Abstract

Background and Aims: Female pattern hair loss (FPHL) is a common but frequently overlooked condition that affects postmenopausal women worldwide. It impacts both physical appearance and psychosocial well-being. This study examined the prevalence, risk factors, and psychosocial consequences of FPHL among postmenopausal women in Saudi Arabia. Methods: A cross-sectional study was conducted from January to December 2025 using a self-administered online questionnaire to assess the prevalence of FPHL and associated factors among postmenopausal women from various regions of Saudi Arabia. Convenience sampling was used. Chi-square tests were used to examine the associations between categorical variables and the prevalence of hair loss among menopausal women. A p-value of <0.05 was considered statistically significant. Results: A total of 385 participants completed an online Arabic language questionnaire. 69.9% of the participants reported experiencing hair thinning or loss. Most noticed these changes within 1–2 years after menopause, with the frontal scalp predominantly affected. Early menopause (ages 40–45), chronic diseases (notably diabetes and hypertension), a positive family history, and high stress levels were significantly associated with increased hair loss prevalence (p<0.05). Despite these findings, only 30.1% of affected women sought medical advice, with many opting for natural remedies over medical treatments. Additionally, FPHL was linked to reduced self-confidence and impaired social interactions, highlighting its substantial psychosocial burden. Conclusion: This study found that FPHL is highly prevalent among postmenopausal women in Saudi Arabia and is significantly associated with early menopause, chronic diseases, family history, and stress. These findings emphasize the need to raise awareness and encourage early intervention to improve outcomes for affected women.

