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

Hair loss can be a symptom of polycystic ovary syndrome. Here's what to know about why hair loss can happen with PCOS, and what to do about it.

As with most hormonal imbalances, polycystic ovary syndrome (PCOS) comes with a slew of less-than-pleasant symptoms: 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 a sign on the flip side of that coin too: unexpected hair loss.

This hair loss, or thinning hair, due to PCOS is commonly known as androgenic alopecia. 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?

Before we dive into hair loss, first let's review what PCOS is. According to Johns Hopkins Medicine, PCOS is a condition in which the ovaries overproduce hormones called androgens. Some people with PCOS develop multiple cysts in their ovaries but they can also have the condition without developing cysts.

Cysts form when there isn't enough hormone to cause the egg to release from the ovary (called ovulation), according to Johns Hopkins. The cysts then produce excess androgen hormone, causing multiple symptoms.

Why Does PCOS Cause Hair Loss?

It's all about hormones here, said Meggie Smith, MD, an ob-gyn who specializes in reproductive endocrinology and infertility in Nashville.

"PCOS can contribute to hair loss as PCOS is associated with higher than normal levels of testosterone, which affects hair growth," Dr. Smith said. "This is known as androgenic alopecia and women often complain of hair loss around their temples and frontal regions of their scalp." This is 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, hair loss is actually not a common side effect of PCOS, as compared to excess hair growth; because, in order to have this type of hair loss, your androgen levels have to be pretty high, said Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at The Feinberg School of Medicine at Northwestern University.

Regardless of whether or not you have PCOS, people of all genders produce androgens, including testosterone, according to the Better Health Channel. Androgens are involved in the onset of puberty and initiate hair growth in the underarms and pubic areas. If you have PCOS, your body will experience extra androgen production, which will trigger excess hair growth in places like your face, neck, chest, and torso, according to UpToDate.

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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.

Medications

According to Dr. Streicher, treatment plans for PCOS-related hair loss are often tailored to each specific patient, depending on how bothersome or severe the hair loss is. One of the most effective lines of treatment, according to Dr. Streicher and Dr. Smith, is the medication minoxidil, more commonly known as the brand Rogaine.

Starting a birth control regimen is another commonly-used 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 this study from 2020 in the Journal of the American Academy of Dermatology, the oral medication spironolactone was used to treat hair loss either alone or with other treatments. The participants experienced significant hair growth as a result.

Scalp Massage

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

Natural Remedies

That brings us to more natural remedies for boosting hair growth—vitamins and supplements like biotin, collagen, and zinc have the possibility of stimulating 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's no real research proving their efficacy either.

Whichever treatment you and your healthcare provider choose, it's important to remember that patience is key, said Dr. Streicher. "It's important to manage expectations and know that it could easily be six months or more to see a difference in your hair," Dr. Streicher said. "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."

When Should You See a Healthcare Provider for Hair Loss?

If you're experiencing unexpected hair loss, but haven't received an outside diagnosis like PCOS, it's important to seek care from a healthcare provider.

The same goes for signs and symptoms of PCOS—if you're experiencing any of those (that can include hair loss, but should be accompanied by irregular periods, increased acne, or unintended weight gain), you should see your ob-gyn to get an accurate diagnosis for that as well, said Dr. Streicher.

When it comes to PCOS-related hair loss specifically, it's important to seek help from a team—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," said 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."

Summary

PCOS is a condition that can cause hair loss. There are a variety of treatment options available to help grow back the hair that you've lost. This can include medications, scalp massages, or other natural remedies.

If you're dealing with PCOS-related hair loss, it's also important to know that you're not alone. Talking it through with a community of people dealing with the same thing can be emotionally helpful and 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 providing emotional support to help each other cope with hair loss or other PCOS symptoms.

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