Oct 23, 2024
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Fact Checked
Exploring the best treatment options for menopausal hair loss: A comprehensive review of Nutrafol, Hers, Happy Head, and Ro.
Our Reviews Team is committed to recommending products and services that we believe add value to our readers’ lives. To provide the most accurate overview of hair loss treatments, we invested hundreds of hours in comprehensive research. To make our selections, we:
Mystery shopped eight online platforms offering hair loss treatments, testing four ourselves
Interviewed dermatologists and trichologists about the causes and treatments of hair loss, with special considerations for specific populations such as older adults, men, and women
Interviewed seven people who sought hair loss treatments to learn about their personal experiences
Compared online platforms and products, evaluating costs, features, and potential benefits and drawbacks
Identified key factors to consider when evaluating hair loss treatments, through independent research and expert guidance
Read verified customer reviews from trusted sources like Trustpilot to understand real user experiences with products and platforms
Consulted the latest resources from the American Academy of Dermatology (AAD) and peer-reviewed articles to ensure our recommendations align with current, evidence-based best practices
Learn more about how we research and test hair loss products.
Key Takeaways
Several online health care providers offer proven over-the-counter and prescription treatments for menopausal hair loss, including medications and supplements such as minoxidil, finasteride, and saw palmetto.
The treatment options in this review range in price from $14–$178 per month.
More than 50% of women experience some degree of hair thinning or loss during menopause.
All of these products have proven effectiveness, but the right choice depends on factors like the need for customization, budget, and comfort with prescription treatments.
Menopause marks a significant transition in a woman’s life, often bringing hot flashes and other less-than-desirable symptoms. One lesser-known symptom is hair thinning, which affects more than 50% of women. The hormonal shifts in menopause can trigger a slowdown in hair growth and an increase in hair shedding, which can be distressing for many.
Hair loss in women is typically different from hair loss in men. Christopher Chu, MD, dermatologist with Pure Dermatology in Austin, Texas, said, “In women, the hairline is often preserved, and then there’s loss of density on the top, while in men, usually there’s temporal recession, and then there’s hair loss on the vertex (very top of head).”
This type of menopausal hair loss is also called diffuse thinning, which causes hair to thin and fall out evenly across the scalp instead of in a specific pattern.
Fortunately, there are a number of effective hair loss treatments for women, including supplements and prescription treatments. This article reviews five leading online brands—Nutrafol, Hers, Happy Head, and Ro—each offering unique hair loss medications and treatments for managing hair thinning and loss during and after menopause.
Best menopausal hair loss treatment options in 2024
What we look for in menopausal hair loss treatments
We found several important factors when testing hair loss products specifically for menopause, including:
Clinically backed ingredients
We prioritize products that contain ingredients like minoxidil that are proven in clinical studies to support hair growth and prevent further thinning.
Ease of use
Given the daily commitment required for hair loss treatments, ease of use plays a key role. Treatments must fit seamlessly into a busy routine.
Safety and side effects
Safety is very important, especially with prescription treatments. We consider products with minimal side effects and a strong safety record for long-term use.
Customer service and satisfaction
We only recommend companies with a record of happy shoppers and that make it easy to get in touch with them when you need to.
Nutrafol
How does Nutrafol work?
Nutrafol’s approach to menopausal hair loss focuses on targeting the various factors that lead to hair thinning, such as hormonal imbalances, stress, and nutritional deficiencies. Nutrafol offers four different supplements tailored to women at various life stages.
Nutrafol Women’s Balance is specifically designed to address the hair health needs of women 45+. This supplement aims to improve hair growth, volume, and strength by targeting the underlying causes of menopausal hair thinning, such as shifting hormone levels, stress, and aging.
The key ingredients in Nutrafol Women’s Balance are:
Saw palmetto: Helps inhibit the conversion of testosterone to dihydrotestosterone (DHT), a hormone linked to hair follicle shrinkage and thinning
Ashwagandha: An
adaptogenⓘ
Adaptogens are natural substances, such as herbs and mushrooms, recognized for their ability to help manage stress. They work by aiming to restore balance or homeostasis within the body.
that reduces stress hormones like cortisol, which can contribute to hair loss
Marine collagen: Supports hair structure and strength by providing essential amino acids for healthy hair growth
Tocotrienols: Suppresses inflammation
It also contains a blend of vitamins and minerals, such as biotin, zinc, selenium, and vitamins A, C, D, and E, which are all crucial for maintaining healthy hair. Nutrafol also offers topical scalp care products that may enhance the effectiveness of the supplements by ensuring the scalp is healthy and primed for new hair growth.
