There are many reasons why women experience hair loss. Some types of hair loss are temporary and sudden, while others are gradual and permanent. PCOS hair loss falls in the latter category. Many women suffer from polycystic ovary syndrome. Unfortunately, the exact cause of this disorder isn’t known. According to the NHS, it is not possible to cure PCOS, but its symptoms can be treated. It’s also possible for women to experience different symptoms of this disorder or just one.
What Is Polycystic Ovary Syndrome (PCOS)?
To understand PCOS hair loss, you need to know what polycystic ovary syndrome is and how it affects the body. For reasons unknown, people with PCOS produce male hormones “androgens” in excess. This hormonal imbalance is caused by the ovaries. However, since the level of androgens increases in polycystic ovary syndrome, the release and development of eggs by the ovaries don’t take place normally.
One explanation for the development of PCOS is that it may be because of the inability of the body to use the insulin present in the blood. This insulin resistance signals the increase in the production of androgens by the ovaries. However, another cause may be “low-grade chronic inflammation“, which can result in the increased production of androgens.
This disturbance in the ovulation process results in the formation of fluid-filled sacs (which are not always cysts). According to the Office on Women’s Health (OASH), this hormonal disorder affects 1 in 10 women. With around 5-10% of women between the ages of 15 and 44 affected by PCOS, it is quite common.
As mentioned above, it is possible that you only experience 1 symptom of this disorder. However, what happens, as a result, is that not many women know that they have PCOS until they’re trying to get pregnant (since it causes infertility). Therefore, its diagnosis is most common in women who are 20-30.
A woman who has a family history of PCOS with any of her blood relatives being affected by it is at a higher risk of developing this disorder herself. In addition, it is more common in people who are overweight or obese. Those who do have PCOS are at a higher risk of developing health conditions such as:
- High blood pressure
- Sleep apnea
- Uterine cancer
- Depression and anxiety
- Cardiovascular disease
What Are the Signs of Polycystic Ovary Syndrome?
You shouldn’t be quick to assume that the hair strands that you’re shedding are because of PCOS. It has other symptoms like:
- Irregular periods – too frequent or infrequent. Since it doesn’t result in the release of the egg needed for fertilization, this is what causes infertility
- Hirsutism – excessive growth of thick, dark hair like males
- Acne – on the face, chest, and back
- Acanthosis nigricans – formation of dark, thick patches of skin due to an increase in cell formation. It usually affects the neck area, groin, armpits, hands, and face
- Skin tags – small skin flaps
- Weight gain – due to hormonal imbalance
- Hair loss – thinning of hair in certain regions of the scalp
Why PCOS Causes Hair Loss?
There are two reasons why PCOS causes hair loss:
Female Pattern Baldness
PCOS hair loss results from an increase in the level of androgens. These androgens convert testosterone into dihydrotestosterone (DHT) through the enzyme 5-alpha reductase. However, keep in mind that there’s a genetic component to hair loss due to PCOS. The binding of the DHT hormone results in the miniaturization of the hair follicles, and it results in female pattern baldness, also known as androgenetic alopecia.
Now although hair thinning may occur on the scalp due to PCOS, hair growth can take place in different areas of the body in a process known as virilization. That results in the growth of thick hair on the face and neck, deepening of the voice and hair loss similar to male pattern baldness, among other symptoms.
Because of this virilization, hair loss in women because of PCOS can be of two types:
- One that has a pattern similar to pattern baldness in males. This means hair loss along the temple region and the hairline (forming an M shape). Moreover, thinning occurs in the crown/vertex region.
- One that normally happens in women, where they start experiencing thinning on the top of the scalp according to the Ludwig scale. The part line widens while the hairline at the front remains intact.
One more thing that the androgens do is that they end up affecting the sebaceous glands. They become larger and produce more oil. Therefore, some people who have PCOS hair loss also notice increased oiliness and dandruff. They are more likely to be affected by seborrheic dermatitis. This can result in the overgrowth of a fungus on the scalp, which causes infection. It can also end up causing hair loss.
Is Hair Loss Due To PCOS Permanent?
Since the hormonal imbalance can cause permanent miniaturization of the hair follicles on the scalp in pattern baldness. You may lose your hair permanently as a result of PCOS. Seborrheic dermatitis on its own rarely, if ever, causes permanent hair loss. Fortunately, there are treatments available for hair loss caused by PCOS.
How To Treat Hair Thinning Due To PCOS?
There are more than a few treatments that are available for treating polycystic ovary syndrome hair loss. These are as follows:
Birth Control Pill
One way to manage the symptoms of polycystic ovary syndrome is to take a birth control pill. Your doctor might also recommend some other methods of birth control. However, the intention is to regulate the menstrual cycle so that the hormones are balanced in the body. It’s true that some kinds of contraceptives can cause hair loss. So, make sure to discuss this with your dermatologist.
Spironolactone is another medication that may be prescribed for the treatment of hair loss caused by PCOS because of its anti-androgenic activity. Instead of letting androgens bind to the hair follicles, spironolactone does that. Therefore, it prevents hair loss resulting from pattern baldness. It can take 6-12 months for you to see results from this treatment.
Metformin is an insulin-sensitizing drug that’s used for the treatment of Type 2 diabetes. However, it is also used for the treatment of PCOS. It works by making the cells use the circulatory insulin in the blood, thus decreasing its overall levels. With less blood sugar, the ovaries aren’t stimulated to produce androgens.
According to the NHS, 5% weight loss can result in an improvement in PCOS. The lower intake of calories due to weight loss will result in a decrease in the levels of insulin in the body. Not just that, but it will also decrease the production of androgens. This can help you better manage the symptoms of polycystic ovary syndrome. Therefore, you can consider dieting and physical exercise to lose weight.
Another way to treat thinning due to PCOS is to use topical minoxidil. There are different ways in which it can help in the growth of hair follicles. To begin with, it can dilate the blood vessels, allowing more oxygen and nutrients to be carried to the hair follicles. It also decreases the duration of the telogen phase of the growth cycle and prolongs the duration for which it stays in the anagen phase of growth. Therefore, your doctor may prescribe this for increasing the hair density from PCOS.
Since PCOS can result in permanent hair loss, one way to restore the growth is to get hair transplant surgery. It will use the hair follicles that have not been affected by the androgens and place them in the balding regions. This treatment gives permanent results.
Another treatment for PCOS hair loss comes from the blood of the patient, where a concentrate of plasma, proteins and growth factors help in the healing of the hair follicles and increase the blood supply to the scalp. This can also be helpful in increasing the hair density of the person who has experienced significant hair loss due to PCOS. It is also recommended that you get PRP with a hair transplant to further improve the results of the treatment.
If you have developed a fungal infection, as may happen in seborrheic dermatitis, you may be prescribed an anti-fungal shampoo. The itchiness and inflammation can also cause damage to the hair follicles, which is why you may need to use them to ensure healthy hair growth. Ketoconazole is a type of anti-fungal shampoo. However, it can also help with the androgens that are causing hair loss in the first place.
Polycystic ovary syndrome is a chronic condition. Its exact causes aren’t known, and it cannot be cured. However, its symptoms are treatable. There are different symptoms of this disorder. However, many people come to know that they have it when they’re trying to get pregnant.
One symptom of this condition is hair loss, where a person experiences thinning due to androgenetic alopecia. This can lead to permanent hair loss. There are different treatment options that are available for it. It’s important that you discuss these with your dermatologist.
Reviewed and Approved by Dr. Hassan Soueid.