Article written by Dr. Blake Bloxham
PCOS Hair Loss: Understanding and Managing Hair Loss in Women with Polycystic Ovary Syndrome
Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects millions of women worldwide, leading to a range of symptoms, including irregular periods, acne, weight gain, and, in some cases, hair loss. Hair loss associated with PCOS can be particularly distressing, as it impacts self-esteem and body image. This article explores the link between PCOS and hair loss, its causes, treatment options, and how women can potentially reverse and manage hair loss symptoms.
PCOS Hair Loss in Women
Hair loss in women with PCOS is typically due to an imbalance in hormones, particularly an increase in androgens (male hormones such as testosterone). While androgens are present in all women, those with PCOS often have elevated levels, which can negatively impact hair health. This hormonal imbalance results in a condition called androgenic alopecia, or female pattern hair loss (FPHL), where hair thins primarily on the crown and top of the scalp.
Unlike male pattern baldness, which often leads to complete hair loss in specific areas, women with PCOS usually experience gradual thinning, often starting with wider hair partings or a reduction in hair density on the scalp. The impact on confidence and emotional health can be significant, which makes it important for women with PCOS to understand and address their hair loss as part of their overall health management.
Does PCOS Cause Hair Loss?
Yes, PCOS does cause hair loss in many women. The primary culprit is the increase in androgen levels, particularly testosterone, which is converted into dihydrotestosterone (DHT) in the body. DHT is known to shrink hair follicles, causing hair to become thinner and shorter, eventually leading to hair loss.
Women with PCOS are also more prone to insulin resistance, which can further exacerbate hair loss. High levels of insulin can lead to even more production of androgens, creating a vicious cycle of hormone imbalance that impacts hair growth.
PCOS Hair Loss Treatment
Treating PCOS-related hair loss requires a multi-pronged approach that focuses on balancing hormone levels, addressing lifestyle factors, and promoting hair regrowth. Some of the most effective treatments include:
1. Hormonal Treatments
Since PCOS is primarily a hormonal disorder, treatments often focus on balancing hormone levels. Common options include:
Birth Control Pills: These regulate menstrual cycles and lower androgen levels, which can help reduce hair loss.
Anti-Androgens: Medications such as spironolactone block the effects of androgens on hair follicles, helping to slow down or stop hair loss.
Metformin: Although primarily used to treat insulin resistance, metformin may also help reduce androgen levels, indirectly supporting hair health.
2. Topical Treatments
Minoxidil (Rogaine): An FDA-approved topical treatment for female pattern baldness, minoxidil works by stimulating hair follicles and promoting hair regrowth. It can be used to counteract the effects of PCOS-related hair loss, though results take time—usually 3 to 6 months to see noticeable improvement.
3. Low-Level Laser Therapy (LLLT)
This non-invasive treatment uses light to stimulate hair follicles and increase blood circulation to the scalp, promoting hair regrowth. LLLT can be used alongside medications and topical treatments for better results.
4. Lifestyle Changes
Lifestyle changes play an important role in managing PCOS symptoms and hair loss. Losing weight, eating a balanced diet, reducing stress, and incorporating regular exercise can help regulate hormones and improve overall health. A healthy diet that includes plenty of antioxidants, vitamins, and minerals supports hair growth as well.
Mandy Robertson, Trichologist
“As a trichologist treating clients with PCOS-related hair loss, I understand that it’s not just about hair—it's about the impact that hormonal imbalances have on their overall well-being and self-esteem. In my clinic, I take a holistic approach, starting with a thorough assessment of hair and scalp health, lifestyle factors, and relevant medical information, including reviewing blood test results. I work closely with my clients to develop a plan that often combines topical treatments, oral medications, dietary and lifestyle recommendations, and sometimes specific supplements to support hormonal balance. Each client's experience and treatment plan is unique, but the goal is always the same: to restore not only hair health but also confidence and a sense of control over their hair's future."
Consult With MandyBest Shampoo for PCOS Hair Loss
While shampoo alone won’t solve PCOS-related hair loss, using the right products can support overall scalp health and complement other treatments. Look for shampoos with these key ingredients:
1. Ketoconazole
This antifungal ingredient helps reduce scalp inflammation and can lower DHT levels in the scalp, making it a good choice for women experiencing androgenic hair loss due to PCOS.
