Enhance Hair and Skin Health During Menopause




by: Olivier Felicio &  Dr. Franziska Weichmann, Manager of Scientific Communications and Product Development at Horphag Research.

Hair loss during menopause can be a distressing experience for many women as much as 30% to 50%. As a health retailer and in the forefront, you play a vital role in providing accurate information, support, and effective solutions to help your customers navigate this challenging time. By understanding the connection between hair loss and menopause and offering targeted products and advice, you can make a positive impact on your customers’ lives and strengthen your reputation as a knowledgeable and compassionate health retailer.

However, the crucial point of contact is your staff.  Just as you do, staff should be well-informed about menopause, its symptoms, and the potential link to hair loss, neither you nor your staff in most cases are not medical professionals. This knowledge will allow them to provide accurate information to customers and recommend suitable products.
It is tempting to suggest dietary changes such as a balanced diet rich in vitamins and minerals, particularly biotin, vitamin D, zinc, and iron, and pycnogenol may help improve hair health. But opt for recommending supplements that have strong evidence to back you up.
Pycnogenol as recently published double-blind, randomized, placebo‐controlled study reveals a natural, safe and effective path for women who face hair thinning (3). The study, conducted with menopausal women, found oral intake of Pycnogenol® to significantly increase hair density, decrease trans-epidermal water loss in scalp skin and to improve microcirculation in scalp skin.
Their work is shown to be beneficial for health and beauty in hundreds of clinical studies (4).
According to a questionnaire in a study with peri-menopausal women, Pycnogenol® reduced hair loss complaints by 43% after 8 weeks (5).

The above mentioned study confirmed these observations in a randomized and placebo-controlled design with specific focus on Pycnogenol®’s effects on hair quality and density (3). 76 healthy menopausal women between 45 and 60 years were randomly assigned to either take 150 mg Pycnogenol® per day or placebo for 6 months.

Remarkably, hair density was significantly improved by 30% compared to baseline and by 15% compared to placebo after 2 months. The effects of Pycnogenol® stayed on a highly improved level after longer supplementation.

In addition, the study showed that Pycnogenol® significantly reduced water loss from the skin of subjects’ scalp, compared to the placebo group. This leads to a better regulated scalp skin moisture balance for healthier hair and scalp.

The study also confirmed that Pycnogenol® intake positively affects microcirculation in the skin, leading to a better supply of nutrients and oxygen to the hair follicle.

In conclusion, Pycnogenol® intake for only 2 months was efficacious in improving hair and scalp health and significantly reduced hair loss in postmenopausal women (3).

How does Pycnogenol® improve hair quality?

There are several mechanisms of action that can explain Pycnogenol®’s efficacy for hair health and beauty.

Pycnogenol® improves microcirculation

Healthy microcirculation is vital for maintaining good hair quality as it leads to a well-functioning supply of nutrients and oxygen to the scalp and the hair follicles. In several previously published studies, Pycnogenol® was shown to improve microcirculation in small blood vessels in the body, like the very fine micro vessels in the skin, fingertips and in the inner ear or the retinal capillaries in the eye (3, 6-12).

In a 3-month study on diabetic retinopathy, Pycnogenol® supplementation improved the retinal blood flow by around 30% compared to no change in the control patients (7). In another study with patients suffering from coronary heart disease, microcirculation on the fingertip improved significantly in 54% of the patients, taking Pycnogenol® and in 33% of the placebo patients after 4 weeks (8). A third study showed improved microcirculation in the legs by 34% after Pycnogenol® intake, in patients with diabetic microangiopathy (9). In addition, Pycnogenol® positively affects microcirculation in the inner ear, relieving symptoms of tinnitus (11, 12).

