Before we dive in I’d just like to make it 100% clear that you are not alone. Hair loss during perimenopause impacts many women and it’s not something that we talk about. Honestly it's up their with vaginal dryness as a symptom that must not be named. On the positive side there is always something that you can do to improve the appearance of your hair, unfortunately it’s not quite as simple as switching shampoos.

Hair loss by any other name...

Perimenopause creates a perfect environment for hair loss due to our changing hormones. Hormonal hair loss can be called female pattern hair loss or androgenic alopecia. These are just different names for the same type of loss. Typically women will notice that their parting is becoming wider or that their hair is thinning all over. It can be described as a diffuse loss. Women with very thick hair in their 20s and 30s are impacted in the same way as women who’ve generally always considered that they have ‘thin’ hair. 

At first it can be tricky to spot because as we age our hormones decline slowly. It’s not as if one day they’re there and then they’re gone. Firstly you might think that it’s just your imagination… and that really it’s the same number of hairs in your brush. After all ‘normal’ hair loss is 50-100/day.

This blog series will cover each in turn. When reading please keep in mind that your hormones work together and don’t exist in silos. Let’s start with insulin.

Insulin

Insulin’s job in your body is to help regulate blood sugar levels. A simple way to think about insulin is it’s the key which lets blood sugar into cells to use as energy. Problems arise if there’s too much sugar floating around (not a technical term). Changes to how your body uses insulin can occur long before physical symptoms appear. 

Sugar

There’s a ton of money in sugar. It's a big business with a murky history emerging from what we’d call human trafficking today. It enabled some of its founders to become ‘philanthropists’ based on the vast sums that they created from this highly addictive substance. Looking at you Mr Tate and Mr Lyle!

Today in the UK we consume on average 700g/week which is about 140 teaspoons. The NHS suggests <210g/week*.

Insulin Resistance

I see the direct impact of this normalisation of excess sugar consumption every day when I’m talking with midlife women. It creates insulin resistance (the key no longer opens the lock as efficiently) and is a primary product for increasing inflammation within the body. The knock-on effects of this gruesome combo is linked to heart disease, impairment of brain function (Alzheimer's aka Type 3 diabetes) and cancer.

Sugar increases inflammation

After age 40 most women tend to be in the perimenopause zone (although be aware that decreasing hormones can start in your mid thirties). The hormone oestrogen is protective for women against inflammation and as oestrogen declines so does our level of protection. At the same time both excess and low levels of oestrogen have been linked to higher rates of insulin resistance.

Similarly for hair loss clients these studies showed that individuals with both androgenetic alopecia and alopecia areata are at a higher risk of both developing and increasing insulin resistance. 

Perimenopausal and resistant to insulin

For the demographic which crosses both of these groups we can see the potential of a double-whammy which means that balancing your blood sugar is critically important.

My clients are beating themselves up because they’re struggling to manage their relationship with this product which is laced throughout both ultra processed and processed food. It turns up where you’d least expect it, for example in supposedly savoury foods like refined carbohydrates. My favourite example of this is in Ireland where local labelling laws don’t allow Subway to describe the stuff that its sandwich fillings sit on as bread. Why? Sugar. It's to do with sugar content and VAT read about it here: https://www.bbc.co.uk/news/business-54370056

Sugar Addiction

So why is it so hard to stop eating sugar? For starters it activates the brain’s reward circuits creating dopamine and stimulates the body’s innate pain relieving opioids. This natural ‘reward’ from eating sugar was designed as an adaptation for high calorie food. We only had seasonal access in the Autumn and it was helpful to lay down that layer of fat to make it through the cold Winter. Today we’re able to lay down that adipose tissue year round!

Sugar hides under different names

Sugar shows up as sucrose, glucose, fructose, maltose, fruit juice, molasses, hydrolysed starch, invert syrup, corn syrup and honey. One way to start avoiding it is avoiding packaged processed foods.

Two weeks

You could start with knowing what your fasting glucose level is as this will give you a baseline to work from.

The good news is that it can be surprisingly quick to start altering your taste buds. Literally in as little as two weeks you can create those changes. It can take longer to change the habits that we have around sugar and refined carbs, together we create new habits that are unique to you. We can prepare for those times when you’re more likely to be sabotaged.  Perhaps most importantly we can change your relationship with what a ‘treat’ looks, feels and tastes like.

Sources:

https://www.nhs.uk/live-well/eat-well/how-does-sugar-in-our-diet-affect-our-health/

https://www.diabetes.co.uk/body/oestrogen-and-diabetes.htm

Sugar Addiction: https://pubmed.ncbi.nlm.nih.gov/29266583/

https://pubmed.ncbi.nlm.nih.gov/28835408/

Opioid Production: https://pubmed.ncbi.nlm.nih.gov/29052153/ and https://pubmed.ncbi.nlm.nih.gov/28747384/

Sugar and immunity:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448089/

Sugar and cancer: https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2003460

Insulin Resistance and Alopecia

https://pubmed.ncbi.nlm.nih.gov/31089876/#:~:text=Alopecia%20areata%20(AA)%20is%20an,increase%20the%20risk%20of%20diabetes.

https://pubmed.ncbi.nlm.nih.gov/22916967/