Hi Alice, I’m 52 (living in Cork, Ireland). My hair started shedding (Telogen Effluvium) four years ago and is still shedding, albeit less. Two years ago my doctor finally put me on oral Minoxidil and Spironolactone. I was then diagnosed with female pattern baldness and my hair has only continued to get worse and worse. The oral Minoxidil and Spironolactone have done nothing to stop the acceleration of female pattern baldness. I’m at my wits end. I’m also on HRT so it seems I’ve covered all bases, but my hair is now miniaturised and I don’t know what else to do.

Ah, how tricky. I know you’re based in Ireland so these suggestions may be of limited use but things that might be worth contemplating are the Trichotest – a DNA swab thing that helps identify which methods of hair restoration may be better for an individual (though it sounds like you’ve already found from experience that minoxidil isn’t helpful – it doesn’t work for everyone). HRT is surely good. As is (though less proven) collagen supplements – I’m very keen on Totally Derma, which I have put on the shop on my website as it’s the Rolls-Royce of collagens and I find it v beneficial.

As to why it keeps shedding – I can’t really guess/ am not a doctor but I know stress doesn’t help and the stress of worrying about hair shedding makes it a vicious cycle, which isn’t a very helpful thing to say, but anything you can do to reduce stress is helpful. BUT, given that your hair is already miniaturised, I’d say it’s time for some direct action on your follicles. Various docs in the UK have a good deal of success with hair using PRP – platelet-rich plasma, needled into the hair, or using a kind of deep-cleansing facial-for-the-scalp called Keravive. The latest helpful thing to have needled into the scalp is a serum of growth factors from a company called Calecim, though this hasn’t really launched yet, but it will have a home use version which you might be able to use at home with a spiky roller.

In order to work out what might be helpful for you, I’d suggest having a consultation over zoom with Kelly Morrell who runs Scalp Confidential and who is one of the few people who takes an overview of all the available treatments. She is also conducting case studies for the Calecim product – I saw some of her before and afters recently and they’re really impressive. Good luck.