"Dearest granddaughter, come close and look into my eyes." Grandmother Growth beckons and her voice grows deeper and more resonant. "Look deep into my eyes and acknowledge the beauty there.

"Yes, my skin is wrinkled. My face is the face of age, and to many, that is fearful. But my beauty, like my wise blood, now resides inside of me. Can you see it? Can you feel it? Can you look beyond the hair on my chin?" she says grinning, flicking her fingers under her chin in a most unladylike manner.

"Can you forgive the places where my scalp shines through? Can you find the truth of my beauty, the beauty of age, which is so different from the beauty of youth?" Her eyes grow fierce, but sparkle with amusement. "I know you can, for I know how beautiful I am."

Grandmother Growth takes your chin in her strong hand and looks at you with eyes so intense you fear you may catch on fire. She commands: "When you look into your mirror, I ask you to look deep into your own eyes and to acknowledge your own inner beauty.

"I know, I know, metamorphosis is changing you and you don't like it. Like a teenager, you peer and peer into the looking glass, noting every new wrinkle, every hair on your face (and other new places). Counting each grey hair as it grows. Worrying that your hair seems to fall out by the handful.

"Dear one, my most precious child, take care, but do not fret. And do not tell yourself that you are becoming ugly. I know it is difficult, in fact it may be one of the most difficult tasks of your menopause, but you must recast your own opinion of beauty so that it includes old women who have hairy problems and live well with them - like you!"

Too much hair (on the chin), too little hair (on the scalp), falling hair, thinning hair, greying hair - no matter what the complaint, many women notice something happening to their hair during menopause. As hormone levels shift during the menopausal years, hair responds to the changing hormones by changing texture, falling out, or by growing in "odd" places. Here are remedies for those who want more hair, and for those who want less.

HAIR LOSS (ALOPECIA) & GREY HAIR

STEP 1. COLLECT INFORMATION

Menopause does not cause grey hair; taking hormones doesn't stop it. Greying, thinning hair is a normal part of aging. Women whose menopause is induced in their 20s and 30s do not suddenly go grey.

Hair loss at mid-life (androgenic alopecia) is more strongly linked to genes than diet or lifestyle. Those of European origins are far more likely to experience it than Asians, Native Americans, Africans, or African-Americans. Hair loss starts earlier and becomes more extreme on men's heads, but just as many women deal with receding hairlines and balding patches. Roughly half of all women experience some hair loss during their menopausal years. Two-thirds of post-menopausal women deal with thinning hair or bald spots. And no one likes it. Americans spend a billion dollars a year trying to regrow their hair!

Normal hair loss (50-100 hairs a day) is gradual. Sudden unexplained loss is not normal. Events which can trigger hair loss include pregnancy, childbirth, menopause, severe emotional stress, rapid or profound weight loss, thyroid disorders, pituitary problems, malnutrition, iron deficiency, lack of protein, large doses of vitamin A, chemotherapy, radiation, general anesthesia, chronic illness, scarlet fever, syphilis, certain medications (see Step 5), and hair abuse including bleaching, permanents, tight braids, tight pony tails, tight wigs, and tight hats.

(The National Alopecia Areata Foundation, 710 C St, Ste 11, San Rafael, CA 94901 (415-456-4644) can help you contact a local hair loss support group, and gather more information.)

STEP 2. ENGAGE THE ENERGY

Homeopathic remedies for women with hair loss include:

• Lycopodium: loss precipitated by hormonal fluctuations.
  
• Sepia especially for menopausal women who have sweaty flushes and heavy bleeding
  
• Phosphoric acid: loss after grief or extreme emotion, accompanied by exhaustion.

STEP 3. NOURISH AND TONIFY

• Infusion of stinging nettle, 2-4 cups a day, strengthens hair and checks falling hair with its superb supplies of protein, B vitamins, vitamin E, iron, and other minerals. Regular use restores thickness, body, shine and sheen to hair. If you have any infusion left over, pour it on your head and rub it into your scalp for faster results.
• "Every grey hair represents a day with too few minerals," a wise woman said to me. Actually, the color of hair is produced by special cells which gradually die as we age. But it is true that hair is loaded with minerals, and getting extra minerals may keep those color cells alive longer. To increase my mineral intake, and keep my hair healthy, I eat more yogurt, drink more nourishing herbal infusions, prepare more mineral-rich soups, use more herbal vinegars, and increase the amount of seaweed in my diet.
• Lack of minerals, especially iron, can cause hair loss. Yellow dock is one of my favorite iron-tonics.
• Natural hair dyes can cure the grey blahs. Henna (Lawsonia inermis) is a plant that is easily purchased ready-to-use to change the color of your hair, and you are not limited to carrot-top red. So long as it is not overused (less than four times a year) henna is strengthening to the scalp and hair.

  Other natural hair dyes include coffee, black walnut hulls, or infusions of sage or rosemary herb.

• Herbalist Amanda McQuade Crawford suggests using lemon balm or lemon grass infusion as a hair rinse to prevent hair loss.
• Burdock seed oil, one of the best selling hair tonics in Russia, is especially recommended for those with thinning hair or hair loss. Apply to your hair and scalp, leave on overnight and shampoo it out the following day. Repeat as needed.
• Just plain olive oil is also a tremendous hair tonic. So is jojoba oil. Apply a handful of either to hair and scalp, wrap well and leave on overnight, washing it out the next morning.
• I know you know, but let me say it again, exercise! Yes, it can make your hair healthier too.

STEP 4. SEDATE/STIMULATE

• While some temporary loss of hair at menopause is considered normal, something worse may be brewing. Thin, dry hair is one of the first signs of an underactive thyroid. Hair loss is also an early sign of lupus, an autoimmune disease.

