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[sjg5]

Hi everyone, I'm new here 

Thought I should join as I spend so long reading posts as a guest. I'm hoping someone somewhere out there may have some insight or advice on my problem. I'm sorry this is so long.  

I'm 55. Been on HRT since November 2022 using Evorol 100 patches and Provera 5mg. March 2023 I requested to try a gel as I was going on holiday. I was prescribed 80g Estradial Gel 0.06% Provera 5mg instead.

April 2023 I was rushed into hospital with issues with my eyes. They had completely dried out and gone into a pre-ulcerative state (SO painful) I'd never had issues with my eyes before. 

Feb 2024 I requested to go back to Evorol 100 patches as my eye issues continued but now I started to notice hair loss.

In July 2024 I saw a private menopause specialist. She recommended I change to Evorol 100 Utrogestan 200 PV at Utrogestan is bioidentical and taking vaginally may lessen systemic effects. Bloods taken and all were within normal limits.

Issues with eyes and  now massive hair loss continued. Plus now I have very painful Symphysis Pubis Dysfunction which I haven't had since I was pregnant with my daughter 24 years ago! 

Last month out of desperation I switched to just 1 Utrogestan 100 PV as I haven't had a period for over 5 years so this is permitted. Almost immediately the issues with my eyes are better.

I have now lost 70% of my hair and am balding in places. I lose approx 300 - 600 strands a day (should be 50 - 100) and my pelvis is agony.GP ran bloods this week. Thyroid function normal. Serum Ferritin 26 which is within normal limits but on the low side. Haemoglobin fine. But Estrogen and Testosterone have literally dropped off a cliff. June 2024 Estrogen was 489 now 151!

I'm at the end of my tether. I feel rubbish. I can't exercise. I'm in so much pain and have stopped socialising because of my hair loss. Everything you read say's that bioidentical HRT helps with hair loss - I just don't understand 
Does anyone have a similar experience or any knowledge at all on this? 

[bombsh3ll]

What an awful time you have had, I am sorry you are suffering like this.

I have not personally experienced all of the issues you are dealing with, however I do have dry eyes (due to dysautonomia and treated adequately with drops and protective eyeglasses) and have had alopecia since adolescence.

I spent my teens and twenties wearing hats, bandanas, hairbands etc and trying to comb my lank strands this way and that to cover it up, but it reached a point where it really couldn't be disguised.

I had tried a wig some years before, which had been very dense and shiny and synthetic looking, not suitable at all as it made me look like a drag queen, however in my late 30's I decided to revisit alternative hair and found that it had really improved to the point that a high quality wig or topper is absolutely imperceptible and looks much better than most people's natural hair. It also doesn't go grey and only needs a wash every couple of months.

I highly recommend looking at lace front toppers as a starting point - Jon Renau and Rene of Paris are my favourite brands, however I now shave my head and wear a full wig, as it's easier and more comfortable.

I know it's probably not what you want to hear but there's no magic treatment which will reverse baldness, but there is snake oil being sold by the bucket load for this problem, so please don't waste your money.

Regarding your hormone treatment - it sounds like you probably weren't fully menopausal when you started, and probably now require a higher estrogen and testosterone dose.

Progesterone is known to cause joint laxity, and an androgenic progestin like provera can be better in this regard. Whilst it is considered less metabolically favourable than micronised progesterone, this difference is marginal and if it were me in that situation I would choose quality of life.

Your ferritin is also low, and it would do you no harm and may help you feel a lot better to supplement with iron until optimal.

[CherrySG]

Hi SJG,

Are you still on the oestrogel or did yiu swap to the patch? I ask because I had crazy hair loss on the gel when I was on HRT previously,  back in 2020, but had no hair loss with the patches.

I'm now back on HRT since May 2025, and there's no obvious hair loss like there was with the gel.

Also, ferritin of 27 is very low. HRT can deplete B12 and iron, which both affect hair as you know.

My hair is still thin, but it passes in public. Doesn't look fantastic, so I have a collection of wigs. As Bombsh3ll says, they are surprisingly good these days.

[sjg5]

Hi bombsh3ll,

Thank you for your reply. The dry eyes I can probably deal with but it is the fear of losing all my hair. There is so little information on HRT causing hair loss. I certainly didn't have any before I started HRT in fact it was probably the best condition it has ever been in. I listened to a podcast recently with Dr Louise Newsome and a Consultant Dermatogist about hair loss in menopause and he ended it saying he'd never come across a woman for who bioidentical HRT caused hair loss!
Losing your hair is such a scary prospect for a woman as you clearly know. I've looked into lace toppers but the hair I have left falls very easily so I've been told it isn't suitable. I may have to just shave off and either be brave or look into wigs. Thank you for the brand suggestions. If you don't mind me asking do you know what caused your hair loss?

I've started taking extra iron amongst a ton of other supplements. 

[sjg5]

Hi CherrySG,

Thank you for your reply. I swopped back onto the Evorol 100 patches as I thought it was the gel but the hair loss has continued and if anything got worse. Did you stop HRT altogether because of the hair loss?

Yes it's crazy but my GP reported the Ferritin as normal. It was only when I checked it online that it say's to aim for a Ferritin level of 50! I'm now taking Iron and B12 supplements along with everything else you can think of.

My hair is crazy thin now. I suppose I'm lucky in the respect that although I've never had super thick hair I've always had a lot of it and I think that's the only reason I'm not completely bald now. I'm just about able to cover the bald spots but not for much longer.

