PCOS Hair Loss: Causes and Treatments

What Is PCOS?

Polycystic ovarian syndrome is a metabolic condition characterized by abnormal hormone levels. Those with PCOS have high levels of androgens, as well as high levels of estrogen and it is caused by a particular kind of hormonal imbalance which can make it difficult to ovulate. This hormonal health condition affects nearly 1 in 10 women of reproductive age and is among the leading causes of infertility.

The condition is notoriously hard to diagnose, though common symptoms include irregular periods, excessive hair growth on the face and body or PCOS hair loss, acne, infertility, and weight gain, among others.

To be diagnosed with PCOS you must have 2 of 3 possible issues:

• Chronic high androgen levels
• Chronic lack of ovulation or irregular ovulation
• Polycystic ovaries (ovaries that have multiple small cysts on ultrasound)

How PCOS Causes Hair Loss

Hormonal Imbalance and Androgens

Thinning hair or hair loss is one of the most common symptoms of PCOS. Severity of this hair loss can vary, however, depending on the individual. Elevated androgen levels are to blame for causing hair loss in those with PCOS. Androgens are considered “male” sex hormones, and men produce them at a rate of twelve times more than women. Because women (and those afab) with PCOS often have higher than average levels of androgen, they are vulnerable to developing symptoms like hair loss, unwanted hair growth, and weight gain.

If you are struggling with symptoms like PCOS hair growth and PCOS hair loss you may be able to gain a better perspective on your hormones through a single at-home lab test like Mira’s Panorama Fertility Lab Test. This convenient kit tests 5 hormones that affect your ovulation, cycle regularity, and ability to get pregnant and can help identify hormonal signals that can lead to PCOS. You get 5 individual and personalized hormone reports with actionable steps to understand what those numbers mean for your fertility health. You can even show these reports to your healthcare provider to help with any treatment. 

Insulin Resistance and Hair Loss

One of the most common PCOS symptoms has to do with how your body converts sugars from foods into energy, leaving insulin and sugar to build up in the bloodstream. This is known as insulin resistance and when insulin levels are high, the body ramps up production of certain male hormones or androgens. The effect on your hair follicles can be devastating. Elevated androgen levels can disrupt the hair growth cycle leading to increased shedding, hair thinning, and PCOS hair loss. 

Another factor affecting PCOS and hair loss is the genetic aspect of PCOS. Although many genes have been implicated, no clear underlying genetic pathway has been found but heritability is a strong factor in the development of the disorder. In other words, PCOS can run in families and if any female relatives have the condition, you may be at a higher risk for developing PCOS. 

Signs and Symptoms of PCOS-Related Hair Loss

Identifying Hair Thinning and Hair Loss Patterns 

Although individual experiences of hair loss with PCOS can vary, there are noticeable patterns of how it progresses.

Initially, female pattern hair loss can feel like an overall slow thinning of the hair. It typically starts in the front of the scalp or the crown region. Next, the part in the hair may begin to thin and widen further. This is then followed by a slow receding of the hairline.

Here are some of the most common PCOS hair loss symptoms to watch out for.

Shedding

It is perfectly normal and natural for hair to shed some throughout the day. However, if you begin to notice that your hair is shedding from the root more frequently or in greater quantities, this could be a sign of hair loss due to PCOS.

Here are a few scenarios to look out for:

• Does your hairbrush collect more hair than usual?
• Do you wake up in the morning with clumps of hair on your pillow?
• Have you noticed more hair coming out in the showing when you wash your hair?
• Does your hair feel thinner than normal?

Bald patches

Bald patches can also appear if you have PCOS. While they can arise anywhere on your scalp, they most commonly develop on the top or the “crown” of your head. In addition to the crown, they can also appear towards the front of the scalp.

Bald patches do not usually appear out of nowhere. Instead, they tend to follow after a period of gradual thinning and overall hair loss.

