H-Hair loss and PCOS -Why it happens and How to Manage it #BlogchatterA2Z

As discussed in detail in my previous posts, Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age.

Among the many symptoms associated with PCOS—such as irregular periods, acne, and weight gain—hair loss is one of the most distressing. Not only does it impact physical appearance, but it also takes a toll on emotional well-being and self-esteem. In this post, we’ll explore why hair loss happens in PCOS, what it looks like, and the treatment options available, including potential side effects.

Why Does Hair Loss Happen in PCOS?

The main culprit behind PCOS-related hair loss is hormonal imbalance, especially an elevated level of androgens (male hormones such as testosterone). Although women naturally produce small amounts of androgens, in PCOS, the levels are abnormally high.

High androgen levels can:

• Shrink hair follicles ( miniaturisation) on the scalp.

• Shorten the hair growth cycle, leading to more hair entering the shedding phase.So the hair follicle falls much earlier.

• Delay the regrowth of new hair, resulting in progressive thinning over time.

This condition is known as Androgenic Alopecia, or Female-pattern hair loss.

The Pattern of Hair Loss in PCOS

Unlike male-pattern baldness, which often causes a receding hairline, PCOS-related hair loss in women has a distinctive pattern:

1. Diffuse Thinning on the Crown

• Hair becomes noticeably thinner at the top of the scalp, particularly along the parting.

• The part line may gradually widen over time.

• The hairline at the forehead usually remains intact.

2. Hair Becomes Thinner and Weaker

• Strands may feel finer, less voluminous, and break more easily.

• Hair may be more prone to falling out when brushing or washing.

3. Increased Hair Shedding

• Many women report losing large amounts of hair daily.

• This may fluctuate with stress, diet, or other hormonal shifts.

4. Contrasting Excess Hair Growth Elsewhere

• Ironically, while scalp hair thins, excess hair growth (hirsutism) on the face, chest, or abdomen is also common—both linked to high androgens.

Diagnosing Hair Loss in PCOS

It’s important to differentiate PCOS-related hair loss from other causes such as:

• Iron deficiency anemia

• Thyroid dysfunction

• Postpartum shedding

• Nutritional deficiencies

• Autoimmune disorders (like alopecia areata)

A proper diagnosis often involves:

• A clinical evaluation of hair loss pattern

• Blood tests for hormone levels (testosterone, DHEAS)

• Thyroid and iron studies

• Scalp examination and occasionally a biopsy

Treatment Options: Managing Hair Loss in PCOS

Managing hair loss in PCOS requires a multifaceted approach, combining medical treatment, lifestyle modification, and hair care strategies.

Let’s look at the main categories of treatment:

1. Hormonal Therapy

These medications aim to reduce androgen levels, thereby slowing or reversing hair thinning.

A) Oral Contraceptive Pills (OCPs)

• How they work: Regulate menstrual cycles and reduce androgen production.

• Common types: Pills containing ethinyl estradiol with anti-androgenic progestins like drospirenone or cyproterone acetate.

• Common Side effects:

  • Nausea

  • Weight changes

  • Mood swings

  • Increased risk of blood clots (especially in smokers or older women)

B) Anti-Androgens

These are often prescribed alongside OCPs to block the action of male hormones.

i. Spironolactone

• How it works: Blocks androgen receptors and decreases testosterone production.

• Dosage: Typically 50–200 mg/day.

• Common Side effects:

  • Irregular periods (hence often combined with OCPs)

  • Breast tenderness

  • Dizziness or fatigue

  • Electrolyte imbalances (requires monitoring potassium levels)

ii. Cyproterone Acetate

• Dual action: Acts as a progestin and anti-androgen.

• Often found in combination OCPs.

• Common Side effects:

  • Liver toxicity (in rare cases)

  • Mood changes

  • Reduced libido

iii. Finasteride

• Mechanism: Inhibits the enzyme 5-alpha-reductase, reducing DHT levels (a potent androgen).

