Hormone Replacement Therapy and Hair: A Review for Trichologists Treating Menopausal Women.

BACKGROUND

Hormones exert complex regulatory effects on the hair follicle and local follicular environments. There has been significantly increased interest among women to utilize hormonal replacement therapy (HRT) in perimenopause and during menopause.

SUMMARY: HRT is recommended to treat vasomotor symptoms in menopausal and postmenopausal women and is also used off-label to manage low sexual function. We conducted a literature search across PubMed/MEDLINE and summarized here the types of HRTs and current evidence regarding HRT's effects on hair. Our research showed that HRT is not currently indicated for hair loss alone in menopausal patients. Patients who are good candidates and have an indication to use HRT can continue transdermal/topical estrogen and oral medroxyprogesterone without increasing concerns for hair loss. Systemic testosterone is contraindicated in women. Transdermal/topical testosterone formulations are acceptable under close gynecological surveillance and usually do not have an adverse effect on the hair.