Our tester found the sign-up process straightforward, with the option to take a quiz that recommends products based on specific hair needs. But the product quiz lacked important health-related questions. For example, people with kidney disease or diabetes should consult their doctor before starting Nutrafol, but our tester wasn’t made aware of that when taking the quiz.
Our tester noticed that it was easy to integrate the product into her daily routine. But she pointed out that these supplements are not for everyone—the capsules are quite large and have a strong taste. She appreciated the hair serum, which didn’t make her scalp oily and could be used even on non-wash days.
Overall, we like that Nutrafol focuses on overall hair health and targets multiple underlying causes of hair thinning, such as hormonal imbalance and stress. We don’t like that it doesn’t ask detailed health questions before allowing you to make a purchase, which could lead to safety issues for some users with specific conditions.
Nutafol offers a combination of oral and topical products to effectively treat hair thinning in women.
Our tester on the Nutrafol Women’s Balance supplement:
“If you have difficulty swallowing pills, the nutraceutical is not for you. The capsules are massive and they also smell/taste very bad.”
Our expert take
Who may love it
Women experiencing general hair thinning due to menopause
Those who want a natural, non-prescription approach to hair health, targeting multiple causes of hair loss
Who may want to avoid it
People with conditions like kidney disease or diabetes, as it may not be safe
Anyone who struggles with swallowing large capsules or dislikes strong-tasting supplements
Customer reviews
Nutrafol Women’s Balance has 4.2 out of five stars on Amazon. Positive reviews mention that the product worked for them and supported thicker hair and new growth. Negative reviews mention the high price of the supplement and that the capsules are difficult to swallow and have a bad taste.
“I’ve taken this product for a full 4 months now and have ordered for the 5th month today. I am definitely giving this product the full 6 months as instructed to get the full benefit. I was getting a lot of hair in my brush after shampooing but, after 2 months I saw a difference and now after a full 4 months I hardly see any hair in my brush. My hair is growing fairly fast but not necessarily thicker but I always had fine hair but lots of it. I think I will cut the dose to 2 capsules a day after the next bottle and see if it is still working so I can save a little money since it is a bit pricey… I’m worth it so I’ll only try the 2 capsules a day if it still works. I have been using the shampoo and conditioner but I think it is this product that is making it work. I doubt I will get the S/C after it is gone but never say never.”
Tracey F, verified buyer on 07/12/2023
“I’m currently on month 3 of using Nutrafol Women’s Balance Hair Growth Supplements, and I’m thrilled with the results so far! As someone in the 45 and up age group, finding a supplement that genuinely works has been a game-changer for me. These clinically proven supplements have noticeably improved the thickness and strength of my hair. I’ve seen a significant reduction in hair thinning and an increase in overall hair volume. The formula seems to be well-suited for my needs, addressing issues related to hormonal changes and age-related hair concerns. The capsules are easy to take, and I’ve had no adverse side effects. The improvement in my hair health has boosted my confidence and made me feel much better about my appearance. Nutrafol Women’s Balance has been a fantastic investment in my hair health. I highly recommend it to anyone looking for a reliable and effective solution for hair growth and maintenance”
– B. Riccio, verified buyer on 07/31/2024
Hers
How does Hers work?
Hers offers a straightforward, over-the-counter solution for menopausal hair loss with its Minoxidil foam and complementary products like biotin gummies, shampoo, and conditioner.
Minoxidil is an FDA-approved treatment for hair loss that is effective for both men and women. It works by widening blood vessels in the scalp, which increases blood flow to hair follicles, thereby stimulating hair growth. About 40% of women who use minoxidil experience moderate to dense hair regrowth after 12 weeks.
Minoxidil must be applied consistently, as any new hair growth can be lost if treatment is discontinued. While effective, it can cause side effects such as scalp irritation and, in some cases, unwanted facial hair growth. Some users also experience an initial shedding phase, which is temporary and usually indicates the treatment is working. Minoxidil is a reliable option for women dealing with hair thinning, but it’s essential to follow instructions carefully and consult a health care provider before starting it.
Our testers found the product easy to apply, with the foam added smoothly into their daily routines. The product was particularly effective for those with busy schedules who appreciated the once-daily application. Over the testing period, our testers reported seeing fuller hair with noticeable baby hairs growing along the hairline, particularly after consistent use for three months.
