I’ll never forget the moment after my daughter was born…
She was finally fed and content in her dad’s arms, so I snuck away for a shower…
And as I massaged my shampoo, enjoying a moment of peace…
I pulled my hands away to find a hamster-sized clump of hair in my hands!
Any postpartum mama knows what I’m talking about. Postpartum hair loss is no joke!
I knew that hair loss was a normal part of the postpartum period, but even with my super-thick and curly hair, the loss was really noticeable.
And at a time when women are often already feeling more fragile and vulnerable than usual, the sudden hair loss can be like adding insult to injury.
But is there anything we can do about it?
Let’s talk about it today.
What Causes Postpartum Hair Loss?
During pregnancy, estrogen levels are high. This prolongs the hair growth phase, leading to less normal hair loss and longer, thicker feeling hair.
But after pregnancy, estrogen levels drop really dramatically – from 5–100x the normal level during pregnancy to less than normal in breastfeeding. With estrogen suddenly so low, control of the hair follicles goes to testosterone, and specifically, a derivative of testosterone called DHT. With DHT in control, the hair growth phase shortens, and the result is significant hair loss.
In addition, the hormone prolactin plays a role as well. Prolactin is the hormone that rises to induce lactation after birth. But, prolactin also further suppresses estrogen and increases the expression of testosterone and DHT. More DHT expression may result in more hair loss.
And if you already have experienced androgen-driven hair loss, like that caused by Polycystic Ovarian Syndrome (PCOS), you may be even MORE sensitive to this shift after pregnancy.
I think of the postpartum period as a mini version of what can happen during menopause – that’s how big the hormonal shifts are. Women can become androgen-dominant in the postpartum period, causing hair loss and symptoms like vaginal dryness, low libido, and even vaginal atrophy—all of which can make sex less pleasurable or even downright painful. (If you’re wondering just how long your sex drive will be MIA for, it’s totally normal and common for it to be gone until you stop breastfeeding!)
Lactation-Safe Postpartum Hair Loss Solutions
First, remember that postpartum hair loss is 100% normal. And I pinky-promise, it is way more noticeable to you than to anyone else. I say this having gone through it recently myself!
But if trying to disguise it using ponytails isn’t enough, there are some evidence-based things you can try.
There are plenty of herbs that can help block DHT, and many of them can be safely used during lactation, without impacting milk supply.
However, not all DHT blocking herbs can be safely used during lactation: one to avoid until you’ve weaned your baby is saw palmetto. Saw palmetto is reported to block the response of prostate cells to prolactin, which are likely also upregulated by high prolactin in breastfeeding. It can work well for any remaining hair loss concerns after breastfeeding, but skip it until you’re done breastfeeding.
Now, let’s talk about the herbs that are safe in lactation!
- Stinging nettle
- 1-3 cups of green tea daily
In addition to these, there are a few more that deserve special mention.
In addition to blocking DHT, fenugreek also supports milk supply in some women. It may be especially helpful if you also experience any insulin resistance, such as that in PCOS. Those with PCOS often have high DHT and greater hair loss.
#2 Nigella Sativa (Black Seed)
This herb has been taken for centuries as a therapeutic medicine and for maintaining health, and animal studies show it also has the potential to block DHT. For mothers who are breastfeeding, black seed has been known to boost the breast refill rate. I especially recommend this to moms who have a low breastmilk supply issue due to insulin resistance.
#3 Reishi Mushroom
In a research study exploring the anti-androgenic effects of 20 species of mushrooms, reishi mushrooms had the strongest action in inhibiting testosterone. That same study found that reishi mushrooms significantly reduced levels of 5-alpha reductase, preventing conversion of testosterone into the more potent DHT. In addition, reishi has an extremely low toxicity profile and is a good adaptogen and immune support in new moms. This is another go-to for my PCOS patients.
Bioidentical Progesterone for Postpartum Hair Loss
Another treatment option during lactation is adding cyclical bioidentical progesterone. Biodientical progesterone helps because progesterone reduces 5-alpha reductase activity, which converts testosterone to its active metabolite dihydrotestosterone (DHT).
And if you’re wondering, is that safe? It is indeed. Think about it this way: many women get pregnant with their second (or third….or…. fourth) while still breastfeeding an infant. When we are pregnant, progesterone skyrockets, going up by a factor of ten. This shift – which is known to be safe – is much, much more dramatic than the increase in progesterone from adding cyclical bioidentical progesterone therapeutically. Some progesterone will pass into breast milk, but, again, it’s much lower than what would pass through milk if a woman were pregnant.
And, cyclical bioidentical progesterone is an FDA-approved treatment for postpartum depression. That’s why I often use it with breastfeeding moms, even when hair loss is not a top concern. It can help normalize the menstrual cycle after baby, improving mood and PMS-symptoms.
Nutrient Support for Postpartum Hair Loss
But before herbs or cyclical bioidentical progesterone, I like to start all women with simple nutrient support.
First up, make sure you’re still taking a great prenatal vitamin. Nutrient needs while breastfeeding are even higher than when pregnant. This Is Needed and Designs For Health are my two favorites.
Next, I recommend getting iron and vitamin D levels checked with a quick blood test. Low levels of vitamin D drive hair loss, and supplementing is so easy if needed. Optimal vitamin D levels are between 50 and 80 ng/mL.
Low iron is also really common postpartum, and low iron is associated with increased rate of hair shedding. Blood loss = iron loss, and childbirth often involves a significant amount of blood loss. Anemia is also very common in pregnancy, and not everyone has iron stores that just bounce back. If a serum ferritin level shows your iron levels are low (anything below 30, but optimal is above 50 and within range), supplement with a high-quality supplement. This is my recommended iron supplement.
Finally, don’t forget minerals! Your body will prioritize providing minerals in your breastmilk over meeting your own body’s needs. That means baby might be stealing all our minerals, through no fault of their own!
#1 Zinc is essential for supporting hair and skin health, plus zinc acts as a DHT blocker by reducing 5-Alpha-reductase. Zinc levels can easily get low in pregnancy and postpartum. If you’re going to supplement with more than what is included in your prenatal, I recommend testing along with copper. If taking zinc, you’ll also need to take copper to keep the two from becoming imbalanced. Serum Zinc should be 64-126, and copper should be 81-157, and the ratio between zinc/copper should be between .85-1.2. I use this product the most, in clinic.
#2 Magnesium is something every nursing or postpartum mama should be on. I suggest 300 mg per day minimum, but some women need more. This one is great!
#3 Copper and Selenium are also important, but should be part of any postpartum vitamin worth it’s merit. Check your prenatal and be sure these are included.
Hang In There, Mama!
Becoming a new mom is tough for so many reasons. I hope this information can help ease that transition a bit.
And if you’re looking for more natural but no-nonsense, judgement-free support from another woman who has been there – look no further! Whether you’re looking for support with hormone issues, fertility, or postpartum life, myself and my team of clinicians would be honored to help.
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PS – Struggling with wild hormones, the baby blues, milk supply, or anything else postpartum? Yes, hormone shifts are a normal part of the postpartum period… but NO they do not have to make you miserable. Let me help.