Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects millions of women globally. PCOS has multiple effects on a woman's body, which might include irregular or absent periods, excessive hair growth on the face and body, and acne/oily skin. There are many more effects of PCOS, which does include hair loss which is an often overlooked symptom of Polycystic Ovary Syndrome. 

Understanding the underlying cause of PCOS hair loss is the first step towards an effective treatment. In this blog, we will discuss what PCOS is, and how it is different from PCOD. We will also talk about how it affects hair fall in women and how to regain control of your health.

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What is PCOS?

Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects women of reproductive age. It usually starts during adolescence, but symptoms may fluctuate over time.

PCOS can cause hormonal imbalances, irregular periods, excess androgen levels and cysts in the ovaries. Irregular periods, usually with a lack of ovulation, can make it difficult to become pregnant. PCOS is a leading cause of infertility.

PCOS is a chronic condition and cannot be cured. However, some symptoms can be improved through lifestyle changes, medications and fertility treatments. 

The cause of PCOS is unknown but women with a family history or type 2 diabetes are at higher risk.

Read more about this: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

Difference Between PCOS and PCOD

Although the terms PCOS (Polycystic Ovary Syndrome) and PCOD (Polycystic Ovarian Disease) are often used interchangeably, they are not exactly the same.

Understanding this difference is very important when it comes to diagnosis, treatment, and setting the right expectations for recovery, especially when dealing with issues like hair loss.

Read more about this: https://www.unicef.org/india/stories/do-pcod-and-pcos-mean-same-thing-or-are-they-different#:~:text=The%20Differences&text=PCOD%20can%20often%20be%20managed,always%20requires%20external%20hormone%20intake 

PCOS and Hair Thinning: Signs to Watch For

Hair thinning caused by PCOS is a gradual process. It might be difficult to notice at first, but eventually large clumps of hair start to fall out at once. Over time, your hair will start looking thinner, flatter, and less voluminous. PCOS related hairfall is also temporary but is hormonal bases and can remain if not addressed in time. 

Early Symptoms of PCOS and Hair Thinning

Here are some early signs that your hair loss might be related to PCOS:

• Gradual thinning around the crown or part line

• A widening hair part or visible scalp through the hair

• More hair fall during brushing or washing

• Loss of volume and decreased hair density

• Hair growing finer and weaker over time

Read more about this: https://pubmed.ncbi.nlm.nih.gov/36606524/ 

Connection Between PCOS and Hair Health

One of the most frustrating symptoms of PCOS is its effect on your hair. During PCOS, the androgen levels are increased. It leads to shrinking of hair follicles on the scalp. This leads to thinning of hair especially around the crown. This condition is known as hormonal hair loss or female-pattern baldness.

At the same time, these androgens can also increase facial and body hair growth, which is a combination known as hirsutism. This irony of thinning of hair while increased hair production leads to a paradox which adds to the emotional toll PCOS gives.

In PCOS, the elevated androgen levels such as testosterone and dihydrotestosterone (DHT) begin to impact hair follicles. These hormones shrink the hair follicles in a process known as miniaturization. Over time, the follicles become too small to produce healthy, thick strands of hair. This leads to: 

• Shorter growth phases (anagen cycle)

• Longer resting phases (telogen cycle)

• Finer, weaker hair strands

• Permanent follicle damage if untreated

This pattern of hormonal hair loss is medically called androgenetic alopecia. It's more common than most people realize among women with PCOS.

How PCOS Hair Loss Differs from Normal Hair Fall

How to Differentiate from Other Types of Alopecia

There are several types of hair loss, and distinguishing PCOS-related hair thinning from others is important for effective treatment. Here's a comparison:

Diagnosing PCOS-Related Hair Loss

If you suspect PCOS is the main cause for your hair thinning, the first and most important step is to get a proper medical diagnosis. This involves both a clinical evaluation and lab tests to confirm hormonal imbalances and rule out other conditions.

Medical Consultation and Hormone Testing

Start by consulting a gynecologist, dermatologist, or endocrinologist. They may ask about:

• Menstrual history

• Hair loss pattern and timeline

• Skin changes (acne, facial hair)

• Weight and lifestyle factors

• Family history of PCOS or hair loss

To confirm the diagnosis, your doctor may recommend the following hormonal and health screenings:

• Thyroid panel (TSH, T3, T4): 

To rule out hypothyroidism or hyperthyroidism, which can mimic PCOS symptoms and cause hair loss.

• Total and free testosterone: 

High levels suggest androgen in excess, which is also common in PCOS.

• DHT (Dihydrotestosterone): 

A potent androgen directly linked to hair follicle miniaturization.

