Polycystic ovary syndrome (PCOS) is a relatively common condition that affects up to 20% of reproductive-aged women worldwide . And while PCOS causes many troubling symptoms — including infertility, irregular periods, acne, and weight gain — it can also affect 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?
What is PCOS and what are the symptoms?
Polycystic ovary syndrome 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.
But PCOS doesn’t just affect fertility — it also impacts your hair. More than 50% of women experience hirsutism (excessive hair growth) as a result of PCOS . But other women with this condition have reported losing hair, and there’s evidence to suggest a link with female pattern hair loss [1, 4] . Research suggests that 20-30% of women with PCOS also have symptoms of female pattern hair loss .
So how can PCOS cause both excessive hair growth and hair loss?
Why does PCOS cause excessive hair growth?
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 . But while excessive 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?
Why does PCOS cause hair loss?
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 with PCOS loses their hair. 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 — whether they suffer from PCOS or not — you’re more likely to experience it, too.
What type of hair loss is associated with PCOS?
Female pattern hair loss is the most common type of hair loss seen in PCOS patients . This type of hair loss is characterised by a parting that becomes wider, extending into diffuse hair loss across the scalp.
The Ludwig scale shows the common stages of female pattern baldness. But other people with the condition may see other types of hair loss, including:
- Alopecia areata — a hair loss condition characterised by bald patches across the scalp
- Telogen effluvium — hair loss caused by emotional shock or trauma
- Lichen planopilaris — scarring hair loss caused by skin conditions like lichen planus .
These other types of hair loss aren’t usually associated with hyperandrogenism, or the other physical symptoms caused by PCOS. While some patients have reported these types of hair loss, the only established link with PCOS is female pattern baldness .
Is my female pattern hair loss caused by PCOS?
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:
- Irregular periods
- No periods at all (also called amenorrhoea)
- Excessive body or facial hair growth.
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.
Find out about other hair loss symptoms and causes.
What to do if you think you have PCOS
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 treatment options for hair loss and excessive hair growth symptoms. For hair loss, treatments include:
- Anti-androgen therapy — a hormone-based treatment that can rebalance the androgens in your body, using medication like spironolactone
- Minoxidil — a topical hair loss reduction solution
- Finasteride — a hair loss reduction drug that’s particularly effective for treating female pattern hair loss related to hyperandrogenism 
- Low-level laser light therapy — targeted light therapy may stimulate hair growth
- Hair transplants for women — in severe cases of irreversible hair loss, a hair transplant is the best way to achieve thick, natural hair.
If you’re seeing more hair growth on your face or body, you can treat this with:
- Hair removal treatments — including waxing, shaving, plucking, electrolysis, and laser hair removal
- Anti-androgen therapy — rebalancing your hormones should reduce the effects of hyperandrogenism, including body hair growth.
Taking care of your hair
People with PCOS should use good haircare practices to maintain the health of your hair. This includes:
- Not overbrushing your hair
- Minimising the use of heat styling tools, such as hairdryers and straighteners
- Conditioning and detangling your hair in the shower.
Good haircare 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 . 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 .
Hair transplants and non-surgical solutions for PCOS sufferers
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.
- The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review
- Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee
- Hirsutism in Polycystic Ovary Syndrome: Pathophysiology and Management
- Polycystic ovarian syndrome in patients with hair thinning
- Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits
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