PCOS Hair Loss: Symptoms, Causes, And Treatment

Have you recently noticed a lot of hair loss? Is this followed by an unusual menstrual cycle, weight increase, and odd chin and body hair growth? These are all possible symptoms of polycystic ovary syndrome (PCOS). Up to 27% of women in their childbearing years may have PCOS. Ovarian cysts, elevated levels of male hormones, and irregular periods characterize it.¹

Many women develop PCOS without realizing it. According to one study, up to 70% of women with PCOS had not been diagnosed. Like most hormonal abnormalities, polycystic ovary syndrome (PCOS) can cause many unpleasant symptoms.²

This post will look more closely at PCOS hair loss, including how it occurs, the consequences it may have on your hair, and the symptoms to look out for. We'll also discuss how you can treat and manage your PCOS symptoms, including solutions for hair loss.

What is PCOS?

In women with PCOS, the ovaries produce an abnormally high level of androgens. Androgens, which are hormones such as testosterone, are produced by the bodies of people of all genders.

Biological men generally have much higher levels of androgens than biological women. Androgens play a role at the beginning of puberty and trigger hair growth in pubic and underarm regions.

Polycystic ovary syndrome occurs when the ovaries produce too many androgens. In many cases, multiple tiny cysts (fluid-filled sacs) are found in the ovaries. However, some women with PCOS don’t have cysts.

These cysts can form when high levels of androgens block the process of ovulation. 

Ovulation is the release of a mature egg from an ovary. If a sperm does not fertilize the egg, it is expelled from the body during the menstrual cycle.

High levels of testosterone and other androgens interrupt the normal menstrual cycle. They may block the process of ovulation, which can then lead to the formation of cysts on the ovaries.

High androgens levels can also induce many other symptoms associated with PCOS.

Why does PCOS cause hair loss?

One documented symptom of PCOS is hair loss caused by high levels of androgens. Women with PCOS may experience hair loss or hair thinning or find themselves with brittle, dry, and damaged hair. Acne is also common.

Most commonly, women with PCOS have female pattern hair loss. This occurs when the hair on your head begins to thin. It commonly shows up first, either near your forehead or temples or along the part of your hair.

Women don’t generally experience the same pattern of hair loss that many men experience as they age, but having thinning hair, a visible scalp, and a widened part can be upsetting for many women.

Androgens ("male" hormones like testosterone as well as DHT or dihydrotestosterone) are normally made in both sexes and play important roles in puberty, sexual desire, and the regulation of hair growth. When a woman’s levels of androgens are too high, then she may start experiencing symptoms, including hair loss.

Hair loss is actually not the most common symptom of PCOS because it takes very high levels of androgens to cause this. Excessive hair growth on the face and body is more common. However, hair loss is definitely a potential symptom of PCOS, and some women with PCOS, unfortunately, experience this.

Symptoms of PCOS-related hair loss

The specifics of PCOS-related hair loss can vary, depending on the individual. Here are a few of the more prevalent ones to be aware of.

Shedding

Hair shedding is entirely normal and natural and occurs every day. If you’re shedding significantly more hair than usual, this may indicate PCOS-related hair loss.

Here are a few situations to be on the lookout for:

• Is your hair looking thinner than usual?

• Is your hairbrush gathering more hair than usual?

• Do you have clumps of hair on your pillow when you wake up, or do you see excessive hair in the shower drain?

Itchy and dry scalp

Women with PCOS may also experience a dry, itchy scalp and dandruff. Here are some ways to detect dandruff:

• Is your scalp itchier than usual?

• Does it appear sore or red?

• Is your scalp covered with white or yellow flakes?

• Do you often see these flakes on your clothes?

Bald spots

If you have PCOS, you may notice bald patches. While they can appear anywhere on your scalp, they most frequently appear on the top of your head, sometimes known as the "crown,” or towards the front of the scalp.

In most cases, bald patches do not emerge suddenly. They usually appear after a period of progressive thinning and hair loss.

Other common PCOS symptoms include:

• Excessive body hair development, typically in a masculine pattern (also known as hirsutism)

• Weight gain, particularly on the abdomen

• Inconsistent, very light, or absent periods

• Acne outbreaks due to oily skin

• Infertility or difficulty becoming pregnant

• An increased risk of miscarriage or problems during pregnancy

• Large ovaries and the formation of ovarian cysts

• Skin discoloration around your neck, groin, and under your breasts

Women with PCOS may discover that their hair is dry, brittle, and thinner than usual. Because of the dryness, hair might break more easily during styling, which contributes to the problem of hair loss.

