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E203
September 15, 2026
Menopause Masterclass: Why Your Hair Is Thinning and What Works
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In this solo episode of unPAUSED, Dr. Mary Claire Haver explains why hair loss in women over 40 is a medical condition with real, identifiable causes rather than a cosmetic complaint to be dismissed as stress or aging. She starts with the biology of the hair growth cycle, describing the growth, transition, and resting phases and how normal daily shedding compares with the kind of hair loss that signals a problem. She also outlines the warning signs that require prompt evaluation by a dermatologist, including bald patches, a receding hairline, and scalp scarring, redness, scaling, or burning.

Dr. Haver walks through the most common types of hair loss in midlife women. She explains how androgenetic alopecia, also known as female pattern hair loss, often appears as a widening part and thinning at the crown while the hairline stays intact. She explains the hormonal mechanism behind it, including how the balance between estrogen and androgens like testosterone and dihydrotestosterone shifts as estrogen declines, leading to follicle miniaturization over time.

Next, she covers telogen effluvium, the dramatic shedding that can appear months after pregnancy, illness, surgery, significant stress, or rapid weight loss, including weight loss associated with GLP 1 medications. Dr. Haver explains why this type of shedding occurs, when it is likely to resolve, and how an underlying trigger that is not addressed can lead to ongoing hair loss.

A big focus of the episode is iron deficiency, one of the most frequently missed contributors to female hair loss. Dr. Haver explains why ferritin needs to be checked even when standard blood counts appear normal. She also covers thyroid dysfunction, low vitamin D, low vitamin B12, zinc imbalance, inadequate protein intake, and medications that may contribute to thinning hair. She details the lab work women should request and what to bring to a clinician appointment, including scalp photos, a medication and supplement list, and a record of nutrition and protein intake.

On treatment, Dr. Haver begins by addressing iron, thyroid, protein, and vitamin deficiencies. She then reviews topical and oral minoxidil, finasteride, spironolactone, platelet rich plasma, microneedling, low level laser therapy, and hair transplantation. She discusses whether hormone replacement therapy can treat hair loss, which supplements have supporting evidence, and why biotin is unlikely to help without a true deficiency. The episode closes with a practical plan for documenting hair loss, requesting the right tests, and addressing the underlying causes.

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Chapters

00:00:00 – Hair loss is a medical signal
00:01:15 – How the healthy hair cycle works
00:04:35 – Why women’s hair loss gets dismissed
00:05:47 – The iron deficiency many tests miss
00:06:36 – Red flags that need medical attention
00:08:09 – Female pattern hair loss after 40
00:09:50 – Sudden shedding and telogen effluvium
00:13:28 – Iron, thyroid and nutrient deficiencies
00:17:09 – The hair loss workup to ask for
00:19:26 – Ferritin, thyroid and vitamin D targets
00:29:47 – Why treatment usually requires more than one approach
00:35:22 – Minoxidil, results and side effects
00:42:09 – Anti-androgens and the truth about HRT
00:44:11 – PRP, microneedling, lasers and supplements
00:48:09 – A five-step hair loss action plan

About the guest

Dr. Mary Claire Haver

Dr. Mary Claire Haver, MD, FACOG, MSCP, is a board-certified OB-GYN and Menopause Society Certified Practitioner. She is the #1 New York Times bestselling author of The New Menopause, a book written to empower women with evidence-based menopause care, and the newly released New York Times Bestseller, The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again. She earned her medical degree from Louisiana State University Medical Center and completed her residency in Obstetrics and Gynecology at the University of Texas Medical Branch (UTMB), where she is now an Adjunct Associate Professor. 

In 2021, she founded The ‘Pause Wellness, a clinic committed to providing comprehensive menopause care. In 2023, she launched ThePauseLife.com, a trusted resource for women navigating menopause. She is also the host of the podcast unPAUSED with Dr. Mary Claire Haver, where she continues the conversation on women’s health, empowerment, and evidence-based care. 

A sought-after speaker and educator, Dr. Haver is a regular contributor to national media and has been featured in The New York Times , Forbes , The Today Show , CBS Mornings , and Oprah’s Menopause Revolution, and the 2025 TIME100 Creators List . Her social media presence has grown to more than 7 million followers, where she continues to demystify menopause with relatable, science-backed content.