Most women remember the first one. A single, wiry dark hair on the chin, spotted in the car mirror or under the harsh light of a hotel bathroom. You pluck it, forget about it, and a few weeks later there are three. By your late forties there may be a small crop along the jawline or upper lip that seems to grow back overnight.
You are in very good company. New or coarser facial hair is one of the most common changes of midlife, and one of the least discussed, because most women deal with it quietly with a pair of tweezers. Understanding why it happens makes it far less upsetting, and it also helps you spot the rare times when it's a sign of something that needs checking.
Women make testosterone and other androgens throughout life, in the ovaries and the adrenal glands. These hormones are not a male intrusion; they matter for libido, energy, muscle and bone. (There's more about their role in testosterone for women.)
Through perimenopause and menopause, oestrogen falls steeply, while testosterone declines much more gradually, mostly with age rather than with the menopause itself. The balance between the two shifts. Hair follicles on the chin, upper lip and jaw are particularly sensitive to androgens, so with relatively less oestrogen around to counterbalance them, some fine, pale hairs (called vellus hair) are gradually converted into thicker, darker terminal hairs.
A second factor is a protein called sex hormone-binding globulin, or SHBG. It carries testosterone in the blood and keeps much of it inactive. Oestrogen tends to push SHBG up, so when oestrogen falls, SHBG often falls too, leaving a little more free testosterone available to act on the follicles. Weight gain and insulin resistance lower SHBG further, which is one reason facial hair can become more noticeable when weight creeps up in midlife.
Genetics and ethnicity play a big part as well. How much facial hair is "normal" varies widely between families and between populations, so comparing yourself with a friend isn't very useful.
A few coarse hairs on the chin or a slightly darker upper lip that develop slowly over years are very common and are not a sign that anything is wrong.
Doctors use the word hirsutism for excess, male-pattern hair growth across areas such as the chin, upper lip, chest, upper back, lower abdomen and inner thighs. It's worth getting checked if:
Rapid hair growth with other masculinising changes, especially after menopause, is uncommon but needs prompt assessment. It can occasionally be caused by a condition called ovarian hyperthecosis or, rarely, by a hormone-producing tumour of the ovary or adrenal gland. Your GP can arrange blood tests, usually including testosterone, and an ultrasound or referral if needed.
Certain medicines can also cause extra hair growth, including some steroids, some epilepsy treatments and testosterone itself. If you've started testosterone alongside your HRT and notice more facial hair, mention it, because it usually means the dose needs adjusting.
For many women, standard HRT makes little difference to existing facial hair. Some notice that new hairs appear more slowly, because oestrogen nudges SHBG up and helps restore the balance. The effect is stronger with oral oestrogen than with patches or gels, although oral oestrogen carries a small extra risk of blood clots, so it isn't chosen for this reason alone.
The type of progestogen can matter. Some older progestogens have mild androgenic effects, while others, including the micronised progesterone in Utrogestan, don't. Our guide to progestogen options explains the differences if this is a concern for you.
Every method has its fans. The best choice depends on how many hairs you have, their colour, your skin and your budget.
Tweezing. Perfect for a handful of hairs. It doesn't make them grow back thicker or more numerous, whatever you may have heard. Good light and a magnifying mirror help, especially once your near vision starts to change.
Shaving and dermaplaning. Quick and painless. Shaving doesn't change the thickness, colour or speed of regrowth, although the cut ends can feel blunter as they grow back. A single-blade facial razor is gentle on most skin.
Threading and waxing. Remove hair from the root and last a few weeks. Skin often becomes thinner and more fragile after menopause, so take care with waxing, and avoid it on skin treated with retinoids.
Hair removal creams. These dissolve hair at the surface. Always patch test first, because facial skin can react.
Laser hair removal. Lasers target pigment in the hair, so they work best on dark hair and much less well on light, red, grey or white hair. That's an important point in midlife, because the hairs that appear later are often lighter or grey. Several sessions are needed, results are long-lasting rather than permanent, and you'll get the safest results from a trained professional, especially if you have darker skin.
Electrolysis. A fine probe destroys each follicle with an electrical current. It's slow and can be uncomfortable, but it works on hair of any colour and can be permanent, which makes it a good option for stubborn grey or white hairs.
Eflornithine cream. A prescription cream that slows facial hair growth. It doesn't remove hair, but used twice a day alongside another method it can extend the time between treatments. Results take about two months to show, and availability varies by country; in the UK, some NHS areas no longer fund it.
Skin after menopause is drier, thinner and slower to heal, so hair removal needs a little more care than it did in your thirties.
If you use retinoid creams or prescription acne treatments on your face, check with a pharmacist before waxing or threading, as these make the skin more fragile.
If hair growth is more extensive or upsetting, medicines that block the effect of androgens can help. Spironolactone is the one most often used for this, although it's prescribed "off-label" for hair, and it needs blood tests to check potassium and kidney function. Before menopause, reliable contraception is essential with these medicines because they can affect a developing baby. Results are slow: hair grows in long cycles, so it usually takes six months or more to judge whether a treatment is working.
If insulin resistance or extra weight is part of the picture, losing even a modest amount of weight can raise SHBG and reduce hair growth over time.
It can feel silly to be upset about a few hairs, but many women find facial hair really distressing, particularly alongside other midlife changes to skin, weight and the hair on their heads. Our article on thinning hair in your 40s and 50s covers the other side of this hormone shift. If it's affecting your confidence, that's a perfectly good reason to ask your GP about treatment.
Why are my chin hairs coming in grey or white?
Facial hair follicles lose pigment with age, just like the hair on your head. Grey and white hairs don't respond well to laser, so electrolysis is usually the better long-term option.
Will plucking make more hairs grow?
No. Plucking doesn't create new follicles. More hairs appear over time because more follicles are switching to terminal hair, not because of the tweezers.
Is a hairy chin a sign of high testosterone?
Usually not. Most women with a few chin hairs in midlife have normal testosterone levels. The change is in the balance with oestrogen and in how sensitive the follicles are. Widespread or rapid hair growth is a different matter and should be checked.
Can facial hair go away after menopause?
Hairs that have become terminal usually stay unless they're removed. The rate of new growth often settles once hormones stabilise after menopause.
Sources: NICE Clinical Knowledge Summaries, Hirsutism · Martin KA et al, Journal of Clinical Endocrinology & Metabolism, 2018, "Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline" · Davis SR, Wahlin-Jacobsen S, Lancet Diabetes & Endocrinology, 2015, on testosterone in women · British Association of Dermatologists, patient information on hirsutism · Educational only, not medical advice.
Keep reading: Testosterone for women · Thinning hair and hormones · PCOS, explained · Why your skin changes at menopause · Low oestrogen symptoms · Take the free Hormone Quiz