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Why has my pubic hair thinned so much after menopause?

Answers, by Dr. Joseph Collins



The thinning and loss of hair, whether head or pubic, can occur for a number of reasons. Hormonal deficiencies, nutritional deficiencies and medications (such as some forms of HRT) should all be considered as possible causes. Nutritional deficiencies brought on by increased stress (such as the stress of menopause) or severe dieting may contribute to hair loss. Because individual vitamins and minerals have interactive roles on tissue health, including hair follicles, the best course of action when addressing hair loss should be a grade multiple vitamin-mineral. I have found this first step - nutritional support - to be effective in a number of cases involving hair loss in women.



A number of drugs may also be responsible for hair loss (1), (2). To find out if hair loss may be due to a medication ask your physician or pharmacist or go to RxList.com to learn more about your medications. Always talk to your physician or pharmacist if you suspect any medication is causing side effects - including hair loss.


After ensuring good nutrition and reviewing medications that may cause hair loss, the effect of hormonal deficiencies on hair loss must be assessed. The changes that we categorized as normal for aging, such as decreased hair growth, may specifically be due to the decline in the concentration of, testosterone or other androgens that occur with aging (3). Though a drop of testosterone does not occur in every menopause type, those menopause types that do experience such a drop may experience decreased pubic hair. Since estrogens also play a role in secondary sexual characteristics, such as pubic hair, menopause types with a drop in estradiol may also experience hair loss.

But testosterone and estradiol are not the only hormones to consider. The hormone IGF-1 (insulin-like growth factor 1) is a growth hormone that is believed to work with androgens to initiate and maintain hair growth. Working with androgens, IGF-1 may induce hair growth factors (4) (5). Researchers also suspect that IGF-1 may be able to stimulate the growth hair follicle cells directly (6) (7) and may regulate hair growth and the hair growth cycle on its own (8) (9). So the role of IGF-1 (also known as Somatomedin-C) in hair health cannot be ignored.



Nutritional support in the form of a high grade multiple vitamin mineral should be considered.

Review medications you are taking for possible side effects.

Assess hormone levels.


(1) - Tosi A, Misciali C, Piraccini BM, Peluso AM, Bardazzi F. Drug-induced hair loss and hair growth. Incidence, management and avoidance. Drug Saf 1994 Apr;10(4):310-7 [PubMed]

(2) - Gollnick H, Blume U, Orfanos CE. [Adverse drug reactions on hair].Z Hautkr. 1990 Dec;65(12):1128-34. Review. German.[ PubMed ]

(3) - Bolognia JL. Aging skin. Am J Med 1995 Jan 16;98(1A):99S-103S [PubMed]

(4) Itami S, Kurata S, Takayasu S. Androgen induction of follicular epithelial cell growth is mediated via insulin-like growth factor-I from dermal papilla cells. Biochem Biophys Res Commun 1995 Jul 26;212(3):988-94 [PubMed]

(5) - Blok GJ, de Boer H, Gooren LJ, van der Veen EA. Growth hormone substitution in adult growth hormone-deficient men augments androgen effects on the skin. Clin Endocrinol (Oxf) 1997 Jul;47(1):29-36 [PubMed]

(6) - Su HY, Hickford JG, Bickerstaffe R, Palmer BR. Insulin-like growth factor 1 and hair growth. Dermatol Online J 1999 Nov;5(2):1 [PubMed]

(7) - Philpott MP, Sanders DA, Kealey T. Effects of insulin and insulin-like growth factors on cultured human hair follicles: IGF-I at physiologic concentrations is an important regulator of hair follicle growth in vitro. J Invest Dermatol 1994 Jun;102(6):857-61 [PubMed]

(8) - Philpott MP, Sanders D, Westgate GE, Kealey T. Human hair growth in vitro: a model for the study of hair follicle biology. J Dermatol Sci 1994 Jul;7 Suppl:S55-72 [PubMed]

(9) - Hembree JR, Harmon CS, Nevins TD, Eckert RL. Regulation of human dermal papilla cell production of insulin-like growth factor binding protein-3 by retinoic acid, glucocorticoids, and insulin-like growth factor-1. J Cell Physiol 1996 Jun;167(3):556-61 [PubMed]


Dr.Joseph J. Collins

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