• Note: Not typically used in women of childbearing age due to potential risks to a male fetus.

• Common Side effects:

  • Breast tenderness

  • Headaches

  • Risk of birth defects if pregnancy occurs during use

2. Topical Treatments ( that can be applied on scalp)

A) Minoxidil (2% or 5%)

• Only FDA-approved topical treatment for female pattern hair loss.

• How it works: Increases blood flow to hair follicles and prolongs the growth phase.

• Application: Applied directly to the scalp once or twice daily.

• Common Side effects:

  • Scalp irritation or itching

  • Initial shedding (temporary and usually subsides)

  • Unwanted facial hair growth if applied improperly

3. Nutritional Supplements

While not a cure, addressing nutritional gaps can support hair health.

Common supplements:

• Biotin: Promotes hair strength (although true deficiency is rare)

• Zinc: Helps regulate hair follicle cycles

• Vitamin D: Often deficient in PCOS, and low levels are associated with hair loss

• Iron: Essential for oxygen transport to follicles

• Omega-3 Fatty Acids: Anti-inflammatory and support hair structure

Always check levels with a healthcare provider before starting any supplements.

4. Lifestyle Modifications

Addressing insulin resistance and inflammation—often underlying contributors in PCOS—is key.

a) Balanced Diet

• Low glycemic index foods to stabilize blood sugar

• Anti-inflammatory foods: leafy greens, berries, nuts, olive oil

• Adequate protein intake to support hair structure

b) Exercise

• Improves insulin sensitivity

• Helps regulate hormones

• Reduces stress, which is a known hair loss trigger

c) Weight Management

Even a 5–10% weight loss can significantly lower androgen levels and improve symptoms.

5. Hair Care and Cosmetic Solutions

While medical treatments work internally and gradually, cosmetic approaches can provide immediate confidence boosts.

• Gentle Hair Care: Use sulfate-free, volumizing shampoos; avoid harsh treatments.Read more HERE

• Camouflaging Products: Hair fibers or scalp concealers can hide thinning spots.

• Hairstyling: Layers or cuts that create volume can minimize the appearance of hair loss.

• Wigs or Hair Toppers: A good quality topper can be a life-changing confidence tool.

• PRP Therapy (Platelet-Rich Plasma): Injections that may promote follicle healing and growth (results vary and require multiple sessions).

6.Homeopathy as a Holistic Option

Homeopathy offers a gentle and individualized approach to managing PCOS and its symptoms, including hair loss. Rather than targeting hair fall alone, homeopathic remedies aim to restore hormonal balance, regulate the menstrual cycle, and address underlying emotional and metabolic factors that contribute to PCOS. Commonly used remedies like Thuja, Lycopodium, Sepia, and Calcarea carbonica etc. are selected based on a person’s unique constitution and symptom profile. While scientific evidence is still evolving, many women report improvements in hair density, reduced hair shedding, and better overall well-being with consistent homeopathic care.

As with any treatment, it’s important to consult a qualified homeopath for a personalized prescription, and consider it as part of a broader, integrative approach to PCOS management.

Important Points to Remember

• Hair loss in PCOS is often gradual and progressive but treatment can slow it down or reverse hair loss partially.

• Medications take at least 3–6 months to show visible improvement.

• Stopping treatment may result in recurrence of hair thinning.

• Managing stress is critical—chronic stress can worsen both PCOS and hair loss.

• Every individual responds differently—customized treatment under medical guidance is essential.

Conclusion

Hair loss in PCOS can be emotionally challenging, but it’s not irreversible. With the right combination of hormonal balance, lifestyle changes, medical support, and self-care, you can regain control—not just of your hair, but your overall health and confidence.

If you’re struggling with PCOS-related hair loss, don’t hesitate to consult a specialist. Early intervention often leads to better outcomes. Remember, you’re not alone—and with the right care, things can get better.

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Share this post with someone who has been suffering from #PCOS related Hair loss. Leave your queries and comments below and I shall be happy to address them.