Pycnogenol® has anti-inflammatory effects

In addition, Pycnogenol® protects hair follicles by capturing free radicals, generated either by stress, sun rays, pollution or inflammation. In many studies, it was shown that Pycnogenol® has potent anti-inflammatory activities (13-15). Already after 5 days of daily intake, a study reported that Pycnogenol® significantly prevented the up-regulation of the pro-inflammatory enzymes 5-LOX and COX-2 (13). In another ex vivo study, plasma samples of volunteers after intake of Pycnogenol® showed to statistically significantly inhibit NF-κB activation by 15.5% and matrix metalloproteinase 9 (MMP-9) release by 25%, two important regulators in the inflammation process (14). In a similar study, statistically significant inhibition of inflammatory molecules COX-1 and COX- 2 was observed after intake of 300 mg Pycnogenol® (15).

Pycnogenol® is a strong antioxidant

The antioxidant activity of Pycnogenol® has been investigated in a number of clinical studies (16-23). Orally administered Pycnogenol® has been shown to both increase the plasma antioxidant capacity, expressed as oxygen radical absorbance capacity (20), and decrease the plasma oxidative stress measured as plasma free radicals (24). Pycnogenol® has further been shown to protect lipids from peroxidation by free radicals in elderly people and people with coronary artery disease (16, 17). The protective effects of Pycnogenol® on DNA oxidation was shown in a randomized, double-blind, placebo-controlled study of children with ADHD, by measuring the level of oxidized purines (18).

Pycnogenol® benefits skin elasticity and hydration

Further reinforcing scalp skin health, Pycnogenol® strengthens the extracellular matrix by binding and thus protecting collagen and elastin as well as by stimulating the production of new collagen and hyaluronic acid in the skin (14, 25-27).

In a study with 78 subjects, who work outdoors in an urban area, the water loss of the skin during the hot summer season could be reduced by 14% with Pycnogenol® supplementation for 3 months and only by 5% with placebo (25). In this placebo-controlled double-blind study, the skin elasticity was shown to be improved by 13% after supplementation, compared to an increase of 1% in the placebo group.

Interestingly, clinical investigations of Pycnogenol® supplementation for 12 weeks with menopausal women, aged 55 to 68 years revealed increased hyaluronic acid synthase levels within the skin by 44%, leading to improved skin hydration (27). Hyaluronic acid synthase is the natural source of water-binding hyaluronic acid in the dermis, which moisturizes the skin and keeps it taut and smooth. Consequently, an average skin-hydration increase by 21% in the group of Pycnogenol® supplementation was found, particularly in women presenting with dry skin prior to Pycnogenol® intake. In this study, Pycnogenol® was also shown to improve skin elasticity by 25% and decrease skin fatigue by 30%. The results were paralleled by Pycnogenol®’s ability to generate skin´s connective tissue collagen in average by 40%.

In addition to stimulating the synthesis of new collagen, Pycnogenol® metabolites can inhibit the release and activity of destructive enzymes (metalloproteinases 1,2 and 9), which break down dermal tissue proteins, like collagen or elastin (14, 28). The reduced activity of these lytic enzymes saves the connective tissues from degradation, representing the basis for maintaining an elastic, smooth and youthful looking skin.

Pycnogenol® relieves menopausal symptoms

Apart from improving hair quality, Pycnogenol® has been shown to be very efficient for different other conditions or disorders connected to menopause. To date, almost 500 menopausal women took part in different studies investigating the effects of Pycnogenol® on climacteric symptoms (5, 22, 29, 30).

A randomized, double-blind placebo-controlled 6-month study with 155 peri-menopausal women found all symptoms of the Women’s Health Questionnaire (WHQ) to be significantly improved in the Pycnogenol® supplementing subjects, as compared to placebo controls (22). The symptoms on the WHQ include somatic (tiredness, headache) and vasomotor problems (hot flashes, sweating), depressed mood, memory and concentration issues, attractiveness, anxiety, sexual behavior, sleep, and menstrual problems.

In another study, the symptoms of 70 women in menopausal transition were evaluated with 38 subjects being supplemented with 100 mg Pycnogenol® per day for 8 weeks (5). The scoring system included 33 common signs and symptoms of menopausal complaints, which were improved significantly after Pycnogenol® intake.

A significant efficacy of a low dosage of Pycnogenol® (60 mg daily) on climacteric symptoms could be shown in a randomized, double-blind placebo-controlled investigation with 170 women (29).