  Chugging down a gulp of cod liver oil or wheat germ oil every day for six weeks could help your hair.

• Menopause sends lots of energy to the crown of your head. That can overstimulate the scalp and cause hair loss (and/or headaches). Get your energy moving with a scalp massage. Let your head calm down and your hair cool off.
• Blow dryers, dyes, perms, and other harsh treatments damage hair and scalp. Rosemary essential oil, a few drops rubbed into the scalp several times a week, repairs the damage, increases hair growth, and improves hair texture.

  Other essential oils which improve hair growth and reduce hair loss include lavender oil, lemon oil, thyme oil, sage oil, and carrot seed oil. You can mix 10-20 drops of any of these into 4 ounces of plain olive oil, infused burdock seed oil, or jojoba oil. Other essential oils said to reduce hair loss include birch, calendula, chamomile, cypress, rose, and yarrow.

• Avoid chlorinated water on your hair. A shower filter is more important than a drinking water filter. And cut down on the number of times you wash your hair. Once every 5-10 days is ideal for healthy hair.
• Avoid cayenne. Heroic herbalists say it increases hair growth by improving blood circulation to the scalp. But when there is hair loss, says Janet Roberts MD, specialist in women's hair loss and member of the Oregon Menopause Network, there are inflamed follicles. Cayenne increases inflammation, ultimately increasing hair loss.

STEP 5A. USE SUPPLEMENTS

• Dry, brittle, thin hair is often due to a deficiency in one or more of these nutrients: protein, vitamin A, vitamin B12, vitamin C, iron, zinc, essential fatty acids. Food and herbal sources of these nutrients are preferable to pills.
• Avoid hair weaving, a cosmetic treatment that weaves replacement hair in with the still existing hair; it actually causes more loss (by creating traction alopecia).

STEP 5B. USE DRUGS

• Hair loss can be caused by drugs, including: birth control pills, anticoagulants, diet pills, thyroid medications; non-steroidal anti-inflammatory drugs including aspirin, ibuprofen, and Aleve; cholesterol-lowering drugs such as clofibrate and gemfibrozil; arthritis medications such as gold salts (auranofin), indomethacin, naproxen, sulindac, and methotrexate; beta-blockers such as atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal), and timolol (Blocadren); and ulcer drugs such as cimetidine (Tagamet), ranitidine (Zantac), and famoridine (Pepcid). And, of course, chemotherapy.
• Minoxidil (Rograine) dilates blood vessels, encouraging baby-fine hair. Only the 2% solution is approved for women. Of those who use it only 19% achieve even moderate regrowth; 40% have minimal regrowth. Meanwhile, 40% of the women using the placebo had regrowth! CAUTION: Side effects in women include unwanted hair growth on the face, heart disturbances, and dizziness.
• Fertile women are not allowed to use (or even touch) finasteride (Propecia) for fear of the severe birth defects it causes. This is probably a blessing in disguise, as the side-effects (loss of libido, lip swelling, breast engorgement, birth defects) are not pleasant. Finasteride is completely ineffective in reversing hair loss for postmenopausal women. Tell your men friends a dose of 0.2 mg (one-fifth the normal dose) works just as well, costs less ($10 a month instead of $50), and is gentler on the liver.
• Hormones, including ERT, HRT, birth control pills, and anti-androgens (cypoterone acetate, spironolactone, and fluramide) are used singly or in combination to treat women with androgenic alopecia.

STEP 6. BREAK AND ENTER

• Hair transplants can cover a bald spot but are far less successful on women than on men. Micrografts do a better job of dealing with women's diffuse pattern of hair loss.
• "Scalp lifts" tighten the scalp, making hair appear thicker and fuller.

HIRSUTISM/TOO MUCH HAIR

STEP 0. DO NOTHING

A few brazen souls just grin and bear it. Seriously, does anyone else notice that extra hair? Ask a few people who will tell you the truth. Perhaps you are making a mountain (beard/moustache) out of a molehill (a couple of extra hairs)?

STEP 1. COLLECT INFORMATION

It is not at all unusual to find extra hairs growing on the chin, upper lip, breasts, and legs during or after menopause. It is thought that menopause makes some hair follicles more sensitive to testosterone's hair-promoting effects. However, sudden hair growth can be caused by a tumor on the ovaries, thyroid, adrenals, or pituitary.

STEP 2. ENGAGE THE ENERGY

Visualize a large mirror. Look at yourself in this mirror. When you see something you don't like, ask the mirror how you can change. Finish by telling your image how much you love her. Repeat frequently.

STEP 3. NOURISH AND TONIFY

Oatstraw infusion tends to increase the activity of testosterone; increased levels of testosterone contribute to excess hair growth during menopause. It's a long shot, but avoiding oats, oatmeal, and oatstraw infusion may help eliminate or reduce those extra hairs.

STEP 4. SEDATE/STIMULATE

• Natural bleaches, like lemon juice or sunlight (or both together), are generally safe even for use on the sensitive skin of the face.
• Shaving, plucking, and waxing are minimally invasive means of removing excess hair. Such means may increase the rate of hair growth, however, or make the texture of the hair coarser, or cause hair follicle inflammation and ingrown hairs.

STEP 5B. USE DRUGS

• Hirsutism may be caused by corticosteroids and medications for high blood pressure. (Rograine was originally a blood pressure drug.)
• Drug treatments - which are 80% successful according to one MD - include the corticosteroids prednisone and dexamethasone. Hormones, including birth-control pills and anti-androgens such as spironolactone, are occasionally used.

STEP 6. BREAK AND ENTER

Electrolysis is expensive, painful, tedious, must be done several times over, and can cause scarring. Most sources advise against home electrolysis.