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[paperdoll]

I’m 56 years old and was prescribed Estrogel and Progesterone earlier this year to help cope with the effects of menopause. I used one pump of the Estrogel on each arm daily along with the progesterone at night. Soon after I started noticing that I was losing a large amount of hair that wouldn’t ease up.

After 4 months and continued hair loss, I stopped HRT. My friend encountered the same side effect with the Estrogel and was given an injection of testosterone to counteract and stop the hair loss. I was reluctant to try it because I always heard that Testosterone caused more hair loss, but she was right, after a long acting dose of testosterone, the hair shedding stopped completely within 2 weeks. Not only did the hair loss stop, my libido woke up, I had more energy and better mood. I felt like my old self again. Wow.


My OBYN is very understanding and is willing to prescribe testosterone injections but doesn’t have a clue on the correct dosage for women.  Also he wants me back on Estrogen and Progesterone first, I’m terrified of going back on the Estrogel, I’m afraid that it will trigger the hair loss again.

Any suggestions on an estrogen that won’t cause hair loss, perhaps injection instead of cream form or another type altogether?

As for the testosterone, is anyone else taking it by injection, it would greatly help me to know what dosage per week you’re on.

Thanks in advance 😊

[CLKD]

Why doesn't your OBYN do his/her research  .  ?   Perhaps ringing a dedicated menopause clinic for advice?  U could ask to be referred however, there are waiting lists.

Browse round, join in.  Welcome!

[Bandango42]

Hi

I use evorel patches and have substantial hair loss. Seems to get worse with each increase, which is hugely depressing because I don't think I could cope without hrt.

So, no advice really, just to say patches can also cause hair loss so you may want to avoid them (evorel anyway)

X

[paperdoll]

Why doesn't your OBYN do his/her research  .  ?   Perhaps ringing a dedicated menopause clinic for advice?  U could ask to be referred however, there are waiting lists.

Browse round, join in.  Welcome!

They hardly have any info for menopausal women on testosterone, so he’s sending me to a compound Pharmacist to figure our the proper dosage. Thanks for the welcome!

[paperdoll]

Hi

I use evorel patches and have substantial hair loss. Seems to get worse with each increase, which is hugely depressing because I don't think I could cope without hrt.

So, no advice really, just to say patches can also cause hair loss so you may want to avoid them (evorel anyway)

X

Hi

I use evorel patches and have substantial hair loss. Seems to get worse with each increase, which is hugely depressing because I don't think I could cope without hrt.

So, no advice really, just to say patches can also cause hair loss so you may want to avoid them (evorel anyway)

X

I’m going to speak with a compound pharmacist this week and see if they have any recommendations. For myself, the injection of testosterone made a world of difference for HRT hair loss.

I appreciate your advice. 😊

[Hurdity]

Hi paperdoll

This is a UK based site and no menopausal women have testosterone by injection - I'm not even sure whether men do. Also not sure whether injections are with testosterone or a synthetic type as used to be given to men in UK before the bio-identical gels became available. There is no licensed T preparation for women in UK ( and not in US either I don't think though your system is different over there - if that's where you're based - thinking it is because of  obgyn - we don't have these!). Off licence, women can sometimes be prescribed testosterone (bio-identical) gels (made for men) and the doses are given by the British Menopause Society. There is a cream for women (Androfeme) made in AUS which some private menopause specialists can prescribe.  Neither the BMS nor the NHS endorse compounding preparations or such pharmacies.

Sorry to hear about the hair loss but I'm sure this cannot be because of the oestrogen unless it;s something to do with how you;re taking it - because oestrogn should have the oppositie effect - think of when we're pregnant and our is glossy, thick and luxurious - when oestrogen levels are really high, and post-menopause when it gets much thinner and less lustrous... Some progestogens can cause hair loss especially the androgenic synthetic ones.

Sorry I can't be of more help but all the best with your search for the right HRT.

Hurdity x

[Bandango42]

Hi hurdity

If your explanation is correct, can you advise why mine might be shedding? And it gets worse with each increase of oestrogen patch I use? I thought the same as you, as in the more oestrogen you have, the less your hair will fall out but that's not happening in my case! I definitely absorb well because most other symptoms are very well controlled. I also take utrogestan sequentially which I believe is bio identical, not synthetic.

Are you aware of any other conditions/reasons that encourages hair loss? I had blood tests a few months ago which didn't throw up anything untoward.

Many thanks x

[Wrensong]

I'm assuming if you had bloods done, Bandango, that included thyroid function & FBC?  But perhaps not ferritin if on the NHS?  Low ferritin can be one reason for hair loss.  Presumably not on Testosterone?

We did have another member who had probs with hair loss she was sure had been caused by oestrogen replacement & the NHS website does list it as a side effect.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/

"Side effects of oestrogen
Side effects of taking oestrogen can include:

headaches
breast pain or tenderness
unexpected vaginal bleeding or spotting
feeling sick (nausea)
mood changes, including low mood or depression
leg cramps
mild rash or itching
diarrhoea
hair loss
They will often go away after a few weeks"

[Bandango42]

Is low ferritin iron? No, not on testosterone. Hair loss started in November 2022 so hasn't got better in a few weeks ☹️

[Wrensong]

It's a protein that stores iron, but not usually tested by NHS GPs if a full blood count looks OK.  It's possible to have iron deficiency with low ferritin without being classed as anaemic e.g. if you have heavy bleeds.