2. Saw Palmetto
Saw palmetto is a natural DHT blocker, often included in shampoos to help counteract the effects of excess androgens. It can help slow the hair loss process when used regularly.
3. Caffeine
Caffeine has been shown to stimulate hair follicles and promote hair growth. Shampoos that include caffeine can help energize hair follicles and reduce hair loss.
Using a combination of a gentle, sulfate-free shampoo with these active ingredients can contribute to a healthier scalp environment, supporting better hair growth over time.
PCOS Hair Loss Regrowth Success
The success of hair regrowth for women with PCOS varies from person to person and depends on how early treatment begins and the methods used. For many women, combining hormonal treatment (such as anti-androgens), topical treatments (like minoxidil), and lifestyle changes yields positive results.
Typically, it takes several months for new hair to grow, and visible changes may not appear until six months to a year into treatment. Women who maintain consistency with their treatment plans are more likely to experience regrowth success. Early intervention is key, as delaying treatment can lead to permanent follicle damage.
Supplements for PCOS Hair Loss
Certain supplements can support hair growth by addressing the nutritional needs of the body and promoting a healthier hormonal balance. Some supplements commonly recommended for women with PCOS-related hair loss include:
1. Zinc
Zinc is important for hair tissue growth and repair. It also helps regulate hormones, making it beneficial for women with PCOS hair loss.
2. Vitamin D
A deficiency in vitamin D is linked to hair loss. Since many women with PCOS hair loss are deficient in this vitamin, supplementation can improve hair health.
3. Omega-3 Fatty Acids
Omega-3s are anti-inflammatory and support a healthy scalp environment. They are also essential for regulating hormone levels and reducing insulin resistance, which can contribute to hair loss.
Before starting any supplement, it’s important to consult a healthcare professional, as interactions with other medications and health conditions should be considered.
Is PCOS Hair Loss Reversible?
The good news is that, for many women, PCOS hair loss is reversible with the right treatment. By addressing the underlying hormonal imbalances, women can slow down or even stop hair loss and regrow their hair. However, the earlier the treatment begins, the better the chances for a full recovery.
If left untreated for too long, hair follicles may become permanently damaged, making regrowth more difficult. This is why it’s important to consult a healthcare provider at the first signs of hair thinning to create a treatment plan that works for you.
PCOS Hair Loss Pattern
The hair loss pattern associated with PCOS is similar to male pattern baldness but less extreme. It is characterized by diffuse thinning on the crown and top of the scalp, while the hairline generally remains intact. Women may notice their part widening or their hair becoming less dense over time. Unlike male baldness, women with PCOS are less likely to experience complete bald spots, but the thinning can become significant if not treated.
This client is a 30 year old female with PCOS and androgenetic alopecia. She was managing PCOS symptoms by focusing on a low carb, high protein diet, exercising regularly, and reducing stress levels. She was also taking magnesium and ashwagandha supplements and using topical minoxidil (although not consistently). While these treatments were helping her overall symptoms, her hair loss was still a concern. She was experiencing increased hair shedding and a widening of her center part. We discussed the addition of a low dose of spironolactone and oral minoxidil, adding a vitamin D supplement, and considering the addition of a myo-inositol supplement. I also suggested that she speak to her doctor about switching to a birth control pill with a lower androgenic activity. Lastly, I recommended that she treat her mild seborrheic dermatitis with an anti-dandruff shampoo (once weekly use of Nizoral). I saw her for follow-up after 11 months of treatment and she was ecstatic with her results!
PCOS Hair Loss Pattern Before
PCOS Hair Loss Pattern After Treatment
PCOS Hair Loss Conclusion
PCOS hair loss can be challenging to manage, but with the right treatments, supplements, and lifestyle changes, it is possible to reduce hair loss and promote regrowth. Early intervention and a holistic approach to managing PCOS are essential for improving hair health. By addressing both the underlying hormonal causes and supporting hair health directly, women with PCOS can take control of their hair loss and regain confidence in their appearance.