Hormone Replacement Therapy as a Hair Loss Treatment

When women experience thinning hair and balding on the scalp, they have a number of options.

Women may opt for a topical treatment like minoxidil (Rogaine) or ketoconazole shampoo (Nizoral shampoo) as their hair loss treatment.

But women who are menopausal, experiencing severe hot flashes, and are prescribed hormone replacement therapy (HRT) for their menopausal symptoms may get a double-whammy benefit: HRT can be a good treatment for hair loss, as well.

About Hormone Replacement Therapy

Hormone replacement therapy involves taking female hormones, typically estrogen and progestin together. Women may get these hormones in varying forms, including estrogen and progesterone creams, pills, and patches.

HRT is most often prescribed to help women combat the uncomfortable symptoms of menopause, including:

• Difficulty sleeping
• Hot flashes and night sweats
• Moodiness
• Loss of libido

Menopausal women may also take hormone replacement therapy to ward off osteoporosis, a bone-thinning condition that is common in women after menopause due to a drop in estrogen levels.

HRT and Hair Loss

Estrogen is related to hair growth — and hair loss. During pregnancy, for example, a woman's estrogen levels are higher than normal, which signals more hair follicles to "grow" and fewer to "rest."

While estrogen levels are high, women have full, thick hair. But when they drop, such as after a pregnancy or during and after menopause, more hair enters the "resting" phase, where it soon falls out and causes thinning and even balding patches.

So for women who have hair loss caused by low estrogen levels, hormone replacement therapy may restore estrogen levels, ward off menopausal symptoms — and slow hair loss.

HRT as a Hair Loss Treatment: Benefits and Risks

Although it’s generally only prescribed as a last resort for menopausal symptoms, hormone replacement therapy is a common and very effective hair loss treatment for some women — as long as they are menopausal or post-menopausal and are not at higher risk for adverse effects from HRT. It's most often prescribed for women who have androgenetic alopecia, also called pattern baldness. Hormone replacement therapy has a number of benefits for both general health and symptom management, but also a number of side effects — which range from unpleasant to dangerous.

Serious side effects of hormone replacement therapy can include:

• Slightly increased risk of breast cancer (when HRT is taken long-term)
• Higher risk of dying if you do get breast cancer
• For women with an intact uterus, increased risk of uterine cancer if estrogen replacement is not accompanied by progesterone therapy
• Increased risk of heart disease and stroke
• Increased risk of blood clots

Some women may experience uncomfortable side effects that are less serious, including:

• Abnormal vaginal bleeding (which will need to be evaluated to rule out the possibility of uterine cancer)
• Nausea and bloating
• Irritability
• Frequent headaches
• Sore breasts

Before you start hormone replacement therapy, it's important to talk to your doctor about the possible risks and negative effects versus the benefits of HRT. If you're already at an increased risk for health conditions like heart disease, cancer, and blood clots, HRT may not be the best hair loss treatment for you. If you are prescribed HRT, it important to take the lowest doses that are effective, and to only take the drugs for the shortest amount of time needed to control symptoms.

Getting HRT: Progesterone and Estrogen Pills and Creams

Topical estrogen and progesterone creams and oral medications are generally the forms prescribed for post-menopausal women with androgenetic alopecia. But HRT will rarely, if ever, be prescribed for treatment of hair loss alone.] If you have other bothersome symptoms which might warrant HRT, in addition to hair loss, you'll first need to undergo a thorough gynecologic and physical exam, and will likely have blood tests done to measure hormone levels before these drugs are prescribed.

You will need to check with your health insurance company to find out if hormone replacement therapy will be fully or partially covered, or how much your copayment will be. If you don't have health insurance, costs can still vary greatly depending on the type of medication you get, and whether you take brand name or generic drugs. Prices may range from as little as about $7 per month to as high as $150 a month for hormone replacement therapy.

There's a lot to consider when it comes to deciding whether hormone replacement therapy is the right hair loss treatment for you. Talk it over with your doctor, and determine the best way to restore hair growth without risking your health.

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