-of-hair-loss#

I know how distressing hair loss can be.  I hope you're able to find an effective treatment. 

[Mariegil]

Thank you so much for taking the time to reply. Yes I think an anti androgen would be a good idea. Did you have to get this on a private prescription or does your Gp prescribe it for you?

Hi Mariegil!

You need to see a dermatologist to determine the cause of your hair loss.  There are many different types of hair loss.  You need a diagnosis in order to determine appropriate treatment options.  Unless you know your hair loss is caused by low estrogen, the HRT may not help.  For example, if you've recently had covid or experienced another stressful event, you may be experiencing telogen effluvium and your hair will grow back in time without any treatment.  Taz's hair loss was caused by a vitamin D deficiency.  More estrogen would not have improved her hair growth.  She needed to increase her vitamin D level.

I'm postmenopausal and was already on MHT (Estradot 50 + Prometrium) when I experienced sudden hair loss and other symptoms.  My meno doc suspected low estrogen and blood tests confirmed I wasn't absorbing the patch.  He switched me to oral estrogen to get my levels up.  At the same time, my GP referred me to a dermatologist but the pandemic was in full swing and I would have to wait 6 months for an appt.  She recommended that I start using minoxidil 5% foam (Rogaine) right away.  It was excellent advice.  By the time I saw the dermatologist and rec'd a diagnosis of female pattern hair loss (aka androgenetic alopecia), it was clear that I needed more than minoxidil.  I was able to start an anti-androgen right away.  As with my MHT, it's been a process of trial and error.  My current regimen is minoxidil foam 5% and 2.5 mg finasteride, a DHT blocker.  That combination is working well for me.  My hair looks normal now.  Most of my density has returned.

At the height of my hair loss, I could not leave the house without some sort of head covering.  My hair loss is male pattern, central front hairline and temples.  It's very obvious as I have dark hair and light skin.  Because my front hairline was not preserved, products like Toppik hair fibres did not work for me.  They work well for other hair loss patterns.

My type of hair loss is very common.  By age 50, about 35% of women have this form of hair loss.  It's hallmark is miniaturization of the hair follicles.  All that was required for my diagnosis was an examination of my follicles using a determatoscope, as well as additional blood tests to rule out other factors. 

Hair loss can be multifactorial and you need to address all the underlying issues.  Some types of hair loss require a biopsy before a diagnosis can be made.  Some types are scarring and lead to permanent hair loss, so you want to start treatment ASAP.

Different types of hair loss:
https://donovanmedical.com/types-of-hair-loss#

I know how distressing hair loss can be.  I hope you're able to find an effective treatment.

[Mariegil]

Thanks for your reply. Yes I’d be worried about continuing at this rate of hair loss. It’s a pity as I’ll probably be put off using it in the future due to this experience!

Hi sorry to say my hair loss seemed to get worse when I started HRT, I lasted 5 months on it then stopped because of that reason, i have thin hair anyway. Its now starting to look better after 12 months off it. We're all different so please don't let this put you off. Best of luck, it's awful xxx

[Mariegil]

Thanks, I might try halving the dose of the oestrogel (i.e reducing from one pump to half a pump) for the next 2 weeks and if the hair loss continues I will stop it altogether 😔

Hi do U have thyroid problems?  Many GPs won't investigate further if results are returned 'within normal limits' even when patients continue to complain of symptoms.  Something to bear in mind, perhaps.

Which symptom did U want to ease first?  mayB visit a salon who specialise in hair restoration and hair loss conditions.  Let us know how you get on.

[Ana21]

Hi Mariegil!

I'm in Canada and my dermatologist prescribed first spironolactone and later finasteride.  Costs are covered by my health insurance plan.  You'll need a diagnosis before you'll be prescribed any Rx treatments.  Topical minoxidil 5% foam (eg Rogaine/Regaine) is available without a Rx, but some doctors will prescribe it if that results in an out-of-pocket cost savings to the patient.  Here, finasteride is approved for men with hair loss, not women.  For women, it is used off label, although it's been used to treat women with female pattern hair loss/androgenetic alopecia for nearly two decades.  Many of the Rx drugs used to treat FPHL/AGA are used off label.  It's unlikely that your GP will feel comfortable making a diagnosis or prescribing these drugs.  I suspect you'll need a referral to a derm.   Even some derms are reluctant to prescribe these drugs.  Some women are forced to hunt for a knowledgeable and supportive doctor.

The derm will likely do additional tests and take a more detailed health/lifestyle history than your GP, because your current health status and diet may be a factor in your hair loss.  Female hair loss is complex and often multifactorial.  I discovered I had FPHL after an episode of telogen effluvium.  The rapid hair loss caused by TE unmasked the AGA.  It made it very obvious, although it was brewing for years.  I've always worn my hair with a side part.  If I had worn a central part, I probably would have noticed the gradual thinning years earlier.

Stay positive.  There are many treatment options available, but it starts with a diagnosis.

[Mariegil]

Thankyou Ana21, that was very helpful. I will take your advice and ask for a referral to a dermatologist. In the meantime I’ll try to stop obsessing over it!! … easier said than done. Lol

Hi Mariegil!

I'm in Canada and my dermatologist prescribed first spironolactone and later finasteride.  Costs are covered by my health insurance plan.  You'll need a diagnosis before you'll be prescribed any Rx treatments.  Topical minoxidil 5% foam (eg Rogaine/Regaine) is available without a Rx, but some doctors will prescribe it if that results in an out-of-pocket cost savings to the patient.  Here, finasteride is approved for men with hair loss, not women.  For women, it is used off label, although it's been used to treat women with female pattern hair loss/androgenetic alopecia for nearly two decades.  Many of the Rx drugs used to treat FPHL/AGA are used off label.  It's unlikely that your GP will feel comfortable making a diagnosis or prescribing these drugs.  I suspect you'll need a referral to a derm.   Even some derms are reluctant to prescribe these drugs.  Some women are forced to hunt for a knowledgeable and supportive doctor.

The derm will likely do additional tests and take a more detailed health/lifestyle history than your GP, because your current health status and diet may be a factor in your hair loss.  Female hair loss is complex and often multifactorial.  I discovered I had FPHL after an episode of telogen effluvium.  The rapid hair loss caused by TE unmasked the AGA.  It made it very obvious, although it was brewing for years.  I've always worn my hair with a side part.  If I had worn a central part, I probably would have noticed the gradual thinning years earlier.

Stay positive.  There are many treatment options available, but it starts with a diagnosis.