• LH/FSH ratio: 

Elevated Luteinizing Hormone compared to Follicle-Stimulating Hormone is a classic PCOS marker.

• Insulin and glucose levels: 

Helps detect insulin resistance, which is often associated with PCOS.

• Prolactin levels: 

To rule out other hormone-related issues that might be present.

These tests will help determine whether your hair loss is caused by PCOS, or another condition, or even a combination of factors.

How to Reverse PCOS Hair Loss

A. Lifestyle Changes

• Diet for PCOS Hair Loss: 

One of the easiest ways to tackle PCOS-related hair thinning is through dietary adjustments. Since PCOS is closely linked with insulin resistance, a low-glycemic index (GI) diet helps to regulate blood sugar and reduces the hormonal imbalances which trigger hair loss. A stable insulin level reduces the excess androgen production, and is usually responsible for follicle miniaturization and even hair thinning.

Focusing on whole, nutrient-dense foods such as leafy greens, whole grains, berries, fatty fish, nuts, seeds, and avocados is very important, because these foods are rich in antioxidants, vitamins, and essential fatty acids that support both hormone health and promote hair growth.

• Best Foods for PCOS Hair Health

There are certain foods that help counteract the declining hair health that PCOS patients often seem to undergo. These include:

1. Leafy green vegetables like spinach and kale which provide iron and folate, and support healthy hair follicles.

2. Berries and citrus fruits that are packed with vitamin C, which enhances iron absorption and even promotes collagen production.

3. Whole grain foods such as quinoa and oats help maintain a steady blood sugar level.

4. Avocados, nuts, and seeds supply the essential healthy fats and vitamin E, which help to nourish hair strands.

5. Fatty fish like salmon and sardines contain omega-3 fatty acids that help fight inflammation and boost gut health.

• Best Nutrients for Hair Regrowth

Certain nutrients play a very important role in supporting the hair growth cycle. Incorporating these either through diet or even supplementation can make a sizable difference over time.

• Biotin helps improve the structure of keratin. Which is a key protein in hair, and makes the strands stronger and less prone to breakage.

• Zinc has anti-inflammatory properties and also helps regulate oil glands around the hair follicles, reducing follicle damage.

• Vitamin D is essential for new follicle creation and is often found to be deficient with cases regarding PCOS.

• Omega-3 fatty acids help lower inflammation and help restore the hormonal balance, which indirectly supports hair growth.

• Foods to Avoid

To reduce the hormonal spikes and inflammation that contribute to hair loss, avoid foods high in refined sugar and processed carbs such as white bread, cookies, pastries, and sugary beverages. 

Dairy products also tend to increase levels of insulin and insulin-like growth factor-1 (IGF-1) in certain people, which have a chance to worsen symptoms. Additionally, staying away from processed snacks and trans fats, which contribute to systemic inflammation and metabolic dysfunction is very important.

B. Exercise and Stress Management

• Why Regular Exercise Matters?

Regular physical activity plays a very important role in managing PCOS and, so by extension, the hair loss it tends to cause. Exercise improves insulin sensitivity, which helps to regulate blood sugar levels and also lower androgen levels. As discussed earlier, lower circulating androgens lead the scalp to experience less follicle shrinkage and shedding.

Some of the best exercises for PCOS include strength training, which improves the insulin response; walking or light cardio helps reduce stress; high-intensity interval training (HIIT) for fat metabolism; and Pilates for core strength and hormone support.

• Stress, Cortisol, and Hair Health

Chronic stress can elevate cortisol. When it is found in high levels, it leads to an increased adrenal androgen production. This adds to the hormonal imbalance already present in PCOS and can trigger or worsen hair thinning. Managing stress is crucial in preventing further hair loss.

Incorporate ‘hormone-friendly’ stress relief practices such as yoga, meditation, and deep breathing techniques. Establishing a consistent sleep routine of 7 to 8 hours per night also plays a major role in hormonal recovery and hair health.

C. Natural Remedies

• Ayurvedic and Herbal Solutions

Some herbal remedies have been found to naturally reduce the androgen levels and support the body in hormonal balance. These include:

1. Spearmint tea: which has shown promise in reducing the free testosterone levels when consumed on a regular basis.

2. Saw Palmetto: Is a plant extract known for its DHT-blocking properties.

3. Licorice root: Helps support adrenal function and might balance testosterone levels.

However, it is advised that it should be used cautiously in individuals with high blood pressure. Always consult a healthcare professional before starting any herbal remedies, especially if you are on other medications.

• Essential Oils for Hair Regrowth

Essential oils are another known natural method that can stimulate hair growth and improve the scalp health. Rosemary oil is known for its ability to increase circulation in the scalp and promote thicker hair. Peppermint oil invigorates the hair follicles, while pumpkin seed oil has natural DHT-blocking properties.