How does PCOS hair loss progress?

Although each person's experience with PCOS hair loss is unique, there are some common patterns in how it progresses. 

Female pattern hair loss can initially appear as a steady thinning of the hair. It usually begins in the front of the scalp or towards the crown. As the hair becomes thinner and thinner, the part may appear wider, and the scalp may become visible.

Although not always achievable, PCOS hair loss can sometimes be reversed. This is because PCOS hair loss therapies usually focus on avoiding more hair loss rather than regrowing any hair that has been lost. However, some treatments can be beneficial.

Which medical treatments can help?

PCOS-related hair loss is treatable medically. Because the primary problem with PCOS is hormone imbalance, the treatments generally involve managing hormone levels. Various approaches have been shown to help attain this goal. 

Here are several treatments that may be effective for PCOS-related hair loss:

Oral contraceptive pills

Oral contraceptives decrease male hormone (testosterone) production while increasing the production of sex hormone-binding globulin (SHBG), which is a protein that binds to and carries sex hormones (including estrogen, progesterone, and testosterone) in the blood. 

By regulating the activity of testosterone, PCOS symptoms such as facial hair growth and scalp hair loss are lessened.

Spironolactone (Aldactone)

Additionally, your doctor might advise spironolactone, a diuretic that aids in regulating the body's androgen activity. Spironolactone typically combats the skin-damaging effects of androgen and is effective when combined with an oral contraceptive.

Minoxidil (Rogaine)

Minoxidil is a topical medicine frequently marketed under the trade name Rogaine. It is the only FDA-approved treatment for female pattern baldness. It functions by lengthening your hair growth cycle and expanding your hair follicle size.

Finasteride (Propecia) and dutasteride (Avodart)

The FDA has approved the oral hair-regrowth drugs finasteride (Propecia) and dutasteride (Avodart) to treat male pattern baldness and hair loss. While they might be effective for some, their use may be constrained in biological women due to their unfavorable side effects.

Home remedies for PCOS hair loss

Home treatments are also available for PCOS hair loss. For damaged and color-treated hair, moisturizing shampoos and conditioners can help maintain hair health, and shampoos made for thinning hair may promote new hair growth and protect the existing hair.

Using natural bristle brushes, which are kinder to hair than conventional synthetic brushes, and using a pick on the hair before brushing are further at-home cures. The latter prevents the hair from being pulled too tightly and breaking off during brushing.

One good idea is to steer clear of tight hairstyles that might add additional stress to the hair, such as high ponytails or buns. These can lead to additional hair breakage.

Using one or more treatments for PCOS can sometimes stop hair loss. The most essential thing is to not give up on PCOS hair loss and to be hopeful!

Your hair, like any other body part, is affected by your general well-being. The following lifestyle behaviors will assist in increasing your chances of hair regrowth:

• Eat a well-balanced, nutrient-dense diet

• Get regular physical activity

• Avoid tobacco products

• Reduce stress levels

When should you see a doctor for hair loss?

Consult a doctor immediately if any of the following symptoms occur:

• You're losing a lot of hair suddenly.

• Hair loss is associated with scalp redness, irritation, flaking, or color changes.

• Your hair loss is followed by pus-filled pimples or discharging pimple-like sores on your head.

To understand how PCOS contributes to hair loss and what your potential treatment options are, you should talk with a doctor, preferably a gynecologist or an endocrinologist. This will allow you to get personalized advice about how best to manage this challenging situation.

Finding out what helps with PCOS hair loss may take time and some trial and error. Be patient and gentle with yourself.

The lowdown

Hair loss is a typical symptom among women with PCOS. The good news is that it is treatable if the underlying cause is addressed by medication and other lifestyle modifications.

Although hair lost due to PCOS does not normally regrow on its own, medication, hair treatment creams, and a mix of home therapies can encourage hair growth. It is critical to remember that the key to regrowing hair loss due to PCOS is first to treat the source of the problem, which is a hormonal imbalance. 

You should consult your doctor to optimally manage this challenging situation.