Menopause is a leading risk factor of cardiovascular disease (31). Supplementation of peri-menopausal women with 100 mg Pycnogenol® per day for 6 months was shown to normalize high blood pressure and to improve lipid profile (30). Cardiovascular risk factors (homocysteine and CRP values) improved significantly and plasma free radicals decreased significantly by 22%. Additionally, almost all symptoms of a menopausal questionnaire with 34 items, were improved after Pycnogenol® supplementation.


1. Zouboulis CC, Blume-Peytavi U, Kosmadaki M, Roó E, Vexiau-Robert D, Kerob D, et al. Skin, hair and beyond: the impact of menopause. Climacteric. 2022;25(5):434-42.

2. Chaikittisilpa S, Rattanasirisin N, Panchaprateep R, Orprayoon N, Phutrakul P, Suwan A, et al. Prevalence of female pattern hair loss in postmenopausal women: a cross-sectional study. Menopause. 2022;29(4):415-20.

3. Cai C, Zeng B, Lin L, Zheng M, Burki C, Grether‐Beck S, et al. An oral French maritime pine bark extract improves hair density in menopausal women: A randomized, placebo‐controlled, double blind intervention study. Health Science Reports. 2023;6(1).

4. Oliff H. American Botanical Council – Scientific and clinical Monograph for Pycnogenol. ABC. 2019:1-46.

5. Errichi S, Bottari A, Belcaro G, Cesarone MR, Hosoi M, Cornelli U, et al. Supplementation with Pycnogenol® improves signs and symptoms of menopausal transition. Panminerva Med. 2011;53(3 Suppl 1):65-70.

6. Cesarone MR, Belcaro G, Agus GB, Ippolito E, Dugall M, Hosoi M, et al. Chronic venous insufficiency and venous microangiopathy: management with compression and Pycnogenol(R). Minerva Cardioangiol. 2019;67(4):280-7.

7. Steigerwalt R, Belcaro G, Cesarone MR, Di Renzo A, Grossi MG, Ricci A, et al. Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J Ocul Pharmacol Ther. 2009;25(6):537-40.

8. Wang S, Tan D,  Zhao Y,  Gao G, Gao X, Hu L. The effect of Pycnogenol® on the microcirculation, platelet function and ischaemic myocardium in patients with coronary artery diseases. European Bulletin of Drug Research. 1999;7(2):19-25.

9. Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ledda A, Vinciguerra G, et al. Improvement of diabetic microangiopathy with pycnogenol: A prospective, controlled study. Angiology. 2006;57(4):431-6.

10. Belcaro G, Cesarone MR, Errichi BM, Ledda A, Di Renzo A, Stuard S, et al. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin Appl Thromb Hemost. 2006;12(3):318-23.

11. Luzzi R BG, Hu S, Dugall M, Hosoi M, Cacchio M, Ippolito E, Corsi M Improvement in symptoms and cochlear flow with Pycnogenol in patients with Meniere’s disease and tinnitus. Minerva Med 2014;105:245-54.

12. Grossi MG, Belcaro G., Cesarone, M.R., Duggall, M., Hosoi, M Cacchio,. Improvement in cochlear flow with Pycnogenol® in patients with tinnitus: a pilot evaluation. Panminerva Med. 2010;52(2):63-7.

13. Canali R, Comitato R, Schonlau F, Virgili F. The anti-inflammatory pharmacology of Pycnogenol in humans involves COX-2 and 5-LOX mRNA expression in leukocytes. Int Immunopharmacol. 2009;9(10):1145-9.

14. Grimm T, Chovanova Z, Muchova J, Sumegova K, Liptakova A, Durackova Z, et al. Inhibition of NF-kappaB activation and MMP-9 secretion by plasma of human volunteers after ingestion of maritime pine bark extract (Pycnogenol). J Inflamm (Lond). 2006;3:1.

15. Schäfer A, Chovanova Z, Muchova J, Sumegova K, Liptakova A, Durackova Z, et al. Inhibition of COX-1 and COX-2 activity by plasma of human volunteers after ingestion of French maritime pine bark extract (Pycnogenol). Biomed Pharmacother. 2005;60(1):5-9.