One downside noted by our testers was that the foam left a residue when applied to dry hair, which made hair feel slightly dirty the next day. Also, the Hers website could be challenging to navigate, especially for those trying to distinguish between prescription and non-prescription products (it also offers prescription oral minoxidil). Despite these issues, the overall experience was positive, with testers feeling satisfied with the product’s ease of use and gradual results.
Our testers found Hers Minoxidil Foam easy to use.
Our tester on the Hers Minoxidil Foam:
“After using this product for three months, there is a definite improvement in the fullness of my hairline area. I would definitely recommend this product for hormone-related hair thinning.”
Our expert take
Who may love it
Women with busy schedules who need a quick, once-a-day treatment
Those looking for a non-prescription, affordable solution to hair thinning
Who may want to avoid it
Women who prefer not to use topical treatments or are inconsistent with daily application
Those with sensitive scalps who may experience irritation from minoxidil
Those with high blood pressure or who are on other prescription medications
Customer reviews
Hers Minoxidil Foam has 4 out of five stars on Amazon.
“I was not sure how this would turn out, but I really regret not taking pictures before I started this because I can tell it’s working for sure! When I brush my hair every day, I am noticing that I’m not shedding like I used to, and new hair is coming along…baby fuzz. Will be purchasing more in the near future, I recommend this.”
– Annie, verified buyer on 07/26/2024
“It took about 2 1/2 to 3 months to really start working and I am so happy with how my hair is starting to grow!”
– Miya C., verified buyer on 07/18/2024
Read our full Hers hair growth review to learn more.
Happy Head
How does Happy Head work?
Happy Head offers a personalized approach to treating menopausal hair loss through custom-formulated topical treatments. Unlike generic options, Happy Head provides a prescription-strength solution that combines FDA-approved ingredients like minoxidil, finasteride, and retinoic acid. The inclusion of finasteride, typically used to treat male-pattern baldness, adds a powerful element to the formula, though it also requires careful monitoring due to potential side effects. Dr. Chu recommends this type of multi-ingredient approach to treatment. He prefers a combination of minoxidil and finasteride for the most noticeable results. These types of medicines that combine different prescription ingredients are known as compounded medication.
The product works by stimulating hair follicles, reducing DHT levels, and promoting new hair growth. Many users report noticeable improvements within a few months, especially in hair density and thickness. Because it’s a prescription product, it does come with a higher price tag and requires a consultation with a health care provider. They can confirm that you’re actually experiencing menopause since the product is intended for menopausal women only. Perimenopausal women can still get pregnant, so they should not take Happy Head since finasteride increases risk of birth defects.
We like that Happy Head tailors its formula to your needs based on a detailed questionnaire, ensuring a more targeted approach. But it requires a prescription, which may involve a higher cost and a more complex sign-up process.
Happy Head offers oral and topical treatment options.
Our expert take
Who may love it
Women who need a personalized and adjustable hair loss treatment plan
Those comfortable with prescription-strength products and telehealth consultations
People looking for a comprehensive approach combining topical and oral treatments
Who may want to avoid it
People looking for an over-the-counter solution
Those concerned about the potential side effects of finasteride or retinoic acid, specifically perimenopausal women
Adults on a tighter budget, as personalized care may be more expensive
Customer reviews
Happy Head has 4.2 out of five stars on Trustpilot, although reviews are not specific to female buyers.
“I reached out to Happy Head in order to update my existing subscription. The rep (Raian B.) was patient in listening (well, via online chat) to my request and gave me the best possible options to suit my needs. With a lot of direct-to-consumer brands they only give you the illusion of choice/customizability… But Happy Head has so far truly been a personalized experience. I would also add that I went to a dermatologist who advocated NOT for HappyHead itself but rather for the compounding pharmacy with which they work. This gave me a LOT of trust in the company’s product.”
– Raj, verified buyer on 08/20/2024
“Best customer service I have ever experienced. I was totally surprised when I received a ‘welcome’ call providing a confirmation of my order and offering to answer any questions. When I would reach out to my Happy Head Doctor I received responses within hours! (I was a HERS client and couldn’t get a response at all). Every customer service agent has gone above and beyond to help me. Oh and BTW….THE PRODUCT WORKS!”
– Jewell, verified buyer on 08/02/2023
Ro
How does Ro work?