Dry and itchy scalp

Alongside shedding and balding, those with PCOS may also suffer from a dry and itchy scalp accompanied by dandruff. If you have never experienced dandruff before, here are some ways to spot it:

• Is your scalp itchier than normal? Does it look red or irritated?
• Can you see white or yellow flakes on your scalp?
• Do these flakes fall off? Do you notice them on your clothing?

Increased breakage

Those with PCOS may notice that their hair feels dry, frizzy, and weaker than usual. This dryness can cause hair to break more easily when styling, which then contributes to overall thinning and hair loss.

Differences Between PCOS Hair Loss and Other Types of Alopecia

Female pattern hair loss (FPHL) is a complex issue and even though other types of alopecia can be seen in patients with PCOS, this type of hair loss is a clinical sign associated with PCOS.

Unlike PCOS, most of the time your hormone levels will be fairly normal with female pattern hair loss. Other types of alopecia, like alopecia areata can actually be the result of an autoimmune condition, rather than a hormone imbalance. 

There are a number of other potential reasons why hair loss may occur including stress, illness, styling, medications, or even a vitamin deficiency. 

When to See a Doctor

Hair loss can be distressing and affect your self esteem. If you suspect that PCOS may be the reason behind your hair loss, speak with your doctor immediately. They can review your medical history, evaluate your symptoms, and run further tests to assess your situation.

Lifestyle Changes to Reduce Hair Loss

Healthy Lifestyle

Just like any other part of your body, your hair is impacted by your overall health. The following lifestyle habits can help to maximize your hair regrowth chances:

• Eating a balanced and nutrient-rich diet
• Exercising regularly (at least 150 minutes of moderate-impact exercise per week)
• Avoiding tobacco products
• Keeping stress levels low

Exercise, in particular, can be a beneficial habit alongside any other PCOS treatments. Exercise can help many PCOS symptoms and even promote PCOS hair growth. Not only does it increase blood circulation, which is beneficial to hair follicles, it can reduce stress.

Stress and fertility are intimately connected and the continued production of stress hormones can cause your body to have a prolonged hormonal imbalance. Exercise is a known stress reducer, but did you know that techniques like meditation can also help? The knock-on effects of meditation can help with many symptoms of PCOS and self care is a must in managing this condition. Incorporating even a small amount of meditation into your daily practice can help so if you’ve never meditated before, you may find it helpful to watch guided meditations on youtube or even fertility meditations like the ones offered by Mira. 

If you are struggling to implement lifestyle changes or trying to figure out how they can help with your PCOS symptoms, consider a hormone health coach. Mira’s own Hormone Health Clinic has coaches specialized in PCOS that can help you better understand the underlying causes of your hormonal imbalance. 

Fertility coaches like those at our Hormone Health Clinic aren’t medical doctors so they don’t provide medical advice and can’t diagnose you. But they can provide practical and emotional support and advice and tips on how to balance hormones naturally and incorporate lifestyle changes to help manage any symptoms of a hormone imbalance. And if you’re using the Mira device to track your cycle, our coaches have first-hand experience with the Mira App and Monitor and can help you understand and interpret your data. 

Medical Treatments for PCOS Hair Loss

To combat thinning, balding, and breakage due to PCOS, there are several treatment options you can try with guidance from a medical professional.

Oral contraceptives

Oral contraceptives, or specifically combined birth control pills with estrogen and progestin, are one of the primary ways to treat PCOS. This is because they help to regulate the menstrual cycle and rebalance hormones, which is the underlying cause of PCOS in the first place.

Anti-androgens

Your doctor may also advise taking anti-androgens. Anti-androgens work by inhibiting the effect of the excess androgens in your body, which are responsible for hair loss in women with PCOS. Your doctor may even prescribe an anti-androgen together with an oral contraceptive to maximize your hair regrowth chances.

