Menopause can lead to increased facial hair growth, medically known as hirsutism. Hirsutism is characterized by the growth of coarse, dark hair in areas typically associated with male patterns, such as the upper lip, chin, and jawline. This change is a common physical manifestation of the hormonal shifts that occur during the menopausal transition.
The Hormonal Mechanism Behind Hair Changes
The physiological driver behind this hair growth is a shift in the body’s hormone balance. As a woman approaches menopause, the ovaries gradually reduce estrogen production, leading to a significant decline in circulating levels. Androgen hormones, such as testosterone, also decline with age, but at a much slower rate than estrogen.
This differential decline results in a relative increase in the androgen-to-estrogen ratio. Reduced estrogen no longer counteracts the effects of existing androgens. Hair follicles in the chin and upper lip are highly sensitive to androgen stimulation, which transforms fine vellus hair (“peach fuzz”) into thick, pigmented terminal hair. This explains why darker, coarser hairs appear during perimenopause and postmenopause.
When It Might Not Be Menopause
While menopausal hormone changes are the most frequent cause of mild hirsutism in older women, not all excessive hair growth is attributable to this transition. A sudden, rapid, or extreme onset of hirsutism may signal an underlying medical condition requiring thorough evaluation. Distinguishing between the gradual, mild growth typical of menopause and a more pronounced change is important.
Conditions like Polycystic Ovary Syndrome (PCOS) can continue to manifest as hirsutism or be diagnosed during the perimenopausal period. Adrenal gland disorders, such as Cushing syndrome or nonclassic congenital adrenal hyperplasia, can also result in an overproduction of androgens. Rarely, a rapidly growing tumor on the ovaries or adrenal glands may secrete androgens, causing abrupt and severe hirsutism.
Certain medications can also contribute to facial hair growth as a side effect. These include some immunosuppressants, glucocorticosteroids, and androgen-containing supplements like DHEA or testosterone. If hair growth is sudden or accompanied by other signs of hyperandrogenism (e.g., a deepening voice, increased muscle mass, or rapid weight gain), consult a healthcare provider for diagnostic testing.
Practical Steps for Managing Facial Hair
For women who find menopausal hirsutism bothersome, a wide range of management options exists, from simple at-home methods to professional treatments. Cosmetic approaches offer immediate relief and are easily incorporated into a daily routine.
At-Home Methods
Plucking or tweezing is effective for removing a small number of individual hairs. Waxing and threading can remove larger patches of hair from the chin or upper lip.
Shaving is a fast and painless option. The myth that shaving makes hair grow back thicker or darker is scientifically inaccurate; shaving cuts the hair at the surface, leaving a blunt tip that may feel coarse as it regrows. Depilatory creams contain chemicals that dissolve the hair shaft, but they may cause skin irritation in sensitive individuals.
Professional and Medical Treatments
For lasting results, professional treatments provide significant hair reduction or permanent removal.
Electrolysis is the only method approved by the FDA for permanent hair removal. It uses a fine probe to deliver an electrical current directly into the hair follicle, destroying its ability to regrow hair. This technique is effective on all hair colors, including light or gray hair, but it is slow and requires multiple sessions.
Laser hair removal offers long-term hair reduction by using concentrated light to target the pigment in the hair follicle. It is generally faster than electrolysis and works best on individuals with light skin and dark, coarse hair.
Prescription topical treatments are also available, such as eflornithine hydrochloride cream (Vaniqa). This cream slows the rate of hair growth by inhibiting the enzyme ornithine decarboxylase (ODC) within the hair follicle. It requires continuous, twice-daily application for several weeks to see improvement.
Hormonal therapies, such as oral contraceptives or anti-androgen medications like spironolactone, may be prescribed to help lower the body’s androgen levels. These medical interventions are reserved for more severe cases of hirsutism or when there are other concurrent symptoms of hormone imbalance. Discussing options with a dermatologist or endocrinologist can help determine the most appropriate plan.