Ro offers two prescription-strength hair loss treatments for women: oral minoxidil and a topical solution combining minoxidil, tretinoin, and melatonin. These treatments are designed for women experiencing female-pattern hair loss (FPHL) who require more potent options than what over-the-counter products can provide.
The oral minoxidil works internally to stimulate hair growth by increasing blood flow to hair follicles. For those who prefer a topical solution, the combination of minoxidil, tretinoin, and melatonin not only promotes hair regrowth but also improves scalp health. Tretinoin helps to enhance the absorption of minoxidil by increasing cell turnover, while melatonin acts as an antioxidant to reduce inflammation and oxidative stress on the scalp. You will take either the oral or topical treatment—not both.
The combination of minoxidil, tretinoin, and melatonin in the topical solution addresses not just the symptoms but also the underlying scalp conditions that can inhibit hair growth. The prescription process requires a consultation and ongoing care with a Ro health care provider though, which adds a layer of complexity.
Our expert take
Who may love it
Women who need stronger treatment options due to lack of results from over-the-counter products
Those who prefer a tailored, prescription-based approach
Who may want to avoid it
Women with sensitivities to the active ingredients
Those who prefer non-prescription or natural treatments
Those uncomfortable with telemedicine consultations
Customer reviews
Ro has 3.9 out of five stars on Trustpilot. These are not specific to female buyers and include reviews across a wide customer base since Ro treats many conditions in addition to hair loss.
“My experience has been great so far. From the doctor visit, to the communication, the product, etc.”
A.R., verified buyer on 08/21/2024
“I am using Ro for three different scripts, eyelashes which my script works great, hair growth and I’m regrowing hair where there had been bald spots, and now weight loss which I hadn’t started yet. I chose Ro because of the ease of getting the scripts I need, the treatment plan addressing any issues and the speed of getting my medication right to my door.”
– Kathy E, verified buyer on 08/05/2023
How we research hair loss medications and test platforms that offer them
Because treatments for hair loss include prescription and over-the-counter options, our Reviews Team took special care to base our recommendations on the best clinical guidelines and what the research says. We consulted with dermatologists and trichologists to get their expert-informed recommendations. Also, we surveyed hair loss treatment users and conducted in-depth interviews with them to better understand the experience of hair loss and hair loss treatment.
Using this information, our testers signed up for online hair loss treatment platforms, paying special attention to the following aspects of their experience:
Treatments available, including prescription, compounded, and over-the-counter options
Ways to interact with a prescriber, for example through messaging or video sessions
The nature of their intake or medical assessment, if prescribed a medication
Shipping times
Costs of subscription, product, and consultation
Ease of use of the app or website
Treatment experience, including challenges with using the treatments on a daily basis
Interactions with customer service
All of our reviews are medically reviewed by a licensed and practicing medical expert to ensure the information is appropriate and in line with current best medical practices in dermatology.
Symptoms and causes of hair loss after menopause
Hair loss during menopause typically involves overall thinning rather than isolated bald spots. You may notice more hair shedding when brushing or washing, a wider part, or a receding hairline. This gradual thinning usually occurs on the top, sides, or front of the scalp. The primary cause is the significant drop in estrogen and progesterone levels that occurs during menopause. These hormones play a vital role in maintaining hair growth, and their reduction can slow hair production and trigger shedding. Also, an increase in androgens (male hormones) can shrink hair follicles, further contributing to hair loss.
How to treat menopausal hair loss
While you may think hormone replacement therapy would make sense as a treatment for menopausal hair loss, Dr. Chu explains that it is not recommended due to risks and lack of proven effectiveness. Safer, more targeted treatments are available.
Several effective medications and supplements are found in the top products we recommend above for menopausal hair loss. Nutrafol contains a blend of clinically proven ingredients like saw palmetto, ashwagandha, and marine collagen, which work together to balance stress hormones, reduce inflammation, and support hair growth. Hers and Ro offer treatments featuring minoxidil, an FDA-approved topical solution that stimulates hair follicles and promotes regrowth. Happy Head’s customizable formula also includes finasteride, a prescription medication that blocks the conversion of testosterone to DHT, a hormone linked to hair follicle shrinkage. Dr. Chu points out that these medications and supplements are not quick fixes. Patients should commit to at least four to six months of dedicated use in order to see results.
