PCOS Hair Loss: Why It Happens and What To Do About It

As with most hormonal imbalances, polycystic ovary syndrome (PCOS) comes with a slew of less-than-pleasant symptoms, like irregular periods, unintended weight gain, increased acne—the list goes on.

While excess body and facial hair is another difficult symptom that those with PCOS deal with, there's also a sign on the flip side of that coin: Unexpected hair loss. That hair loss, or thinning hair, is commonly known as androgenic alopecia due to PCOS. 

Here's what you need to know about PCOS and hair loss, including why it happens, what you can do about it, and the support groups available to people who experience it.

What Is PCOS?

According to the Johns Hopkins Medicine Health Library, PCOS is a condition in which the ovaries overproduce hormones called androgens. People of all genders produce androgens, such as testosterone. However, cisgender men typically produce more androgens than cisgender women. Androgens are involved in the onset of puberty and initiate hair growth in the underarms and pubic areas.

Also, some people with PCOS develop multiple cysts in their ovaries, but they can also have the condition without developing cysts. 

Cysts form when an egg does not mature and release from the ovary during ovulation, according to Johns Hopkins Medicine Health Library. The cysts then produce excess androgen hormone, causing multiple other symptoms in addition to thinning hair, such as:

• Irregular menstrual bleeding
• Excess body hair growth
• Weight gain
• Acne
• Excess sebum (oil) on the skin
• Infertility
• Skin tags
• Dark, thick patches of skin

Why Does PCOS Cause Hair Loss?

It's all about hormones here, said Meggie Smith, MD, an OB-GYN specializing in reproductive endocrinology and infertility in Nashville, Tenn.

"PCOS can contribute to hair loss as PCOS is associated with higher than normal levels of testosterone, which affects hair growth," explained Dr. Smith. "This is known as androgenic alopecia, and women often complain of hair loss around their temples and frontal regions of their scalp." 

That's different than male-pattern baldness, which is characterized by a receding hairline and thinning on the crown of the head, according to the American Academy of Dermatology (AAD).

However, compared to excess hair growth, hair loss is not a common side effect of PCOS. That's because your androgen levels have to be pretty high to have that type of hair loss, explained Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine in Chicago.

If you have PCOS, your body will experience extra androgen production, triggering excess hair growth in places like your face, neck, chest, and torso, according to UpToDate.

What Can You Do for PCOS-Related Hair Loss?

With this particular type of hair loss, there is a possibility of restimulating hair growth with certain treatments. But keep in mind: Whatever treatment you and your healthcare provider choose, it's important to remember that patience is key. 

"It's important to manage expectations and know that it could easily be six months or more to see a difference in your hair," said Dr. Streicher. "The reason for this is that the hair growth cycle itself isn't fast and takes a few months regardless of circumstances. It can be frustrating for someone going through this to wait for treatment to take effect."

Medications

According to Dr. Streicher, treatment plans for PCOS-related hair loss often tailor to each specific patient, depending on how bothersome or severe the hair loss is. According to Dr. Streicher and Dr. Smith, one of the most effective lines of treatment is the medication Rogaine (minoxidil).

Starting a birth control regimen is another common tactic for treating PCOS and its various symptoms, according to Harvard Health. 

"One of the mainstays in managing many of the effects of PCOS is birth control pills, which help lower testosterone by increasing sex-hormone-binding globulin," said Dr. Smith. "However, this generally helps more with controlling hair growth [...] above the upper lip or chin."

In a study from 2020 in the Journal of the American Academy of Dermatology, participants used spironolactone, an oral medication, to treat hair loss alone or with other treatments. As a result, the participants experienced significant hair growth.

Scalp Massage

There are some other less-studied methods, too. Dr. Streicher recommended trying a daily hair and scalp massage and low-level laser therapy to stimulate hair growth.

Natural Remedies

There are also more natural remedies for boosting hair growth. Vitamins and supplements like biotin, collagen, and zinc can possibly stimulate hair growth.

But, while Dr. Streicher said there's no harm in trying them (though you can ingest too much zinc, leading to zinc toxicity), there isn't significant research proving their efficacy either.

When Should You See a Healthcare Provider for Hair Loss?

If you're experiencing unexpected hair loss, but do not yet have an official diagnosis of PCOS, it's important to seek help from a team of healthcare providers. That could look like a dermatologist and OB-GYN or a reproductive endocrinologist.

"Some patients may get frustrated because they may feel like their gynecologist or endocrinologist or whoever is treating their PCOS isn't necessarily addressing things like hair loss," explained Dr. Streicher. "Many people don't realize that dermatologists are hair loss experts and they're the ones who have the most expertise in treating this issue."

The same goes for other signs and symptoms of PCOS. If you're experiencing irregular menstrual bleeding, acne or excess sebum on the skin, or excess hair growth, among others, you should consult an OB-GYN, according to Dr. Streicher.

A Quick Review

PCOS is a condition that may cause hair loss. There are various treatment options available to help grow back the hair you've lost—includinf medications, scalp massages, or other natural remedies.

When dealing with PCOS-related hair loss, it's important to know that you're not alone. Talking it through with a community of people dealing with the same can be emotionally helpful. It may lead you to inquire about treatment options you may not have considered. 

Some potentially helpful resources include the Soul Cysters, PCOS Challenge, and myPCOSteam, all of which offer forums for sharing tips and emotional support to help each other cope with hair loss or other PCOS symptoms.