Hair Changes in Menopause: The Appearance of Unwanted Hair.

With ovarian activity stopped, menopause is marked by a lack of female sex hormones synthesized by the ovaries: estrogen and progesterone.

In addition to the female sex hormones, women also have small amounts of testosterone, which is a male hormone androgen. At the time of menopause, this testosterone level tends to increase and overtake the female hormones.

Note: Progesterone has a known anti-androgenic activity. At the time of menopause, the ovaries no longer synthesize progesterone and the anti-androgenic activity is therefore no longer maintained.

Thus, menopause is marked by a true hormonal imbalance. While female hormones drop, androgens increase. This increase in male hormones is the cause of certain undesirable effects.

Androgens are hormones that cause the appearance of male sexual characteristics. The best known androgen is testosterone. The appearance of hair is linked to the level of testosterone because the pilosebaceous follicle is androgen-dependent.

Arriving through the bloodstream, testosterone binds to the androgen receptors, which are present in the pilosebaceous follicles. Once bound to its receptor, it is converted by the action of 5-alpha reductase into dihydrotestosterone (DHT), a new active androgen.

Androgens cause mainly facial hair changes in women during and after menopause. They transform downy hair into thick, coarse hair.

Scientifically speaking, these hair changes 

in menopause in unusual places, 

especially in the facial area is called hirsutism.

In fact, hirsutism is the appearance 

of hair in so-called masculine areas,

normally hairless in women 

(face, chest, back, buttocks etc.). 

In postmenopausal women, 

hirsutism is the consequence of the 

hyper-androgenic state in relation 

to the modifications of the 

androgen/estrogen balance.

A study done on 45-year-old post-menopausal women showed that 49% of them noticed that new facial hair in menopause had appeared. 39% of these women noticed unwanted hair on their chin, 22% on their upper lips and 39% on both.

Note: Unwanted hair changes in menopause appear mostly on the face. This is due to the high sensitivity of the pilosebaceous follicles to androgens in this area.

The appearance of unwanted facial hair is very frequent during menopause. This is due to the hyperactivity of 5-alpha-reductase and the disappearance of the anti-androgenic activity of progesterone. In general, this impacts the quality of life of women and leads to a decrease in their self-esteem.

There are solutions to combat hirsutism and regain self-confidence:

• Medication treatments:

  The molecule acting against hirsutism is cyproterone acetate. This medication contains a progesterone derivative that acts against androgens thanks to its anti-androgenic activity. Thus, this treatment is prescribed when excessive hair changes in menopause seriously affect emotional and social life;

• Cosmetic treatments:

  Cosmetic treatments are based on hair removal. In the case of hirsutism, the most effective techniques are electric hair removal (electrolysis) for the face and laser hair removal for larger areas. These techniques are performed by doctors only (dermatologist, aesthetic doctor).