Of course, surgical hair transplant is an option, although it’s not suitable for some women who may have universal thinning on their entire head. That’s because the surgery works best when areas of thick density are transferred to areas of thinner density. Other nonsurgical options exist. Low-level laser therapy (LLLT) devices are a non-invasive option that can stimulate hair follicles and encourage growth. These devices are easy to use at home and have shown promising results in clinical studies. Platelet-rich plasma (PRP) therapy is another innovative treatment that involves injecting your own platelets into the scalp to promote hair growth. It is effective in slowing hair loss and enhancing hair thickness.
Coping with hair loss after menopause
Hair loss can be emotionally challenging, but there are effective ways to cope with it. You can embrace new hairstyles and products that add volume or try hairpieces like wigs or extensions to help boost your confidence. Seeking support from friends, family, or a professional counselor can provide emotional relief. Also, focusing on a healthy lifestyle, including regular exercise and stress management techniques like meditation, can improve overall well-being. Remember that you’re not alone—many women experience menopausal hair loss, and with the right approach, you can manage both the physical and emotional impacts.
Compare treatments for menopausal hair loss
Bottom line
Menopausal hair loss can be challenging, but effective treatment options are available. Whether you choose the compounded medications of Happy Head, Ro’s clinically proven formula, the natural ingredients of Nutrafol, or the convenience of Hers, each product offers a path to supporting thicker, healthier hair.
Frequently asked questions
Is menopause hair loss reversible?
Menopausal hair loss is often reversible, but the extent depends on how early you address the issue and the treatment methods you use. Topical treatments like minoxidil, along with supplements and lifestyle changes, can help regrow hair and prevent further thinning. Results may vary, though, and complete regrowth is not guaranteed.
Can I prevent menopause hair loss?
Preventing menopause hair loss entirely may not be possible due to the hormonal changes involved, but you can minimize it. Maintaining a healthy diet, managing stress, and using hair care products designed to strengthen and protect hair can help reduce the severity of hair loss. Early intervention with appropriate treatments can also make a significant difference.
How can I stop my hair from falling out after menopause?
To stop hair from falling out after menopause, consider using a combination of treatments. Topical minoxidil, dietary supplements like biotin, and low-level laser therapy can help promote hair growth. Also, maintaining a nutrient-rich diet and reducing stress levels can support overall hair health. Consulting a health care provider for personalized advice is also recommended.
Can hormone replacement therapy (HRT) help with thinning hair?
HRT is not considered suitable for treating menopausal hair loss due to its related health risks, including an increased chance of blood clots, stroke, and certain cancers, especially for women with a history of these conditions. HRT might also not effectively target hair loss, as thinning hair during menopause often involves multiple factors beyond hormonal changes. Side effects like weight gain and mood swings may also outweigh its benefits. Safer, more targeted treatments like topical minoxidil, low-level laser therapy, and supplements are often preferred for managing hair loss.
Have questions about this review? Email us at reviewsteam@ncoa.org.
Sources
Rinaldi F, et al. The Menopausal Transition: Is the Hair Follicle “Going through Menopause”? Biomedicines. Nov. 14, 2023. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669803/#B14-biomedicines-11-03041
Liang X, et al. Efficacy and Safety of 5% Minoxidil Alone, Minoxidil Plus Oral Spironolactone, and Minoxidil Plus Microneedling on Female Pattern Hair Loss: A Prospective, Single-Center, Parallel-Group, Evaluator Blinded, Randomized Trial. Frontiers in Medicine. July 10, 2022. Found on the internet at https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.905140/full
American Society of Plastic Surgeons. Hair Transplantation and Restoration. Found on the internet at https://www.plasticsurgery.org/cosmetic-procedures/hair-transplantation-and-restoration/women
Pillai JK and Mysore V. Role of Low-Level Light Therapy (LLLT) in Androgenetic Alopecia. Journal of Cutaneous Aesthetic Surgery. Oct./Dec. 2021. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/
Paichitrojjana A and Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Design, Development, and Therapy. March 10, 2022. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922312/
Lauren Sherman, M.S., is a health content writer with a master’s degree in human genetics from the University of Colorado Anschutz Medical Center, laboratory experience from National Jewish Health, and clinical experience from Children’s Hospital Colorado.
Kathleen Cameron, BSPharm, MPH, has more than 25 years of experience in the health care field as a pharmacist, researcher, and program director focusing on falls prevention, geriatric pharmacotherapy, mental health, long-term services and supports, and caregiving. Cameron is Senior Director of the NCOA Center for Healthy Aging, where she provides subject matter expertise on health care programmatic and policy related issues and oversees the Modernizing Senior Center Resource Center.
