PCOS Hair Loss: Root Causes and Holistic Solutions for Androgenic Alopecia

For many women struggling with Polycystic Ovarian Syndrome (PCOS), the emotional and physical impacts are many, with one of the most common and often distressing being hair loss. While the condition itself is a hormone disorder associated with other symptoms like fatigue & fertility struggles, it’s the visible symptoms such as hair loss that are often the driver for women to seek treatment. The type of hair loss most commonly seen with PCOS is now called female-pattern hair loss (FPHL), and was previously known as androgenic alopecia, or male pattern baldness.

We’ll dive into the ‘why and how’ of hair loss for those navigating  PCOS, with a primary focus on helping you find holistic solutions for managing androgenic alopecia.

Understanding the Link: PCOS and Hair Loss

Why is androgenic alopecia called male-pattern baldness if it’s happening in women with PCOS? I can understand why you might be confused about the terminology, so let me break it down simply. 

One of the hallmark changes associated with PCOS is high androgen levels. Androgens are hormones like testosterone that are primarily male hormones, though all women have testosterone too—just a much lesser amount. 

These high androgen levels can lead to the thinning of hair in a pattern similar to that seen in men, affecting the crown and frontal areas (1). So the underlying mechanism for hair loss in women with PCOS is similar to what occurs with men. Though, factors like inflammation and stress can also play a big role.

For women with PCOS, this type of hair loss can be especially concerning. Not only is there the emotional toll of losing your hair, but it can also play into the already delicate relationship with body image that many women with PCOS struggle with. Understanding the hormonal underpinnings of this hair loss is the first step toward finding effective solutions.

Shop: The Holistic Beauty Box—for hair, skin, and nails.

Root Causes of Hair Loss in PCOS

Androgens and DHT

The main androgens responsible for hair loss in PCOS are testosterone, and its derivative, dihydrotestosterone (DHT). High levels of these hormones can cause hair follicles to shrink, shorten the hair growth cycle, and cause finer hair to be produced (2).

This is the main process responsible for PCOS-related hair loss and thinning hair.

High androgens also cause excessive hair growth on the body, while causing it to thin on the head (3). Hair thinning on the head with PCOS is a generally progressive process known as hair follicle miniaturization, and can lead to permanent hair loss if left unaddressed.

Insulin Resistance and the Hair Growth Cycle

Insulin resistance, a hallmark of PCOS, can disrupt the hair growth cycle. Hair grows, rests, and sheds in a cyclic pattern. When insulin resistance interferes with this process, it can result in the shedding of hair follicles to be out of sync with the regrowth phase, leading to overall thinning hair (4).

Exploring these root causes proactively can lead to better management of hair loss symptoms associated with PCOS.

Related: PCOS & Diabetes: What’s the Link Between Hormones & Insulin Resistance?

Diagnosing Hair Loss in PCOS

Seeking Professional Diagnosis

Diagnosing the type of hair loss in PCOS is best approached through a professional’s assessment. This might involve a holistic dermatologist, an endocrinologist, or a gynecologist familiar with PCOS symptoms. It’s crucial to work with a provider who has experience with PCOS and can treat your body as a whole.

Common Diagnostic Tests

If you have female-pattern hair loss, there are tests that an integrative or functional provider may use to diagnose the root cause of your hair loss, including:

• Blood or saliva tests: Assessment of hormone levels, particularly androgens, and insulin. A DUTCH test is a common way providers measure the amount of free hormones in the body. 
• Biopsy: A small skin sample can be taken from the scalp to examine the hair growth cycle and the hair follicle structure.
• Physical examination: Close examination of the scalp and hair to assess the pattern and extent of the loss.

In all women who experience female-pattern hair loss, assessment of a potential androgen excess should be mandatory. Also very helpful are tests to evaluate vitamin D, iron, zinc, thyroid hormones, and prolactin (5).

Understanding the specific reason for your hair loss can guide targeted management and intervention strategies.

Related: Is Your Hair Loss Caused by Hormonal Imbalance?

Is PCOS Hair Loss Reversible?

To treat hair loss and restore healthy hair growth if you have PCOS,  it’s essential to address the underlying hormonal imbalances. In many cases, hair loss associated with PCOS is reversible.

Read: Birth Control Isn’t the Only Way to Manage PCOS

Treating Hair Loss Beyond the Scalp

Managing hair loss associated with PCOS goes beyond addressing hormonal imbalances. Taking care of overall health and well-being is crucial for promoting healthy hair growth.

Hair Care Practices

Using gentle products and avoiding harsh chemicals on the scalp can help minimize damage to hair follicles. Additionally, limiting heat styling tools and opting for protective hairstyles can also help preserve the health of your hair.

Diet and Lifestyle Changes

Managing insulin resistance through dietary and lifestyle changes can positively impact hair loss that’s caused by PCOS. This includes adopting a PCOS-friendly diet that balances blood sugar and reduces insulin resistance.

Regular exercise and weight management are also key components to managing insulin resistance, which in turn can support healthier hair growth.

Stress Management and Its Impact on Hair Health

Chronic stress can exacerbate hormonal imbalances and contribute to hair loss. Integrating stress management techniques—such as meditation, yoga, or counseling—can be beneficial in preventing or reducing hair loss symptoms.

Supplements and Natural Remedies

Several supplements and natural remedies may help to support hair health and growth. Some herbs, vitamins, and minerals that can help with PCOS-related hair loss include:

• Saw palmetto, which can have positive effects on the hair growth cycle (6).
• Amla, an Ayurvedic herb that can support hair growth and strength (7).
• Biotin, a B vitamin that has been shown to improve hair health.

Additionally, topical treatments like pumpkin seed oil or rosemary essential oil have been associated with promoting hair growth.

WATCH: What Hair Supplement Should I Take?

Scalp Microbiome

Nurturing the balance of bacteria living on the skin may be as crucial for hair health as it is for the gut. Regular and gentle cleansing of the scalp, along with the use of probiotic and prebiotic hair products, can influence this microbiome and potentially impact hair growth positively.

Medical Treatments

For those seeking more immediate and potent intervention measures, a range of medical treatments are available.

Topical Solutions

Minoxidil, a topical solution, is the only FDA-approved over-the-counter medication for hair regrowth. While it doesn’t address the root causes of hair loss, it can help to maintain and potentially regrow hair in some individuals.

Medications

Medications like anti-androgens and insulin sensitizers may help manage hair loss caused by high androgen levels in women with PCOS (9). These medications may be the right choice for some women to achieve symptom relief while working on addressing underlying hormonal issues with more holistic methods. Though, it’s important to remember that managing PCOS with diet & lifestyle changes is possible. 

Procedures

Hair transplants and procedures such as platelet-rich plasma (PRP) therapy are more invasive options but can be effective for certain individuals with PCOS-related hair loss.

Seeking Support

Managing hair loss associated with PCOS can be emotionally and psychologically challenging. It’s essential to seek support from loved ones, healthcare providers, and mental health professionals if necessary. Finding a supportive community of individuals experiencing similar challenges can also be beneficial.

Watch: How much hair loss is normal? My hair loss story!

Restoring Healthy Hair When You Have PCOS

Hair loss is a common symptom of PCOS, but it doesn’t have to be permanent. By understanding the root causes and seeking appropriate diagnosis and treatment, women with PCOS can effectively manage their hair loss and restore healthy hair growth. With a holistic approach that includes lifestyle changes, stress management, supplementation, and medical treatments when necessary, it is possible to regain confidence in your hair and overall well-being. Remember to be patient and kind to yourself throughout this process, as managing PCOS-related hair loss can take time and effort.