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Along with all the other changes that accompany getting older, many women are distressed when their crowning glory starts to thin out or lose condition. Here, we explain the phenomenon.

From osteoporosis to heart disease, many of the health problems that women become increasingly susceptible to as they age are well known and widely discussed.

But many women face another change associated with getting older that’s rarely mentioned at all, and even carries a degree of stigma, despite being considered both common and acceptable when it affects men: hair loss.

It’s probably not surprising that when women experience hair loss, the effects on their self-esteem, moods and even self-identity can be more significant than those experienced by men, sometimes resulting in feelings of anxiety and grief.

Most affected women experience a form of hair thinning called female pattern hair loss (FPHL), which typically starts at the crown and may progress until the hair becomes less dense and more diffuse overall, or comprises a sparse area at the top of the scalp with denser hair around the edges of the hairline. It affects only around one in 20 women under the age of 50, but as many as 38 per cent of Caucasian women aged 70 years old.

Less commonly, hair loss in women may be classified as female androgenetic alopecia (FAGA) – a form of hair loss that follows a pattern more typically observed in men, in which thinning usually starts at the front of the hair and the hairline gradually recedes.

Although the terms are FPHL and FAGA are sometimes used interchangeably, it now appears that the increased androgens (male hormones) associated with FAGA do not always occur in FPHL, the causes of which are still not fully understood, but which appear to involve other changes in hormones and/or the enzymes and receptor sites associated with them. Genetic factors are also involved in both these types of female hair loss.

The loss or thinning of the hair occurs via two distinct but related processes.

Hair becomes finer and paler
In a process known as miniaturisation, the scalp follicles that have previously produced thick, strongly coloured strands of hair (known as terminal hairs) shrink, and instead produce hairs that are thinner, finer, less densely pigmented and generally shorter (known as vellus hairs).

The hair growth cycle changes
Under normal circumstances, each strand of hair on your scalp progresses through a cycle comprising an active growth (anagen) phase that lasts from 2-7 years, a brief transition (catagen) phase of up to a fortnight, and then a resting (telogen) phase of 35-100 days, in which hairs are shed from the scalp.

At any given time, the number of hairs in the anagen phase of the cycle is usually around nine times greater than the number in the telogen phase.

However, during hair loss, the anagen phase of the cycle shortens and the telogen phase of the cycle lengthens, altering the balance between new hair growth and the shedding of old hairs, and ultimately reducing the number of individual hairs on the head. (Since the duration of the anagen phase also determines the length of the hair, these changes to the hair cycle also mean that new hairs may become progressively shorter).

Chinese herbs may help
From the perspective of traditional Chinese medicine (TCM), the growth and development of the hair is believed to depend on the health of the Kidney and Liver organ-meridian systems, with Kidney essence (also called Jing) governing growth, and Liver Blood providing nourishment to the scalp and hair follicles.

In this system of medicine, a number of herbs have traditionally been used to promote the healthy growth, volume, and condition of the hair, including fallopia, white peony, rehmannia, dong quai and ligusticum.

Collectively, they work by replenishing Kidney essence (which in turn revitalises the hair follicles and scalp and promotes healthy hair growth), invigorating the circulation and Blood, and supporting the balance of Yin and Yang in the Kidney organ-meridian (among other actions) .

Paul Keogh, a naturopath who has made a lifelong study of Chinese herbal medicine, and who is co-founder and technical director of Fusion® Health, explains that these types of herbs may aid in the management of FPLH, FAGA, and other forms of hair loss affecting women, including alopecia areata (spot baldness) and general thinning of the hair.

One Chinese herb of particular interest for such problems is Fallopia multiflora, which has traditionally been used to promote hair growth and colour, as well as treat hair loss from various causes.

Preliminary research suggests that when taken as a proprietary extract called Phytofol®, fallopia may help to revitalise hair follicles that are in the resting (telogen) phase of the hair growth cycle, while also promoting the anagen phase of the cycle and increasing the percentage of hairs undergoing active growth.

NOTE: In some circumstances, hair problems may be symptomatic of an underlying hormonal imbalance. Consult your healthcare professional if you’re experiencing hair loss that’s severe, sudden or occurs in conjunction with other symptoms that may be attributable to hormonal imbalance (such as acne, obesity, menstrual irregularities or excess hair on parts of your body other than your scalp).