[CherrySG]

Huh, hair loss is a listed side effect according to the NHS: https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/oestrogen-tablets-patches-gel-and-spray/side-effects-of-oestrogen-tablets-patches-gel-and-spray/

You'd think the consultant would know! They are disappointing sometimes when it comes to hair loss. 😒

The NHS acceptable levels of ferritin are really low, aren't they? My hair was falling out when my ferritin was 29, so it's practically the same. Until recently I used to tear up when drying my hair but after 5 years I've got used to it. It's a devastating thing to go through for any woman, though. When I was on oestrogel I would run my hand through my hair and see strands fall out on my desk, also in the washbasin when washing. Have you tried Regaine? It grew all my hair out but it affects my heart so I had to stop taking it.

I did stop taking HRT because of the hair loss. I don't know what I'll do if it starts up again as I need it to retain mobility and this combo is also doing wonders for my debilitating anxiety and general gloom levels 😅

Hopefully the iron and B12 will get to work and restore some growth. I've started Feroglobin as a safeguard 🫰

[bombsh3ll]

I have frontotemporal alopecia which runs in my family, beginning usually at puberty like it did with me.

I had a class photo taken when I was 12 with my hair tied back in a ponytail and people were saying that I looked like uncle fester, or like an egg, and that's when I first realised my hairline was receding which it continued to do over the years.

Honestly I am glad now that I discovered the world of professional quality women's wigs, as I essentially have a major upgrade from what I would have had if I never lost my hair, because it was thin and sparse to begin with, and also everyone else my age is dumping toxic chemicals on their head every 4 weeks to hide the grey.

That wouldn't have been for me, but also I wouldn't have wanted to go grey either, so I don't know what I would have done and am glad now I don't have that problem.

The first time I bought a good quality wig, I made the mistake of choosing my "own" hair - a straight brown bob, and immediately hated it - I cried because I looked just like I had at 12, which I hadn't even liked then!

So after that I switched to the type of hair I'd always wanted - wavy and sunkissed - and loved it. My favourite wig is Evanna by Rene of Paris in
Moccachino, but I have also become much more adventurous with my collection and own wigs from plum to blue ombre.

I do believe hormones played a role in my hair loss due to the age at onset, but would not have chosen a different hormonal milieu for myself as I was strong, lean and athletic with a healthy sex drive.

I have also now been on the combined pill for many years, with DHEA added for the last 5, and no birth control pill or pregnancy made a jot of difference to my alopecia, so I would rather take what I need to feel my best, and then do what I  need to look my best, which for me is to wear a wig.

There is also a great female hair loss community online - Denise sheets has some really good videos for beginners. Even if wigs aren't for you it can be a tremendous source of inspiration and encouragement.

[sjg5]

Hi CherrySG,

I've searched and never found that information! Its so difficult to know if it is the Evorol or if it is a combination of that and low Ferratin etc? I'm tempted to come off it altogether and see if it makes any difference.

I rarely wash my hair now because it is so distressing. Such a horrible thing for anyone to go through but I think particularly a woman.

I haven't tried Regaine. So did it work quite well for you? I don't have any heart issues.

I've never felt lower than I do now. My job involves travelling and meeting lots of clients and I've considered leaving because I don't want anyone to see me. I rarely go out anymore. I had no idea that Menopause could even involve this. I expected lots of the horrible issues but not this. 

[sjg5]

Hi bombsh3ll,

I'm in awe of how strong you are and how you see the positives! I hope I can be just half as strong as you in dealing with this. I'm a bit of a mess at he moment.

I've taken a look at your favourite wig and it's gorgeous. Exactly what I would choose if I need to.

Thank you so much for the advice.

[CherrySG]

SJG, the Regaine is for androgenetic alopecia, same as the guys get, but women get it too, sometimes even young ones, but it often affects us post menopause ladies too. I grew back so much hair it was like I grew a pixie underneath my existing hair, lol. My husband and son use it with no problems. But I had to stop using it so it slowly reverted back to its original state.

I hear you on having to present at work with hair loss. That was what made me start wearing wigs- seeing my image on Teams calls and seeing what others saw. So I started wearing them to work (which is a whole new barrier, but how about starting with one that's like your hair now, but a bit better?)

I also wear John Renau (Kyla was my most recent) and Noriko Wynn (in Shaded Moccachino and also Shaded Praline). And Raquel Welch and Ellen Wille also have good wigs.

I agree with Bombs3ll that Denise Sheets on YouTube is great for wig advice. I'm so sorry you're going through this. Wigs can totally restore confidence and you can literally choose your ideal hair. Be brunette one day, blonde the next.

[sjg5]

Thanks CherrySG,

I'll look into Regaine it sounds incredible. I'd held off using anything like that because I kept hoping it would right itself with the help of vitamins and supplements but I'm losing it too fast now.

Thank you so much for the advice.

[sheila99]

I would go your GP and ask for a referral to a dermatologist. There are numerous causes and a dermatologist can hopefully pinpoint the cause of yours. Whilst it's true hrt can sometimes cause hair loss my own experience is that low oestrogen can too. I had hair loss on 100mcg estradot and blamed it on that (not as severe as yours thoughs). I'm now on 200 and shedding is back to a normal amount.

[bombsh3ll]

The only thing I would say about seeing your GP for hair loss is that if you are getting your testosterone on the NHS this could result in the loss of your prescription.

However if you are funding your testosterone privately this is not an issue.

[sjg5]

Hi Sheila99,

I did ask and they said they could refer me but the waiting time was up to 12 months. I'll have no hair by then so I've actually just made an appointment with a consultant dermatologist via Bupa. I'm not a member but you can pay £200 for a one off consultation so thought it would be worth it. It's so difficult to know whether it is the HRT or not. I was losing a lot of hair when my estrogen was considered high on HRT and still now it is low.

[sjg5]

Hi Bombsh3ll,

I've never taken testosterone. My doctors mentioned that it wouldn't be a good idea given the amount of hair loss already.