PCOS & Hair Loss: Can it be Reversible?
Polycystic ovary syndrome (PCOS) is a hormonal disorder that significantly affects the lives of many women. One prevalent symptom of PCOS is hair loss, affecting a substantial 20% to 30% of people with PCOS (1). Dealing with PCOS can be challenging because it brings along a range of other symptoms like acne, infertility, weight gain, and hair loss. But don't worry, in this blog, we will help you navigate through the different treatment options available to manage PCOS-related hair loss effectively. We’ll also dive into the symptoms and causes of hair loss associated with PCOS. So, let's get started!
What are the symptoms of PCOS-related hair loss?
The symptoms of PCOS-related hair loss differ from person to person; some people have many symptoms, whilst others have few (2). Some possible symptoms include:
Shedding
Bald patches
Dry and Itchy scalp
Increased hair breakage
Hair thinning
Shorter hair
These symptoms can be associated with PCOS, however there are also other conditions which may lead to hair loss or hair thinning such as iron deficiency, menopause or thyroid disorders, which should be ruled out before concluding it is PCOS related hair loss.
Why does PCOS cause hair loss?
One of the hallmarks of PCOS is hyperandrogenism or higher levels of androgen hormones, commonly known as “male-type” hormones like testosterone(3). The elevated testosterone can be converted into another form called dihydrotestosterone or DHT. This DHT can bind to hair follicles which essentially makes them inactive and can lead to the shrinking of hair follicles, resulting in thinner, shorter, and less pigmented hair, particularly near the front of your scalp. This is often termed ‘male pattern baldness’ or androgenic alopecia (4).
Can PCOS hair loss be reversible?
If you're experiencing hair loss due to PCOS, it's important to know that the hair won't grow back on its own; however, there are treatment methods out there that can help to reactivate the hair follicles! These treatment methods focus on balancing your hormones, which in turn can stimulate new hair growth. Exciting, right? If you experience PCOS-related hair loss then you may have tried many ways to reduce its visibility and conceal your hair loss. If you are uncomfortable with your hair loss and it is affecting your quality of life then here are some tried and tested methods you might want to try whilst working on reversing the hair loss:
Hair Extensions: Extensions can effectively add length and volume to your hair, effortlessly covering up bald spots. Depending on your preference and comfort level, you can also choose from various extension types, such as clip-ins or tape-ins.
Wigs: Wigs give you the freedom to experiment with different styles and colours. They also provide full coverage and instant transformations. Of course, you may prefer to go au natural - the choice is yours!
What are the medical treatments for PCOS-related hair loss?
Given the impact of hormonal imbalance on PCOS related hair loss, hormone regulation can be an essential part of treatment to manage hair loss. Some common medical treatments include:
1) Drugs/Medications:
You will need to consult with a doctor if you are interested in finding out more about the following options:
Oral contraceptive pill: The oral contraceptive pill can lower androgen levels in the body and is the first line approach in treating hyperandrogenism (5). This can help reduce the effect of androgens on the hair follicles and slow down hair loss. This medication can also help you with other PCOS-related symptoms, such as acne and irregular periods (6).
Spironolactone (Aldactone): Spironolactone is a medication that can help with PCOS-related hair loss by inhibiting the action of androgens on the hair follicles. By doing so, it can reduce hair loss and even promote new hair growth. Studies have suggested that taking 25mg to 100mg of Spironolactone twice a day can be beneficial for treating PCOS-related hair loss (6).
Minoxidil (Rogaine): Minoxidil is the only MHRA (Medicines & Healthcare products Regulatory Agency) -approved drug for treating PCOS hair loss. This drug promotes hair growth and can give it a thicker appearance (8).
Finasteride (Propecia): Finasteride may improve hair loss by blocking androgens in the hair follicles. The MHRA has not approved Finasteride as a treatment for PCOS hair loss; however, some doctors will still prescribe it (8, 9).
Dutasteride (Avodart): Dutasteride has been found to slow down or even stop hair loss effectively. In one three-year study, researchers discovered that a daily dose of 0.15mg of Dutasteride resulted in an 65.6% increase in hair thickness and density among the women who participated. However, it is important to note that Dutasteride has not yet been approved as a hair loss treatment in the UK. This is mainly due to some known side effects such as; chest pain or discomfort, loss of sex drive and pain/soreness/swelling or discharge from the breast (9, 10, 11, 12).
2) Diet & Lifestyle:
Diet and lifestyle can impact both androgen and insulin levels, both of which can contribute to hair loss. Dietary changes to manage testosterone, reduce insulin resistance and also reduce inflammation are likely to be beneficial for PCOS related hair issues. Here are some diet & lifestyle strategies you might want to try:
Resistance Training: Resistance training, positively impacts insulin sensitivity, reduces inflammation, and helps manage stress. While not a direct remedy, exercises like squats, deadlifts and bench presses promote hormonal balance and overall-well being, potentially supporting improved hair health (13).