Keywords: Hair loss · alopecia · Menopause · Women · Prevalence · Saudi Arabia

References

  1. 1.Wang TL, Zhou C, Shen YW, Wang XY, Ding XL, Tian S, Liu Y, Peng GH,
  2. 2.Ramos PM, Miot HA. Female pattern hair loss: a clinical and pathophysiological review. Anais brasileiros de dermatologia. 2015 Jul; 90:529-43.
  3. 3.Cartwright T, Endean N, Porter A. Illness perceptions, coping and quality of life in patients with alopecia. British Journal of Dermatology. 2009 May 1;160(5):1034-9.
  4. 4.Alsharif, S. H., & AlGhamdi, K. M. (2022). Evaluation of scalp hair density and diameter in the Arab population: clinical office-based phototrichogram analysis. Clinical, Cosmetic and Investigational Dermatology, 2737-2743.
  5. 5.Gan DC, Sinclair RD. Prevalence of male and female pattern hair loss in Maryborough. InJournal of Investigative Dermatology Symposium Proceedings 2005 Dec 1 (Vol. 10, No. 3, pp. 184-189). Elsevier. Xue SQ, Zhou JE, Wang RL. Prevalence of androgenetic alopecia in China: a community‐based study in six cities. British Journal of Dermatology. 2010 Apr 1;162(4):843-7.
  6. 6.Blume-Peytavi U, Atkin S, Gieler U, Grimalt R. Skin academy: hair, skin, hormones and menopause–current status/knowledge on the management of hair disorders in menopausal women. European Journal of Dermatology. 2012 May 1;22(3):310-8.
  7. 7.Al-Rubeaan K, Bawazeer N, Al Farsi Y, Youssef AM, Al-Yahya AA, AlQumaidi H, Al-Malki BM, Naji KA, Al-Shehri K, Al Rumaih FI. Prevalence of metabolic syndrome in Saudi Arabia-a cross sectional study. BMC endocrine disorders. 2018 Dec;18:1-9.
  8. 8.Alenazi AM, Alqahtani BA. National and regional prevalence rates of hypertension in Saudi Arabia: a descrip Prevalence of female pattern hair loss in postmenopausal women in Saudi Arabia 109 Majmaah Journal of Health Sciences ,Vol. 13, Issue 4, October - 2025, Rabi - Althani - 1447 tive analysis using the national survey 14. Mirmirani P. Hormonal changes in data. Frontiers in public health. 2023 Apr 4;11:1092905.
  9. 9.Miranda JJ, Taype-Rondan A, Tapia JC, Gastanadui-Gonzalez MG, Romenopause: do they contribute to a ‘midlife hair crisis’ in women?. British Journal of Dermatology. 2011 Dec 1;165(s3):7-11. man-Carpio R. Hair follicle charac- 15. Al-Safi ZA, Polotsky AJ. Obesity and teristics as early marker of type 2 dimenopause. Best Practice & Research 1;95:39-44. 2015 May 1;29(4):548-53. abetes. Medical hypotheses. 2016 Oct Clinical Obstetrics &Gynaecology.
  10. 10.Assiri A, Rajhi A, Sudi A, Akoor A, 16. 16. Trüeb RM. Association between Juraybi S, Mahzara NK, Abutalib Y, smoking and hair loss: another op- Akoor AA. Knowledge, Attitude, and smoking?. Dermatology. 2003 Kariri AM, Altubayqi T, Madkhali AA, Practices Related to Vitamin D, Zinc, and Ferritin Deficiencies and the Associated Risk of Hair Loss in Jazan, Saudi Arabia. Cureus. 2023 Nov 13;15(11)
  11. 11.Alsuwadia AO, Farag YM, Al Sayyari AA, Mousa DH, Alhejaili FF, Al-Harbi AS, Housawi AA, Mittal BV, Singh AK. Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J. 2013 Aug 1;34(8):814-8.
  12. 12.Alanazi, A. S., Alsalhi, W. A., Alghuyaythat, W. K., Almutairi, A. N., Almazrou, M. A., Alabdulminaim, J. A., ... & Alabdulminaim Jr, J. (2023). Stress-Related Hair Loss Among the General Population in Al Majma’ah, Saudi Arabia: A Cross-Sectional Study. Cureus, 15(10). 110 portunity for health education against 3;206(3):189-91. Jul
  13. 13.Alomaish AR, Gosadi IM, Dallak FH, Darraj AI, Jaafari SM, Alshamakhy AE, Mleeh NT. Quality of life and the presence of depression among adults with hair loss in the South of Saudi Arabia. Psychology Research and Behavior Management. 2022 Jan 1:1989-96.
  14. 14.Aukerman EL, Jafferany M. The psychological consequences of androgenetic alopecia: A systematic review. Journal of Cosmetic Dermatology. 2023 Jan;22(1):89-95.
  15. 15.Gold EB, Crawford SL, Avis NE, Crandall CJ, Matthews KA, Waetjen LE, Lee JS, Thurston R, Vuga M, Harlow SD. Factors related to age at nat- Prevalence of female pattern hair loss in postmenopausal women in Saudi Arabia Majmaah Journal of Health Sciences ,Vol. 13, Issue 4, October - 2025, Rabi - Althani - 1447 ural menopause: longitudinal analyses from SWAN. American journal of epidemiology. 2013 Jul 1;178(1):70-83.
  16. 16.Thornton MJ. Estrogens and aging skin. Dermato-endocrinology. 2013 Apr 1;5(2):264-70.
  17. 17.21. El Khoudary SR, Greendale G, through Menopause”?. Biomedicines. 2023 Nov 14;11(11):3041.
  18. 18.25. Doshi YA, Vegad MM, Mehta MJ. A study of prevalence of nutritional deficiencies and their association with hair loss in Indian women. Int J Trichology. 2018;10(5):201-6. Crawford SL, Avis NE, Brooks MM, 26. Hadshiew IM, Foitzik K, Arck PC, Thurston RC, Karvonen-Gutierrez C, Paus R. Burden of hair loss: stress and pause transition and women’s health pact of telogen effluvium and androge- Waetjen LE, Matthews K. The menoat midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2019 the underestimated psychosocial imnetic alopecia. Journal of investigative dermatology. 2004 Sep 1;123(3):455-7. Oct 1;26(10):1213-27.
  19. 19.Sinclair R, Patel M, Dawson Jr TL, Yazdabadi A, Yip L, Perez A, Rufaut NW. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. British Journal of Dermatology. 2011 Dec 1;165(s3):12-8.
  20. 20.Chaikittisilpa S, Rattanasirisin N, Panchaprateep R, Orprayoon N, Phutrakul P, Suwan A, Jaisamrarn U. Prevalence of female pattern hair loss in postmenopausal women: A cross-sectional study. Menopause. 2022 Apr 1;29(4):415-20.
  21. 21.Rinaldi F, Trink A, Mondadori G, Giuliani G, Pinto D. The Menopausal Transition: Is the Hair Follicle “Going Prevalence of female pattern hair loss in postmenopausal women in Saudi Arabia 111

Peer review

Peer reviewed by 2 reviewers, who chose to remain anonymous.

Majmaah Journal of Health Sciences · eISSN 1658-8223 · Majmaah University · open access