PCOS and hair loss: Why it happens and how to treat it

Although a common symptom of PCOS is hair loss or thinning hair, there are ways to help.

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Tori Crowther
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Hair loss can be extremely traumatic, and polycystic ovary syndrome (PCOS) hair loss can be troubling. To make matters even more confusing, you can be experiencing hair loss from your scalp, yet excessive hair growth in areas like your face.  

It’s a vast topic that can get a little complicated to follow, and even though hair loss is a common and sometimes distressing symptom of PCOS, the good news is there are things out there to help. The first step is understanding the symptoms, causes and treatments. 

We’ve gathered everything you need to know about polycystic ovary syndrome and hair loss, including exactly why it happens and how you can treat it.

What is PCOS?

PCOS stands for Polycystic Ovary Syndrome and is a hormone-related condition that impacts ovulation and causes a variety of symptoms. PCOS is caused by hormones that don't quite work as they should.

This imbalance causes an increased number of follicles on the ovaries, which are basically underdeveloped sacs. For people with PCOS, these sacs don't release eggs and therefore stop ovulation, (which is why many people with PCOS have irregular periods and may struggle to conceive).

It's a common condition, too, affecting 1 in 10 women and those assigned female at birth in Australia [1]. 

Despite being so common, there are still so many misconceptions about the condition, not to mention not being taken seriously enough. This is why it takes an average of about 3 years to diagnose the condition, with some experiencing symptoms long before they even realise what they’re experiencing isn’t normal [2]. 

What’s more, up to 70% of women who have polycystic ovary syndrome remain undiagnosed [3].

It's also not known exactly what causes PCOS but it's confirmed to be a familial condition, meaning it runs in families [4].

What are the symptoms of PCOS?

As with most conditions, everyone experiences the syndrome in a different way, but there are a few signs to look out for. The main symptoms include: 

Irregular periods

One of the main signs of PCOS is experiencing irregular periods. This is caused by a hormonal imbalance resulting in infrequent ovulation.  

Difficulty getting pregnant

This is due to the infrequency of ovulation. To put it simply: if you don’t ovulate you can’t get pregnant. The good news is, there are things your doctor can do to improve this and hopefully help you conceive. 

Weight gain

Weight gain, especially around the belly is something a lot of people with PCOS struggle with. This is due to insulin resistance, meaning your body doesn’t respond to insulin properly [5]. 

Acne

One of the other PCOS symptoms is hormonal acne, this is due to the increase in androgen hormones, which kicks oil production up a notch and can lead to increased breakouts. 

Hair loss

Female pattern hair loss is common in those with PCOS and happens due to an imbalance of hormones like estrogen and androgens like testosterone. This is because those androgen hormones can shorten the hair growth cycle.

Body or facial hair

This is medically known as hirsutism. While it might be surprising, you can actually experience hair loss on your head while also dealing with increased body hair.

This is because the hormone that shortens the growth cycle on your scalp is actually needed to increase excess hair growth elsewhere on your body.

Polycystic ovary syndrome and polycystic ovaries 

PCOS shouldn’t be confused with polycystic ovaries (PCO). To put it simply: you can have PCO without having PCOS and you can have PCOS without having PCO.

Polycystic ovarian syndrome is where someone’s body is producing too many typically “male” sex hormones — testosterone — causing all sorts of symptoms.

Whereas, PCO can be a symptom of PCOS and is where the ovaries appear to be polycystic (which means many cysts), where the ovaries are enlarged and contain fluid-filled follicles (cysts). 

PCO is more common than PCOS — with around 7% of women worldwide experiencing them in their lifetime [6]. Most people don’t get any symptoms caused by ovarian cysts, but others do experience problems like irregular periods and pelvic pain. Those with PCO tend not to have difficulty getting pregnant, whereas those with PCOS might. 

Can PCOS cause hair loss?

Unfortunately one of the common symptoms of PCOS is hair loss or thinning hair. You may see PCOS hair loss referred to as female pattern hair loss.

So, how does this work? Well, the imbalance in hormones, typically an excess of dihydrotestosterone (DHT) (more on that later) actually leads to something called androgenic alopecia, which is also known as female pattern hair loss. 

What is androgenic alopecia?

The clue here is kind of in the name. Alopecia refers to hair loss and as discussed earlier, androgens are a type of hormone, the most prominent being testosterone. Therefore, androgenic alopecia, or female pattern hair loss, is hair loss caused by an excess in the hormone. 

To understand exactly why this is happening, we need to familiarise ourselves with the hair growth cycle: Anagen (active growth), catagen (transition), telogen (resting), and exogen (hair shedding).  Each of these cycles has to work together to ensure healthy hair is constantly in progress. 

The hormone DHT, a byproduct of testosterone, actually shortens the active growth phase, which in turn, makes the hair follicle smaller and thus creates thinning. This process is called miniaturisation, and over time can cause a loss of hair density and then areas of hair altogether [7]. 

Symptoms of PCOS-related hair loss

Interestingly, PCOS hair loss can follow the pattern of male hair loss rather than female pattern hair loss.

Male and female hair loss presents differently due to genetics and DHT. The presence of excess DHT is exactly the reason many people with PCOS find their hair loss follows the traditionally male pattern hair loss or male pattern baldness.  

The first signs of PCOS hair loss include hair thinning, particularly around the frontal and side parts of the scalp, as well as receding near the temples. You might first notice that these areas first start thinning before areas start to expose patches of hair loss.

Is it possible to stop PCOS hair loss?

If no treatment is used then your hair loss is likely to continue without managing PCOS and seeking treatment.

But the good news for improved hair health and hair loss is that there are things you can do to prevent hair loss from getting worse.

Can hair loss from PCOS grow back?

PCOS hair loss won’t be resolved on its own, but getting to the root cause of the problem can help your hair loss grow back. This won’t be an overnight fix, though. Your hair loss may take time to grow back. But, all good things take time so it’s worth the persistence.

What's the best way to treat hair loss?

The first step is seeking help from a healthcare professional who can assess your individual situation and the best treatment plan based on your history and lifestyle. 

Medication

Balancing your hormones is the most important thing you can do; because you need to try and balance the underlying hormone imbalance.

Software’s prescription hair loss treatment contains medication that works to decrease testosterone production, giving your hair follicles the best chance to avoid thinning and shedding. 

Hair care

You can also tailor your hair care routine to thinning hair to promote new hair growth and protect existing follicles.

Heat styling

As tempting as it is, when experiencing hair thinning or loss, it’s always a good idea to drastically minimise heat styling. You can also use volumising hair products to give the appearance of thicker hair.

Avoiding tight hairstyles is also a good idea to avoid thinning hair further. Being mindful of making sure you’re gentle with your scalp when washing, drying and styling hair is important, too. 

Diet

Last (but by no means least) is diet. Making sure you’re having a well-balanced diet is always good for both your general health and your hair loss.

Making sure you’re consuming enough minerals and vitamins is important in making sure you’re not deficient in any nutrients as this can exacerbate hair loss. 

Image credit: Getty Images

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