It appears that you have gone offline, so I will go ahead and address the most common cause of hair loss (called alopecia) in women at the time of menopause. Androgenic Alopecia.
Androgenetic alopecia is the most common cause of hair loss in both men and women. It affects 30 to 40 percent of adult men and women, alike. The incidence of androgenic alopecia increases around the time of menopause. The mechanism is reduced estrogen, which in light of normal ongoing androgen production by the adrenal glands, leads to an androgen predominant state. Testosterone and other androgens from the adrenal glands are broken down into dihydrotestosterone, which travels to the hair follicles and activates a gene in the follicular cell DNA that leads to miniaturisation of the follicle itself ... and along with that miniaturisation process comes a reduced hair "growth phase" and extreme thinning of the hair shaft.
The only treatment approved in the US for Androgenic Alopecia in women is topical minoxidil. Studies suggest that 5% minoxidil is more effective than the 2% formulation. In women who do not respond to topical minoxidil therapy, there are case reports of success by adding 100mg to 200mg of spironolactone (a water pill = diuretic), a diuretic with anti-androgen properties.
This being said, alopecia has many different forms and causes. Androgenic alopecia is the most common, and for women is even more common at and following menopause. If you have not yet seen a Dermatologist, you should. Photographs of the scalp or hair loss regions are important to document progress.
Additional investigations that I routinely perform include:
CBC (complete blood count)
Vitamin B12 level
Complete metabolic panel
RPR - VDRL (tests for secondary syphilis)
Thyroid function studies (including TSH, free-T4, several tests for anti-thyroid antibodies if the TSH or free-T4 are abnormal)
Dermatology Consult - if not already done
I request a 1/4-inch punch biopsy of the affected scalp (and sometimes a draining lymph node if there is lymph node enlargement). This is not common. If a lymph node is biopsied, it is very important to give advanced notifice to the Pathologist that the biopsy is from an alopecia patient with lymph node enlargement, and I wish to have special testing performed on the lymph node ... this allows the Pathologist proper time to set up for the the proper stains, smears, and cultures. The Pathologist will additionally prepare for special studies (including immunohistochemical, cytogenetic, and molecular genetics) before the specimen arrives.
I have also created a PDF document for you as a Patient Handout. This is done with permission of the copyright holder, UpToDate, Inc.. Please save this document to your local hard drive once it is downloaded (it's a large file, 7 pages and nearly 0.5 megebytes, so it may take a while to download depending on your connection speed). I will remove this document from the Internet in a few days:
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