I'm assuming you haven't been under significant stress, you're eating well & there's no other reason you can think of for the hair loss?

[Bandango42]

I never have heavy bleeds, well, not what most women would call heavy anyway. Never flooding or prolonged bleeding. No particular stress I can think of, other than the usual perimenopausal stress of 'oh, what's this amazing new horrific symptom I have today' 😩

My diet is fairly decent, probably could be better but not overly bad. To be honest I've just kind of accepted the hair shedding as yet another menopause symptom that's here to stay and 'try' not to get anxious about it because there's very little I can do. My best friend has recently developed severe scalp psoriasis and lost over 70% of the hair on her head so I try to count myself lucky that mine is nowhere near that bad. I'm more puzzled than worried really, because I always thought if oestrogen levels were good then hair doesn't shed excessively x

[Hurdity]

We did have another member who had probs with hair loss she was sure had been caused by oestrogen replacement & the NHS website does list it as a side effect.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/

"Side effects of oestrogen
Side effects of taking oestrogen can include:

headaches
breast pain or tenderness
unexpected vaginal bleeding or spotting
feeling sick (nausea)
mood changes, including low mood or depression
leg cramps
mild rash or itching
diarrhoea
hair loss
They will often go away after a few weeks"

Wrensong - thanks for posting this but it is really puzzling! I've had a quick look and the sources ( including Newson clinic and other clinics) give the usually accepted scenario - that oestrogen promotes hair growth and lack of it has the opposite effect! The product info for oestrogel gives Alopecia as a potential side effect with unknown frequency though the tablets and patches that I quickly perused, do not, so I dont know how it has come to be listed under the NHS side effects unless this has been generalised from one specific HRT type maybe? However I haven't scoured the literature!

Bandango - I did look into this some years ago and cam to the conclusion that hair growth and loss and the interaction with hormones is very complex. As Wrensong says there can also be other more straightforward reasons and it might be coincidence that you have also increased your patch dose.

Hurdity x

[Wrensong]

Wrensong - thanks for posting this but it is really puzzling! I've had a quick look and the sources ( including Newson clinic and other clinics) give the usually accepted scenario - that oestrogen promotes hair growth and lack of it has the opposite effect! The product info for oestrogel gives Alopecia as a potential side effect with unknown frequency though the tablets and patches that I quickly perused, do not, so I dont know how it has come to be listed under the NHS side effects unless this has been generalised from one specific HRT type maybe?

Hi Hurdity, yes I agree it is odd & somewhat confusing  .  The Estradot SmPC lists alopecia as a "rare" side effect but I can't find it listed under Evorel & haven't checked the gels or spray.  I looked into it some time ago when another member was having very distressing hair loss she attributed to oestrogen use & more recently because I've been shedding more than I'm comfortable with myself. 

Like Bandango, I've been dismayed to notice over time that there does seem to have been a correlation with higher doses of oestrogen, but in my case there have been various other possible contributory factors muddying the picture, inc low ferritin & the thyroid complication.  When I reduced my oestrogen dose to 25mcg the hair loss seemed to gradually slow to minimal but I don't feel the benefits of HRT on a dose that low & also have osteopenia to think about.  With hindsight I've wondered whether the fact the hair loss was worse on higher doses of oestrogen was due to the heavier bleeds I got as a consequence, not knowing until recently that that my ferritin had become low  .  My oestradiol whenever tested had always been below 300, so never mega-high nor into the 300-500 range my good NHS gynae advised to aim for, but my uterus just seemed to lap it up  .   I'm supplementing with iron, with tests to monitor progress & hoping that improving the ferritin will reduce the rate of hair loss.

Frustratingly, I felt I had to discontinue testosterone for several months as a test but found the hair loss didn't decrease during that time.  My levels on T have never been above mid-range, I have no ovaries & definitely feel benefits from supplementing with T that go beyond the sexual aspects it's well known for & I don't want to be in a position where I feel I can't use it  .  It's a conundrum for sure!
Wx

P.S. Kept coming back & adding to this as I thought of more!

[Wrensong]

Bandango, I'm glad to know you don't have significant blood loss as a possible explanation for the hair loss, no extraordinary stress & that your diet is goodish, but if you think there's any leeway for improving that, it might be worth trying?

How distressing for your friend though.  I hope she has good medical help with that.

Like you, I'm puzzled by the hair loss & though I'm lucky it was thick to start with, I can't say I don't find it alarming.
Wx

[Wrensong]

Hi paperdoll &    Your experience is interesting & I'm glad you have found improvement in the hair shedding.  As Hurdity says the association with hormonal status seems to be complex when we try to get a handle on it from the scientific literature & I think genetics probably has a role to play in women as well as in men.

The following link is interesting.  It looks to have involved Rebecca Glaser who has generated many other interesting articles on the role testosterone has to play in women's health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380548/

Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study

"Conclusions

Subcutaneous testosterone therapy was found to have a beneficial effect on scalp hair growth in female patients treated for symptoms of androgen deficiency. We propose this is due to an anabolic effect of testosterone on hair growth. The fact that no subject complained of hair loss as a result of treatment casts doubt on the presumed role of testosterone in driving female scalp hair loss. These results need to be confirmed by formal measurements of hair growth."

Perhaps you'd let us know whether you continue to keep the hair loss at bay & what happens about your testosterone replacement?
Wx