16. Enseleit F, Sudano I, Periat D, Winnik S, Wolfrum M, Flammer AJ, et al. Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study. Eur Heart J. 2012;33(13):1589-97.

17. Ryan J, Croft, K., Wesnes, K and Stough, C. An examination of the effects of the antioxidant Pycnogenol® on cognitive performance, serum lipid profile, endocrinological and oxidative stress biomarkers in an elderly population. J Psychopharmacol. 2008;22(5):553-62.

18. Chovanova Z, Muchova J, Sivonova M, Dvorakova M, Zitnanova I, Waczulikova I, et al. Effect of polyphenolic extract, Pycnogenol, on the level of 8-oxoguanine in children suffering from attention deficit/hyperactivity disorder. Free Radic Res. 2006;40(9):1003-10.

19. D̆uračková Z, Trebatický B, Novotný V, Žitňanová I, Breza J. Lipid metabolism and erectile function improvement by pycnogenol®, extract from the bark of pinus pinaster in patients suffering from erectile dysfunction-a pilot study. Nutrition Research. 2003;23(9):1189-98.

20. Devaraj S V-LS, Kaul N, Schönlau F, Rohdewald P, Jialal I. Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters plasma lipoprotein profile. Lipids. 2002;37(10):931-4.

21. Kolacek M, Muchova J, Dvorakova M, Paduchova Z, Zitnanova I, Cierna I, et al. Effect of natural polyphenols (Pycnogenol) on oxidative stress markers in children suffering from Crohn’s disease–a pilot study. Free Radic Res. 2013;47(8):624-34.

22. Yang HM, Liao MF, Zhu SY, Liao MN, Rohdewald P. A randomised, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopausal women. Acta Obstet Gynecol Scand. 2007;86(8):978-85.

23. Errichi S, Bottari, A., Belcaro, G., Cesarone, M.R., Hosoi, M., Cornelli, U., Dugall, M., Ledda, A., Feragalli, B. Supplementation with Pycnogenol® improves signs and symptoms of menopausal transition. Panminerva Med. 2011;53(3):65-70.

24. Belcaro H, Cesarone,  Dugall. A controlled study shows daily intake of 50 mg of French Pine Bark Extract (Pycnogenol®) lowers plasma reactive oxygen metabolites in healthy smokers. Minerva medica. 2013;104(4):439-46.

25. Zhao H, Wu J, Wang N, Grether-Beck S, Krutmann J, Wei L. Oral Pycnogenol(R) Intake Benefits the Skin in Urban Chinese Outdoor Workers: A Randomized, Placebo-Controlled, Double-Blind, and Crossover Intervention Study. Skin Pharmacol Physiol. 2021:1-11.

26. Grether-Beck S, Marini A, Jaenicke T, Krutmann J. French Maritime Pine Bark Extract (Pycnogenol(R)) Effects on Human Skin: Clinical and Molecular Evidence. Skin Pharmacol Physiol. 2016;29(1):13-7.

27. Marini A, Grether-Beck S, Jaenicke T, Weber M, Burki C, Formann P, et al. Pycnogenol(R) effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women. Skin Pharmacol Physiol. 2012;25(2):86-92.

28. Grimm T, Schäfer A, Högger P. Antioxidant activity and inhibition of matrix metalloproteinases by metabolites of maritime pine bark extract (pycnogenol). Free Radic Biol Med. 2004;36(6):811-22.

29. Kohama T, Negami M. Effect of low-dose French maritime pine bark extract on climacteric syndrome in 170 perimenopausal women: a randomized, double-blind, placebo-controlled trial. J Reprod Med. 2013;58(1-2):39-46.

30. Luzzi R, Belcaro G, Hosoi M, Feragalli B, Cornelli U, Dugall M, et al. Normalization of cardiovascular risk factors in peri-menopausal women with Pycnogenol(R). Minerva Ginecol. 2017;69(1):29-34.

31. Moreau KL, Hildreth KL. Vascular Aging across the Menopause Transition in Healthy Women. Adv Vasc Med. 2014;2014.


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