Hair Loss: Can HRT help?

[BeachBaby888]

Hi, Starting Feb 2021 the back of my head has been itchy in waves - it burns for a week or more and then calms for several weeks/months. Sometimes I think it could be stress related but other times it is not likely. But even when the itch is rabid intense my scalp is pale white and shows no signs of the irritation that I can feel. I take Betacap for this and it does help soothe the burn.

In the meantime (and not necessarily related) my hair is getting visibly thinner all over my head, including the sides and the back. My GP tested my blood in Oct 21 and said folates, vit D and B12 were slightly low so I started supplements for these, adding in Biotin following a second visit to the GP in April 22. I am Coeliac with a long history of low ferritin so I take Spatone (iron) anyway and have continued to do this. At the April visit she checked my bloods again including thyroid – all within normal range but I have maintained the daily supplements.

I started Plantur 39 shampoo and conditioner in Oct ’21, added in Nioxin system 1 in Jan 22 and have just moved to Nioxin system 2 (Aug 22). I started Regaine 5% in June 2022.

With all this extra attention the hair that I do have has never looked or felt so good. But it is still getting thinner, not dramatically with great clumps of hair fall, just a steady and increasingly visible decline in coverage. I can see the shock on people's faces when they haven't seen me for a couple of months. And the itching phases are still coming and going.

I moved jobs in May 2022 to leave a busy job that I loved for one that is less frantic in an effort to reduce any possible stress.

I am 49 and my periods have moved from a life-long reliable 28 days through a phase of the odd month having no bleed to now coming every 6 weeks or so. Some periods are easier than others of course, but sometimes the bleeding is very, very heavy indeed for the first 24-48 hours with noticeable contractions that make me want to reach for the TENS machine I had during labour. The nerves in my groin twitch with the intensity of the pain (as they did in childbirth) so that I can barely walk and it is really very debilitating and life limiting. But all but over by day 3.

I went to see my GP today for the third time about the hair thinning. It didn’t go particularly well although she did agree to refer me to a dermatologist, warning that they have very large backlogs.

The GP has previously put the hair loss down to stress, telogen effluvium, but it has been 18 months of persistent gradual decline with no particularly stressful event as a trigger and no dramatic hair loss so personally I don’t think it is that, and today she denied ever saying that was her previous suspicion.

I queried whether it could be another auto-immune disease (I am Coeliac) but she said no.

Or hormonal. That got us onto menopause and she is prepared to put me on HRT based on the severity of my periods but reckoned that she has ‘never heard that HRT can help hair loss’ which I found a bit strange.

She then hurriedly weighed me and checked blood pressure before issuing a prescription for Evorel 50 patches (one twice weekly) and Progesterone micronised 100mg capsules. 3 months supply.

I had bad experiences whilst on the Progesterone-only pill and the coil, but I loved Microgynon, so before I took the script to the pharmacist I googled best HRT for hair loss. It is a bit of a minefield to a HRT novice, although I did find an article by The Institute of Trichologists suggesting hair-friendly HRTs “are Premique and Indivina (both products contain the anti-androgen medroxyprogesterone acetate) and Angeliq (containing drospirenone)”

Should I go back to the (sneering) GP and request/insist on those? Bound to be fun over the phone given the pronunciations! Anyone had any experience with these?

Does anyone have any experience of Evorel 50 and progesterone micronized 100mg with regards to hair?

Are there any other HRTs good for maintaining hair levels/decreasing rate of loss? In case my GP objects to the Premique etc

And does anyone else get a scalp that pulsates and feels like it is on fire it is so angry and red, but when you look it is entirely clear and white, even on close inspection by a GP? That’s a bit freaky, isn’t it?

Hi! I've had hairloss too, similar to you. Everol patches and utrogestan are working well. Good steady hair regrowth. Also using Plantur 39.

I paid for a private Trichologist appointment for this reason they said sebhorreic dermatitis so been using shampoo and conditioner for that and it’s helped the severe itching and burning and I bought a scalp oil from l’occitane which has helped massively

and lots of really good vitamins Inc vitamin d and a well absorbed iron

Hi, Thanks for responding, that is encouraging. I've taken the plunge and started the HRT, I guess I just need to wait and see what happens. Thanks for the support

Hrt didn’t help my hair loss it got a lot worse over the year so do start any supplements asap top quality ones not over the counter

I was really interested to read your post and see that you've mentioned two 'hair friendly' HRTs. This is because my hair loss got worse when I tried HRT - I was so disappointed. Will be looking into the two you mentioned.

I too get the itching head, but scalp looks perfectly normal. The itching is INSANE - drives me utterly mad. Yes, it can feel like it's burning and like you, comes and goes for no apparent reason. Saw a dermatologist, not much use, gave a diagnosis of androgenetic alopecia. Hair loss has slowed down now, but it's still thinner than it used to be.

Would love to hear how you get in with your HRT, do keep us updated. And good luck!

Forgot to say, I'm using Nizoral shampoo. It's for dandruff but has been shown to help with hair loss as it has anti-androgenic properties. I get it on prescription. There's also a Nizoral cream but I always forget to use it!

