What do you recommend for women on AI therapy who experience excessive hair loss?

In addition to the suggestions from @Dr. First Last, there was also a study reported in 2018 by Freites-Martinez et al. in JAMA Dermatology that reported a moderate to significant improvement in endocrine therapy-induced alopecia with topical minoxidil 5%. This is a relatively straightforward, over the counter option that patients can try.

Hair loss with AIs is a common problem. Estimates vary, but a prospective case-control trial of women treated with AIs and matched 144 control group of women without breast cancer showed at 6-months after AI treatment women self-reported 32% vs. 15%, p<0.05, respectively (Gallicchio et al Support Cancer Care 2017:25;2697-05). The mechanism of hair loss may be rebound androgen levels and decreased estrogen levels that reduce and inhibit hair follicles (Karatas et al Springer plus 2016:5;585-9). A...