Polycystic ovary syndrome (PCOS) is a relatively common condition that affects up to 20% of reproductive-aged women worldwide [1]. While PCOS causes many troubling symptoms including infertility, irregular periods, acne, and weight gain, it can also affect healthy hair growth.
So what’s the link between PCOS and your hair and is there anything you can do to prevent PCOS-related hair loss?
Polycystic ovary syndrome (PCOS) is a medical condition in which small painless sacs grow within the ovaries. Eggs grow within these sacs, so they’re unable to be released during ovulation. As a result, one of the biggest problems many women with PCOS experience is infertility.
In addition to infertility, PCOS also impacts your hair. More than 50% of women experience hirsutism (excessive hair growth) as a result of PCOS [1] while other women with this condition have reported losing hair.
Furthermore, there’s evidence to suggest a link between PCOS and female pattern hair loss [1, 4] as research suggests that 20-30% of women with PCOS also have symptoms of female pattern hair loss [2].
So how can PCOS cause both excess hair growth and hair loss?
PCOS can cause hyperandrogenism. This is where a woman produces too many male sex hormones (known as androgens). Androgens like testosterone cause the development of typically male characteristics like beard growth and substantial body hair. When women produce too much testosterone (or other androgens), they may also develop more hair on their face, chest, or back.
This is known as hirsutism, and it’s a defining feature of PCOS. It affects up to 80% of PCOS sufferers, versus up to 11% of the general female population [3]. While excess hair growth is more common than hair loss for people with PCOS, hair loss is still a worrying symptom for many. So why does it happen?
While hyperandrogenism most often causes excess hair growth, it can also cause the follicles to shrink and stop producing hair. Androgens metabolise to produce dihydrotestosterone (DHT), which binds to androgen receptors in the hair follicles. Overproduction of androgens means higher levels of DHT, which can lead to a higher rate of hair loss. This is why some men experience hair loss after testosterone replacement therapy.
Not everyone will experience PCOS-related hair loss. It all comes down to how sensitive your hair follicles are to DHT. This is usually determined by your genetics. So if a close family member has female pattern hair loss (also known as androgenetic alopecia) you’re more likely to experience it too regardless of whether they also suffer from PCOS or not.
Female pattern hair loss is the most common type of hair loss seen in PCOS patients [4]. Unlike male pattern baldness which often presents with a receding hairline and hair thinning on the crown, female pattern hair loss is characterised by a parting that becomes wider, extending into diffuse hair loss (thinning hair) across the scalp.
The Ludwig scale shows the common stages of female pattern baldness. This scale is used to help diagnose female pattern hair loss in individuals who were assigned female at birth (for individuals who were assigned male at birth, hair loss specialists used the Norwood Scale to diagnose male pattern hair loss).
However, it should be noted that people with the condition may see other types of hair loss, including:
These other types of hair loss aren’t usually associated with hyperandrogenism or other physical PCOS symptoms. While some patients have reported these types of hair loss, the only established link with PCOS is female pattern baldness [4].
Not all women with PCOS have hair loss and not all hair loss is caused by PCOS. To establish a link between your symptoms, it’s important to discuss them with your GP. Your hair loss is more likely to be caused by PCOS if you also experience symptoms like:
If your periods are regular but you’re experiencing female pattern hair loss, your doctor may still perform an ultrasound and/or hormone test to rule out PCOS. Other conditions like endometriosis can also affect your periods, and while it’s unlikely to be the underlying cause of hair loss, the resulting stress from this condition can contribute.
Find out about other hair loss symptoms and causes, including endometriosis and hair loss.
If you are experiencing symptoms of PCOS, book an appointment with your GP. They’ll be able to discuss your options for treating the condition and may suggest lifestyle changes you can make, such as losing weight, eating a healthier diet, and exercising regularly. If you are aiming to lose weight, learn how to prevent hair loss during weight loss.
While there’s currently no cure for PCOS, there are many effective options to treat hair loss and excessive hair growth symptoms. For hair loss, treatments include:
If you’re seeing more hair growth on your face or body, you can treat this with:
People with PCOS should use good haircare practices to maintain the health of their hair. This includes:
Good hair care keeps the rest of your hair healthy and strong. It may help you hide bald patches or thinning while you treat the underlying cause of your hair loss.
Some doctors may prescribe a combination of oral and topical solutions to help treat hair thinning caused by PCOS. These may contain anti-androgens to combat the symptoms of hyperandrogenism. Anti-androgens can have an impact on the sex of a foetus, so make sure you tell your doctor if you’re planning to get pregnant while taking this medication [2]. Learn more about hair loss and pregnancy.
You may also be prescribed birth control pills, as these increase the levels of oestrogen and progestin (female hormones) in the body. In addition to reducing hair loss, these hormones should also make your periods more regular and may improve the condition of your skin too [5].
Many women with PCOS find that hair loss and/or hirsutism makes them feel upset about their appearance. Any change in how you look can be difficult to deal with and may lead to increased stress, anxiety and depression.
The good news is that you don’t have to put up with feeling this way. If hair loss has left you lacking confidence, you may want to consider having a hair transplant.
The Wimpole Clinic have years of experience carrying out hair transplant procedures. We offer Follicular Unit Transplants (FUT) and Follicular Unit Excision transplants (FUE), both of which are safe procedures, carried out by our skilled specialists.
If surgery doesn’t feel like the right option for you, we also provide a number of solutions which don’t require surgery for PCOS hair loss, such as Minoxidil 4% lotion. This is proven to assist in hair growth and thickening.
For advice on the best solution for you, we recommend booking a free, no obligation consultation with one of our specialists. Book your free consultation with the Wimpole Clinic on Harley Street, or learn more about hair transplants for women.
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