BH26 Characterizing hair changes in menopause: symptom patterns and help-seeking behaviours

Abstract

Menopause comprises hormonal changes that can affect hair health. Although the underlying mechanisms are becoming better understood, available evidence on prevalence, symptom range and reported impact remains limited overall. Hair changes may significantly affect quality of life and drive diverse help-seeking behaviours. We describe the prevalence and spectrum of hair symptoms reported during menopause, and evaluate advice-­seeking pathways and experiences of support. This was a mixed-methods ­quantitative–qualitative study comprising an online survey open to people experiencing perimenopause or menopause in England. Semistructured interviews with 17 participants explored lived experiences of symptom burden. In total, 1229 of 1457 respondents (84%) reported hair symptoms. Common symptoms were shedding (65%), thinning (57%), texture change (45%) and itchy scalp (44%). Diagnoses of androgenetic alopecia and frontal fibrosing alopecia were more commonly reported in peri- and postmenopause than in premenopause. Eyebrow thinning (37%), excessive hair growth on the face and body (30%) and eyelash thinning (27%) were also frequently reported. Less common symptoms included dry scalp (24%), receding hairline (21%), scalp soreness (15%), patchy hair loss (9%) and scalp redness (5%). For advice seeking, 32% reported receiving no information from any source and 6% did not know where to seek help. Advice was commonly sought via online searches (20%) and hair, beauty and alternative practitioners (19%), compared with fewer consulting medical professionals (general practitioner 12%, dermatologist 3%). The mean Dermatology Life Quality Index (DLQI) was 4.32; 27% reported at least moderate impact (DLQI ≥ 6). Interviews highlighted negative effects on self-confidence and identity. Menopause-associated hair changes were common and multifaceted. Diagnoses of androgenetic alopecia and frontal fibrosing alopecia clustered around peri- and postmenopause, indicating a key window for recognition and assessment. Many women reported limited information, and reliance on nonmedical or online sources. Improved recognition, signposting to evidence-based resources and accessible support pathways are needed to reduce psycho­social burden and impact on quality of life.