Hair thinning is a common concern among women as they age, particularly after menopause, but it is worth understanding the underlying cause rather than simply attributing it to aging. While some hair loss is a normal part of aging, it can also be linked to underlying health conditions, genetic predisposition, medications, nutritional deficiencies, stress or other treatable issues. The good news is that in many cases, the cause can be identified and sometimes treated.

Aging effects

One of the most common causes of thinning hair in older women is female pattern hair loss, also called androgenetic alopecia. It usually appears as gradual thinning on the top of the scalp or a widening part, rather than bald patches. After menopause, declining estrogen levels can affect the hair growth cycle, causing strands to become finer, grow more slowly and shed more easily over time.

Possible causes

However, hormones and aging are not the only explanations. Hair loss can also follow a major illness, surgery, COVID infection or a period of significant stress. In these cases, shedding often begins a few months later and may improve on its own.

Other possible causes include thyroid disorders, iron deficiency, poor nutrition, autoimmune conditions and scalp disorders. Medications can also play a role. Medications, such as blood thinners, antidepressants, beta blockers, cholesterol medications, thyroid treatments, arthritis drugs and some hormone therapies have all been linked to hair loss in some people. If you suspect a medication may be involved, do not discontinue using it on your own. Instead, ask your doctor about alternatives.

Get checked

Because there are many possible causes for hair loss, it is best to get a proper evaluation. Consult with your primary care doctor or a dermatologist if you notice sudden shedding, rapid thinning, bald patches, scalp itching or pain. They may review your medications, examine your scalp and order blood tests to check for problems such as thyroid imbalance or iron deficiency.

What helps

Treatment depends on the cause. If an underlying condition such as thyroid disease, iron deficiency, medication side effects or poor nutrition is identified, treating it may help restore hair growth.

For older women with age-related female pattern hair loss, the treatment with the best evidence is topical minoxidil (Rogaine), which is available over the counter. It can help slow thinning and stimulate some regrowth, but results take several months and continued use is needed to maintain any benefit. Some women who do not respond to over-the-counter treatment may be candidates for low-dose oral minoxidil, which is an off-label treatment and requires medical supervision because of possible side effects. Talk with your healthcare provider to determine whether this option is appropriate for you.

Take caution with hair-growth supplements. Unless you have a true deficiency, products such as biotin usually provide little benefit and can interfere with certain lab tests, including thyroid and some heart tests.

Gentle hair care and cosmetic options can also help. Avoid harsh chemical treatments, tight hairstyles that pull on the hair and excessive heat from blow dryers or styling tools. A fuller haircut, thickening styling products, hair-building fibers that reduce the appearance of thinning spots or lightweight hairpieces and wigs can also improve appearance and confidence.

While hair thinning in older women is common, it is not always attributed to aging. It may sometimes signal an underlying medical issue and is worth getting checked, especially if it comes on suddenly or worsens quickly. While not every type of hair loss can be reversed, treatment and practical strategies can often slow it down.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.