Sudden Hair Loss after HRT
Dear Dr Redmond:
I am a 54 year old woman; I had been on FemHRT hormone replacement for 5 years after menopause had started. April 2008, my OB/GYN and myself decided I should wean myself off. I did successfully come off the HRT with little problems. In August/September 2008, I noticed the textrure of my thick coarse hair change and become drier and more wirey. I proceeded to condition it with more diligence, stopped beating on it with products and hair tools and paid more attention to treating it well. This had no effect. I then noticed a marked amount of hair loss.
I always lost hair when I washed it or styled it but the amount now has been alarming. I cannot begin to explain the heartbreak when I see the amount of hair in the drain and as far as other times, when I run my hand through my hair, no less than 4 or 5 hairs come out each time. I am not losing it in clumps (yet) and I am lucky I started with a massive amount of hair but I would now guess I have lost almost half the volume of my hair since October 2008! The hair that remains is now dry and frizzy, feels thin and fragile.
I know hormones or lack there of, as well as age and genetics, play a role in hair loss and I would expect that to be the case over several years. But this has occured over a span of months only and I am devastated. I went to my regular doctor and then the dermatologist. No disease was found and very extensive blood work revealed nothing, in fact my DHEA was low!
I am grasping at straws because I do not think this is a normal rate of loss for just stopping HRT but I could be wrong. Before I come to see you, is this something that you think would benefit from a comsultation and evalutaion at your office? I do not want to wait any longer if this can at least be slowed to a more managable rate .
Thank you very much
Hi phurrballe - I like your username - reminds me of my cats(I have 3 Siamese cats)!! I noticed you have not received any replies yet, but I did want to share my issues with you. I chose not to do HRT when I went through menopause at age 52. I just turned 59, but about 1 - 1.5 years ago, I started having awful hot flashes, night sweats, insomnia, and all the symptoms of menopause!! Amazing, huh? Before I initially went through menopause, the hot flashes were really not that bad, but the insomnia, heavy periods, etc were. I have always been an "organic" foods person, always exercised, and tried to do all the healthy living things. No one could explain to me why all of a sudden, it was as if I were going through menopause again, but much worse this time. I teach school and I would have a really major hot flash, and my students would comment that I was "red and sweating"!! I began to have itchy, tingling sensations in my feet and hands. I had long, naturally curly hair, and excessively thick!! About 3 - 4 months after these wierd symptoms appeared, I noticed that my hair felt a bit thinner. I could never put it up in the back with one of those mega clips, but around July, I could . . . which was actually kind of nice. I never concerned myself with the hair loss because I had so much hair. However, in October of last year, I began to get very concerned because for the first time ever, I could see my scalp!! Of course, I had to pull my hair aside, but this was a first for me. It seemed to all of a sudden get worse, and I finally cut my hair in December to about 2 inches below my chin. Being naturally curly, it looked great and still thick. The very few people I shared with didn't believe that I had hair loss issues, but my hair stylist did. It has progressively gotten thinner. The loss has stabilized somewhat mainly because I started HRT in February!! My GYN said he thought the HRT would help the hot flashes, etc and it has. Believe me, I have seen every type of doctor imaginable and everything comes back normal. I read Dr. Redmond's book about hormones and since my son lives in NYC(4 blocks south of Dr. Redmond's office), I decided to go see him. Before I went to see him, I had the "first" hormone test - had every other kind of test but that. I virtually have no testosterone, so that is not the problem. Dr. Redmond told me that he thought my hairloss was due to low estrogen. It was still low(in his opinion) after I had been on HRT for 10 weeks. He switched me to the vivelle dot and prometrium. This past week, my hair shed more, but I think it is due to switching treatments. I have a phone call in to see. Having said all of this, I think some of us have to decide what we will do to keep our hair. My hair definitely did improve even on the oral estrogen, and I may choose to go back to the oral if the transdermal is not helping. I stopped having hot flashes, sleep like a baby, and the tingling in my hands and feet virtually stopped. For some reason after all these years, my estrogen levels must have plummeted. I truly believe that is what caused my hairloss. So, it is possible that you may want to continue your HRT?? Sorry this was so long, but I did want you to know my story. I don't think I realized how badly I did feel without HRT until I started taking it. My mood is 100% better as well. If at any point I have issues that are detrimental to my health, then I would most likely stop the HRT if it is the cause. No hair is better than no life(I have recently come to realize that). I wish you well and hopefully Dr. Redmond will respond to your post soon.
I hear stories similar to yours from my patients frequently. Estrogen makes hair grow faster and stay on the head longer. When estrogen levels drop these benefits are lost, shedding is triggered. This can happen after giving birth, with menopause, with stopping of estrogen replacement or stopping birth control pills.
Originally Posted by phurrballe
Restoring estrogen levels generally stops the shedding and often results in regrowth. Texture usually normalizes on estrogen as well.
There is much misunderstanding about risks of estrogen for menopause. The risks are low for women in their fifties, highest for women who start after age seventy. Transdermal estrogen may well be safer that oral forms and so is the preferred form of estrogen among doctors who focus on menopause.
This does not mean there is no risk for women in their fifties but many women feel the potential benefits such that they opt to go on, or continue, estrogen. Obviously this is a very individual decision.
My book, It's Your Hormones, discusses the estrogen decision in detail.
Geoffrey Redmond, MD
The Hormone Help Center of New York http://www.hormonehelpny.com/
Author, It's Your Hormones
It is not appropriate to make medical diagnoses or treatment recommendations over the internet. Replies to questions intended as general information and not as medical advice for any individual. An appropriate health care provider should be consulted for specific advice.
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