Polycystic ovary syndrome (PCOS) is a hormonal condition that affects how your ovaries work and can cause irregular periods. It’s quite common, and it’s estimated that about 1 in 10 women in the UK have it.
Living with PCOS can be challenging, especially as it can cause several symptoms, including weight gain, acne – and hair problems. PCOS can cause more hair to grow on your face or body, but it can also lead to hair loss from your head, known as female pattern hair loss.
However, there are ways to manage and treat PCOS hair thinning, which we’ll guide you through in this article.
Why does PCOS cause hair loss?
If you have PCOS, your body has higher than usual levels of ‘male hormones’ or androgens, such as testosterone. In some people, this can lead to a type of hair loss called female pattern hair loss, also known as androgenic alopecia.
Some small studies have suggested that PCOS can also be linked to other types of hair loss, such as alopecia areata (read about other types of hair loss).
It’s not known exactly how many people with PCOS get female pattern hair loss as a symptom. Some reports suggest it may affect from 40% to 70% of people with the condition.
When to see a doctor about hair loss and PCOS
Hair loss can be caused by many things apart from PCOS, including other health conditions and stress, so it’s important to see a doctor to find out why it’s happening.
They can do tests to rule out other conditions and check if you should have a PCOS diagnosis, and then discuss treatment options if necessary.
What does hair loss in PCOS look like?
If you have PCOS and hair loss, you may lose 100 to 150 hairs a day. Bear in mind that it’s normal to lose 50 to 100 hairs a day, so this extra loss may not be obvious at first. In fact, you might not notice you’re losing hair until you’ve lost 20-25% of its usual volume.
Female pattern hair loss usually happens as a general hair thinning that starts from the centre (crown) of your head, with the front of your hairline often unaffected. Hairs grow thinner and shorter at first, before failing to grow altogether.
This is different from male pattern hair loss, where the front hairline usually recedes first and then a bald patch develops on top. However, if your hair loss is caused by high levels of male hormones (as in PCOS), it’s possible to get this pattern of hair loss – although it’s very uncommon.
Can I reverse my PCOS hair loss?
PCOS hair loss can sometimes be reversed, but it isn’t possible for everyone. This is because treatments for PCOS hair loss are better at preventing further hair loss, rather than getting any hair you’ve lost to regrow.
However, there are both self-care measures and medical treatments that can help.
Self-care for PCOS hair loss
At-home hair loss treatment
Available from pharmacies, minoxidil is a lotion you apply to your scalp, which can be used for female pattern hair loss caused by PCOS.
It can encourage hair you've lost to regrow, particularly if it’s used in the early stages of hair loss. But it can take 3 to 6 months to work, and only works for as long as you use it – so your hair loss may return if you stop applying it.
Minoxidil can also be used at the same time as prescribed medical treatments for PCOS hair loss. A 2017 study found that combining minoxidil with spironolactone (see below) could be effective, with most women seeing an increase in hair thickness after 6 months of use.
Eating a balanced diet is important to ensure you’re getting all the nutrients your body needs for healthy hair.
While there isn’t a lot of evidence to connect specific nutrients to PCOS hair loss or regrowth, here are the things you need to know:
- a balanced diet can improve PCOS symptoms caused by increased testosterone levels, including hair loss. It’s thought that a lot of PCOS symptoms are caused by your body becoming resistant to insulin. This can lead to your body making more insulin than normal, and high insulin levels can cause your ovaries to make more testosterone – which in turn can make your PCOS symptoms worse. But a healthy, balanced diet can help manage insulin resistance
- losing any excess weight can also help with PCOS symptoms such as hair loss. Insulin resistance can cause you to put on weight, and make it more difficult to lose weight. But losing weight can help lower your insulin levels and testosterone levels. Losing just 5-10% of your bodyweight has been shown to significantly improve PCOS symptoms
- some research suggests that increasing your zinc intake may help with PCOS hair loss. In a small study, women with PCOS who took 50mg of zinc a day for 8 weeks showed a decrease in hair loss. Meat is a good source of zinc, so you may be more likely to get hair loss as a PCOS symptom if you don’t eat much (or any) meat. Find out what to eat to get more zinc
Medical treatment for PCOS hair loss
The medical treatments to help with hair loss in PCOS are mainly ‘anti-androgens’. These work by blocking male hormones (such as testosterone) to reduce the effect they have on your body – including your hair follicles – which can lead to a reduction in the amount of hair you shed.
Anti-androgen medication can also help with excess hair growth on other parts of your body, if this is a problem for you.
Bear in mind that it can take several months to see results from this type of treatment, so you might have to be patient. And this treatment is more likely to slow down or stop further hair loss, rather than encourage regrowth – although in some people it can also do this.
If it does work well for you, you’ll need to keep taking the medication, as hair loss is likely to start again if you stop.
Here’s what you need to know about anti-androgen medication:
- the most commonly used medication is the combined contraceptive pill. Certain types are more effective, as they have better ‘anti-androgen’ actions – such as co-cyprindiol, or those containing drospirenone
- other common anti-androgen medications with some evidence of helping with hair loss in PCOS include spironolactone, cyproterone acetate, flutamide and finasteride (usually only prescribed after the menopause)
- if your hair loss is severe, your doctor or specialist might suggest you try a mix of medications
- some of these medications can have serious effects on developing babies. Your doctor is likely to recommend contraception to prevent you getting pregnant while taking them
Read about other treatments for hair loss in women that may be suitable, including medical procedures, as well as ways to disguise hair loss.
Read about treatment for other PCOS symptoms.
Hair loss can be upsetting and difficult to deal with, whatever the cause. Remember that you’re not alone, and there are support groups and resources available – try Alopecia UK.
Your health questions answered
Can endometriosis cause hair loss?
Answered by: The Healthily medical team
“There’s very little research about whether hair loss could be a symptom of endometriosis – a condition where tissue that’s similar to the lining of your womb grows in other parts of your body, such as your ovaries. However, a recent study suggests that people with endometriosis may be at increased risk of a type of hair loss called alopecia areata. The reason for this link is unclear, but evidence suggests it could involve things such as genetics, levels of inflammation in the body, and hormonal similarities between endometriosis and alopecia. It’s also possible to have both PCOS and endometriosis, but there’s no evidence that having 1 condition can cause you to have the other.”