Minoxidil

Minoxidil, commonly known by the brand name Rogaine, is another possible medical treatment for hair loss due to PCOS. There is even a type of Rogaine designed specifically for women that is often recommended by dermatologists for patients with PCOS.

While a minoxidil solution like Rogaine does not address the underlying cause of hair loss, it can help with hair regrowth.

Natural Remedies for PCOS Hair Loss 

There are a number of natural remedies you can also use to help with PCOS hair thinning and hair loss. For instance, certain essential oils and massaging your scalp may help PCOS hair. Your hair follicles will benefit from a gentle massage but preliminary research has shown that both lavender oil and peppermint oils may help promote hair growth. 

Certain herbal supplements have shown promise in managing hair loss due to PCOS. It’s believed they work by addressing the underlying hormonal imbalance in addition to supporting hair follicles. Herbal supplements that may be beneficial include saw palmetto, nettle root, black cohosh, and chasteberry. 

Certain over-the-counter supplements and vitamins have also been found to help with hair regrowth. You may want to try any of the following:

• Biotin
• Keratin
• Zinc
• Iron
• Vitamin C
• Vitamin D

It can be overwhelming to choose the right supplement and there isn’t one definite treatment for everyone. Mira’s PCOS supplements have an ideal formula to support ovarian health, promote hormonal balance, and assist in metabolic function. 

When it comes to natural remedies, always remember to do your due diligence and use under the guidance of a qualified health professional to make sure it will work for you and won’t cause undue side effects. 

Preventing Further Hair Loss

PCOS hair loss can be frustrating, but there are things you can do to combat it and prevent further hair loss. 

Maintaining a Healthy Hormonal Balance 

Although you can’t cure PCOS, fundamental lifestyle issues such as managing diet, sleep and stress levels, and getting enough exercise are the first line of defense. These elements are critical to overall health and hormone functioning and maintaining a healthy hormonal balance is critical in managing PCOS. 

Ongoing Medical Treatment and Monitoring

People with PCOS must have regular health check-ups to properly monitor their condition. It’s important to work with a specialist that understands PCOS and can customize care to your specific needs. 

Healthcare practitioners can perform routine exams to track hormone levels, menstrual cycles, and metabolic functions. Your menstrual cycle is a key driver of hormonal changes so tracking your cycle and paying attention to how you feel can help you learn about your own hormonal changes. The Mira Fertility Tracker is a great tool to help track your cycle. It measures your reproductive hormone quantitatively to accurately monitor your unique hormone patterns. 

Due to cycle irregularities, many people with PCOS have found that tracking their hormones directly has been a helpful tool in managing the condition. Even if you don’t use our hormone monitor, you can still use the Mira App to track your cycles and log additional cycle data like mood or cervical mucus. Mira’s app is a free tool for cycle tracking and reproductive health management 

Regular Hair Care Routine

One of the best places to start if you are struggling with hair loss due to PCOS is by making sure that you are taking good care of your hair and scalp.

You can begin by investing in a good shampoo/conditioner combo that strengthens and protects your hair. Look for shampoos that have B vitamins and keratin, and try to stay away from shampoos with sulfates which tend to dry out the hair. You may even want to consult your hairstylist on the best products to use for your specific hair type.

To further protect your hair, it’s also a good idea to avoid using heated tools such as hair dryers, curlers, and flat irons. Chemical products like dyes, straighteners, and relaxers should also be avoided as they can be extremely damaging to hair already weakened from PCOS.

Though it may seem like a small change, the brush you use can actually make a big difference in the health of your hair. Make sure to use a natural (not synthetic) bristle brush. The most commonly recommended is a “boar bristle brush” because it is not only soft and gentle on your hair, but it can also help to stimulate your scalp.

If you have hair loss due to PCOS, you may be worried that brushing your hair might make it fall out more. To avoid this make sure you brush gently and try not to brush too often. It’s also advised to never brush your hair when it is wet (to prevent damage). 

Frequently Asked Questions