I was having peri menopausal hair loss, although not with the physical symptoms you describe. I started oestrogel around 18 months ago and my hair returned to normal pretty quickly. I wonder if there is something more going on with yours though, with the itching etc that you describe?

Yes mine slowed falling out and a layer grew back. It wasn't as bad as you though.

I do think taking extra b12 also helped before I tried hrt. - keep that up.

Zinc can help periods, only need to take a few days before. This study is with m acid: www.ncbi.nlm.nih.gov/pmc/articles/PMC4861396/

Low Zinc can also be linked to hair loss. People with hypothyroid hair loss only get hair re growth if zinc levels are good. I think there's some interaction with iron though too.

I agree that perhaps a referral to someone as you also have itching?

I lost hair in my early 40’s, also had the burning you describe, but was just told to take iron by the GP. No referral. It never grew back.
I’ve been hypothyroid for many years with satisfaction levels, but I did wonder if it was something to do with that.

I’m on the same mix of HRT and have not noticed a difference with my hair loss. However, I do have PCOS which also comes with hair thinning issues, so I wasn’t expecting a miracle to be honest.

Hi Thanks for all the help. I am already taking some supplements:
Spatone (iron)
Viviscal (multi-vit specifically for hair, includes Vit C, Niacin, Biotin, Iron, Zinc)
Vitamin D3 5000IU
Folic Acid 400ug
Vitamin B12 250ug
and have been on all of these for min 10 months.

Plus Biotin 10,000ug for last 4 months.

I'm not comfortable taking all these supplements - not least because I don't feel that I've established that this is the issue. I feel a bit blind. Desperate really. But the supplements have definitely helped improve the remaining hair, and bouncy locks are easier to style and comb over, so needs must...

My GP has referred me to the Dermatologist at the local hospital. I have an appointment first week of October. But I'm not getting my hopes up.

My GP has significant hair loss and is very much in the 'there's no obvious explanation, these things happen, deal with it' camp. I'm a bit more of a do-er. But I'm not sure that's going to get me any further than very frustrated.

I sympathise OP, my hair is very thin too.

I have been on evorel 75 and utrogestan since April and haven't seen any improvement so far unfortunately.

I use brunette dry shampoo, root cover spray and keratin thickening powder to help disguise the thinner areas. Good luck - hope you see some improvement soon.

Oh please, 'never heard that HRT can help hair loss'! When will those supposed to be in the know educate themselves?
Oestrogen feeds hair!!
My hair thinned out incredibly, my eyebrows thinned, as did my eyelashes (all body hair stopped too). Within 3 months of taking HRT, everything was back to normal.
I know I was lucky and this isn't the case for everyone, but I hope things work out for you. It sounds as though you've tried lots of other things.

Oh thanks for this I’m glad someone seems to know as the drs appear clueless in this field . I’ve lost 3/4 of my hair in a year .

ive started taking kliofem will this help? I was on sandrena and ultrogestan but supply issues put a stop to that which is a shame as they suited me .

@doodlyfiddly - It's great that HRT helped you. You're right, it doesn't work for everyone and there are some women that find their hair loss continues, or worsens with HRT. My hair was actually in a stable phase when I decided to try HRT and unfortunately, it caused my hair to start shedding dramatically within three weeks. I was so disappointed! Had heard so many great things about how it helps with hair loss. Will be looking into the two types that the OP mentioned, containing anti androgens.

@doodlyfiddly Interesting that you mention reduced eyelashes/brows and body hair as well as thinning hair on your head.

Over the last few weeks (pre-HRT) I've noticed a return in leg and arm hair after a year or two of almost nothing - I have very white skin and dark brown/black hair so it is usually really easy to see every hair. Also my toe nails had stopped growing for a couple of years, and were then really dodgy (white marks, extra thick sections, ridges of thick and thin etc) but they are looking much better too.

I have now started the HRT, and so far so good, certainly no noticeable change in rate of hair loss so far, but it is only day 10.

Hopefully the return of arm/leg hair is a positive, and may even one day translate to hair where I want it (although sod's law...)

Thanks again to everyone for your support and advice - especially those who have managed to get re-growth, it is really very encouraging to hear. Always good to have light to aim for.

I hope things work out for you Beach Baby & Punishment.
Just so you know (and I doubt it makes any difference) I'm on the tablet form as I have a history of skin allergies so need to avoid gels & patches.
I started off on Elleste Duet, which was never available! But have been on Femoston for a couple of years now.

Did you ever sort this as I'm in a similar boat?

Hi, @janalala - Did you mean you're experiencing hair loss too? It really it depressing!

I didn't pursue the HRT as I'm just too nervous that it will result in hair loss (even with the supposedly hair friendly types) and I'm not at a point where I can cope with that yet. My hair is stable at the moment, and I'm reluctant to mess about with it.

The itching calmed down and I rarely get that these days, so that's something.

I added testosterone to my HRT regime and it has really helped. My eyebrows are back!