Embrace High-Fibre Foods: Adding fibre rich foods like fruits, vegetables, nuts, seeds, and whole grains to your diet can help lower the impact of PCOS-related high blood sugar. While not directly linked to hair loss, reducing symptoms and side effects of PCOS may contribute to minimising your hair loss (14).
Boost Protein Intake: Increasing protein intake can be beneficial in addressing PCOS-related hair loss through various mechanisms. Not only does protein contribute to hormonal regulation, but it also improves insulin sensitivity and stabilises blood sugar levels. Moreover, it plays a crucial role in tissue repair and growth, which is essential for the maintenance of healthy hair. Including protein-rich foods such as, fish, legumes, dairy, eggs, nuts, seeds, and tofu in your diet can potentially reduce inflammation associated with PCOS, thereby aiding in minimising hair loss (15).
Limit Ultra-Processed Foods: Diets high in ultra-processed foods, characterised by excessive added sugars, unhealthy fats, salts, and numerous artificial additives, are associated with various health concerns, including increased inflammation that can exasperate PCOS symptoms. Focusing on a diet centred around minimally processed, whole foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats can support healthy hormones and manage PCOS symptoms effectively (16&17).
3) Vitamins & other supplements for PCOS-related hair loss:
Biotin supplement: Biotin is a commonly recommended nutritional supplement for hair loss. While there isn't a lot of evidence specifically regarding its effectiveness in PCOS-related hair loss, the fact that it has been shown to help with hair loss in other cases suggests that it might be worth giving it a try (18).
Omega 3 & 6 supplement: Adding an Omega 3 & 6 supplement to your routine may offer potential benefits for PCOS-related hair loss. These supplements contain essential fatty acids that play a crucial role in maintaining hair health and nourishing hair follicles.
Additionally, Omega 3 fatty acids have anti-inflammatory properties, which could help reduce the inflammation often associated with PCOS. By reducing inflammation these supplements may contribute to improved hair growth. However, It's important to note that while these supplements have potential benefits, they are not a guaranteed solution for PCOS-related hair loss (19).
Zinc: Taking a Zinc supplement may help with PCOS-related hair loss. A recent study examined the effects of either a 50mg zinc supplement or placebo on women diagnosed with PCOS. Those who took the zinc supplement for 8 weeks had a substantial 41.7% reduction in hair loss. In comparison, only 12.5% of those in the placebo group reported a similar improvement.
The magic behind zinc’s impact lies in its ability to hinder the enzyme responsible for converting testosterone into dihydrotestosterone (DHT). This mechanism not only addresses hair loss but also extends its positive effects to other symptoms linked to high testosterone levels in women with PCOS, such as unwanted hair growth and acne (20).
Iron: For certain people with PCOS, a common struggle is heavy bleeding during their period. This excessive bleeding can cause a deficiency in iron, also known as anaemia. Iron is a crucial mineral for making red blood cells. Consequently, a deficiency in iron may lead to hair loss. The good news is that studies have shown an iron supplement can improve hair loss (21, 22).
Vitamin B12: Vitamin B12, plays an important role in many bodily functions, including the health of your hair. Although there's no direct evidence showing vitamin B12 as a solution for PCOS-related hair loss, this vitamin does play a part in overall hair health and can be beneficial for individuals dealing with PCOS-related hair loss (23, 24).
In summary, hair loss in individuals with polycystic ovary syndrome (PCOS) is frequently observed due to the excess production of androgen hormones. High levels of androgen hormones are also responsible for the other PCOS-related symptoms such as weight gain, acne, and abnormal hair growth. Fortunately, various effective drug treatments like Spironolactone, Finasteride, Dutasteride, and Minoxidil are available to reverse PCOS-related hair loss.
While waiting for these prescribed medications or if they don't align with your preferences, you can also take immediate action to reverse PCOS-related hair loss. Incorporating the practical tips discussed in this blog post, such as engaging in resistance training, taking vitamin supplements, and eating a healthy diet, can all contribute significantly to managing and potentially reversing PCOS-related hair loss. For personalised support and guidance, feel free to reach out and schedule a free discovery call to find out more about working together for more tailored advice.
References:
PCOS Hair Loss: Causes, Treatments, and Regrowth Success Stories
A Review of Treatment Options with a Focus on Pharmacological Approaches
Managing the PCOS-related symtoms of hirsuitism, acne and female pattern hair loss
The efficacy and use of finasteride in women: a systematic review
Resistance Training as Therapeutic Management in Women with PCOS: What is the Evidence?
Dietary Patterns and Polycystic Ovary Syndrome: a Systematic Review
Hair Loss And Vitamin B12 - How To Spot And Treat A Deficiency