These oils should be mixed with a carrier oil such as coconut or castor oil and massaged into the scalp 2–3 times a week for best results.

• Scalp Massage Techniques

Scalp massage improves blood flow and encourages the delivery of nutrients to hair follicles. Spending 5–10 minutes daily using your fingertips in gentle, circular motions, or using a silicone scalp brush will work wonders. Over time, this practice can improve follicle strength and stimulate regrowth.

D. Medical Treatments

• Minoxidil (Topical Solution):

Minoxidil is a clinically approved, over-the-counter topical treatment that promotes hair density and regrowth by increasing blood flow to the scalp and extending the growth phase of the hair cycle. Most people start with a 2% or 5% formula and a consistent use over a period of 3 to 6 months is necessary before the results become visible.

• Anti-Androgen Medications

For more severe cases, doctors may prescribe medications that block androgen effects on the hair follicles.

1. Spironolactone: Is an oral anti-androgen that works by preventing testosterone from binding to hair follicle receptors.

2. Birth control pills: Also help regulate the menstrual cycle and reduce the overall androgen levels.

But it is important to note that these medications must be prescribed and monitored by a healthcare provider, especially in women who are trying to conceive.

• PRP Therapy (Platelet-Rich Plasma)

PRP therapy involves injecting a concentration of your own blood platelets into areas of the scalp where you experience hair thinning. This stimulates follicle activity and promotes regrowth. While it is not guaranteed, many patients have reported improvements in hair thickness, as soon as, after a few sessions.

Read more about this: https://pmc.ncbi.nlm.nih.gov/articles/PMC8922312/ 

• Micro-needling

Micro-needling uses small needles to create controlled micro-injuries in the scalp. This stimulates the production of collagen and also enhances the absorption of topical treatments such as minoxidil or other growth serums. It is often performed by dermatologists or trichologists. 

When to See a Doctor

While many people can reverse PCOS-related hair thinning with lifestyle changes and topical treatments, some cases require medical intervention. It’s important to consult a doctor if you experience any of the following:

• Sudden or rapid hair loss over a short period

• Menstrual irregularities, such as missing periods for three or more months

• Unexplained weight gain or increased facial/body hair

• Severe acne or signs of hirsutism

• No visible improvement after six months of consistent self-care
  
  

During your consultation, ask the following:

• Could this hair loss be linked to PCOS or another hormonal imbalance?

• What specific tests should I undergo to confirm the cause?

• Would medications like spironolactone or birth control be suitable for me?

• How long would it take to see improvement with treatment?

• Should I consult a dermatologist, an endocrinologist, or both?

Final Thoughts

If you’re struggling with PCOS-related hair loss, know this: you are not alone, and it is not permanent. It’s easy to feel defeated watching your hair thin, especially when the changes seem slow or out of your control. But with the right knowledge, support, and consistency, hair regrowth is possible.

The journey back to fuller, healthier hair isn’t instant but your body responds when you start caring for it holistically. Balancing your hormones, nourishing your body, using targeted treatments, and being kind to your hair day-to-day all work together like puzzle pieces. Celebrate small wins: fewer strands in your brush, tiny new baby hairs along your hairline, or better scalp health. 

FAQs

• Can PCOS hair loss be reversed?

Yes, PCOS hair loss is often reversible especially if caught early and treated consistently. Addressing the underlying hormonal imbalance, improving diet and lifestyle, and using targeted treatments (like minoxidil or natural DHT blockers) can lead to noticeable hair regrowth over time.

• How long does it take to regrow hair from PCOS?

It typically takes 3 to 6 months to start seeing visible hair regrowth once treatment begins, though it can vary based on the severity of the condition and the method of treatment. Full regrowth may take 9–12 months or longer.

• What is the best shampoo for PCOS hair loss?

Look for sulfate-free DHT-blocking shampoos that are rich in nourishing ingredients like caffeine, biotin, saw palmetto, or rosemary oil. 

• Is hair loss from PCOS permanent?

Not necessarily. While PCOS can cause progressive hair thinning, it’s rarely permanent if you address the hormonal imbalance in time. However, if hair follicles become fully dormant or scarred (which can happen over time), some areas may not fully recover without advanced treatments like PRP or microneedling.

• Are there any supplements that help with hormonal hair loss?

Yes! Several supplements support hormone balance and hair growth in people with PCOS:

• Biotin

• Vitamin D

• Zinc

• Inositol (especially Myo-Inositol + D-Chiro) for insulin regulation

• Omega-3 fatty acids

• Saw Palmetto (as a natural DHT blocked)