PCOS hair loss causes and 7 treatment options

If you’ve started seeing more bald spots than you’re used to or there’s more hair in your brush than you’ve had before, you may be wondering what could be causing this sudden hair loss. One possible culprit if you have ovaries and meet some other criteria: PCOS hair loss.

Keep reading to learn about PCOS hair loss and possible treatments. 

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Polycystic ovary syndrome, or PCOS, is a hormone disorder that affects people born with ovaries. Normally, before menopause, ovarian follicles rupture each month to release an egg, but with PCOS, they continue to grow, turn into cysts, and release extra androgens (nicknamed male hormones, though everyone has them) into the body (Leon, 2020).

This syndrome may cause several symptoms like irregular periods, obesity, and type 2 diabetes.  Some of the more noticeable symptoms of PCOS relates to hair (Leon, 2020). 

Some people with PCOS develop hirsutism, or excess hair, on their face or places on their bodies that don’t usually grow thick hair. Others may also develop hair loss and hair thinning on their scalps. Some people even experience both at the same time (Leon, 2020).

Female pattern hair loss is when the hair on your head starts thinning, either at the crown (the middle of the head) or your hairline, near the front or where you part your hair (Carmina, 2019).

While it isn’t the same style of baldness many men get, it can be distressing to see your scalp showing, hair thinning, and your part widening. 

There is a connection between female pattern hair loss, PCOS, and androgenetic alopecia. Androgens (“male” hormones, like DHT, dihydrotestosterone) are found in all genders because they help with puberty, libido, and regulating hair growth. With androgenetic alopecia, these hormone levels are overly high, and hair loss can happen as a result (Astapova, 2019). 

People with PCOS have higher levels of androgens than is typical for most people with ovaries, causing scalp hair thinning and hair loss. Between 20–30% of people with PCOS have female pattern hair loss (Carmina, 2019).

If you lose your hair from PCOS, it probably won’t grow back by itself. You’ll need to use some treatments to stimulate new hair growth. 

A hormonal imbalance causes PCOS, so it stands to reason that hormonal treatments may help. You may need to try a few medications for a while before you see results. 

1. Topical treatments

Minoxidil (Rogaine) 5% is an FDA-approved drug used to treat female pattern baldness and hair loss. You put this topical treatment on your scalp every day. It helps to regrow hair. Many experts agree that topical minoxidil should be used first before other therapies (Carmina, 2019).

2. Oral contraceptives

Birth control pills or oral contraceptives decrease androgen hormone levels. They are used to treat other PCOS symptoms like acne and to regulate irregular menstrual periods. Some healthcare professionals prescribe a birth control pill together with another anti-androgenic medication for hair loss (Gainder, 2019).

3. Antiandrogens

Spironolactone (Aldactone) is a diuretic approved by the FDA to treat edema (fluid retention). It is also used to treat PCOS hair loss and acne because it blocks androgens. Studies show that 44–74% of people with female pattern hair loss who took spironolactone saw improvement in their hair loss. You may need to take this medication for a while before you see results (Carmina, 2019). 

Flutamide is another drug that’s a pure antiandrogen, sometimes used in hormonal-based cancer treatment. While it does show promise for female pattern hair loss, it may cause severe liver damage in rare instances (Carmina, 2019).

 4. Finasteride and dutasteride

Propecia (finasteride) and Avodart (dutasteride) are two hair-regrowth oral medications approved by the FDA to treat male pattern baldness and hair loss. While they may work for some, they have unwanted side effects for biologically born women, potentially limiting their use (Iamsumang, 2020).

5. Platelet-rich plasma (PRP)

PRP is where your blood is drawn, spun down to concentrate the platelets inside, and then this concentrate is injected into your scalp wherever there is thinning or hair loss. More research is needed to see how well this works for PCOS-caused hair loss (Girijala, 2018).

 6. Low-level laser light therapy

Red, near-infrared, or low-level light therapy may help with stimulating hair growth. There is conflicting evidence, with some studies showing it helps and others that show no difference (van Zuuren, 2016). Clearly, more research is needed. 

7. Hair transplants

Hair transplants are surgical procedures where hair follicles are removed from an area with a lot of hair and then transplanted to where you have hair loss. You may need a few procedures to regain fullness. There’s no guarantee it will work, and it is costly (Carmina, 2019).

There are home remedies or natural ways to lessen the effects of high androgen levels on your hair.  

Diet

High-fiber foods help lower the impact of PCOS-induced high blood sugar. Though it doesn’t directly affect hair loss, decreasing the symptoms and side effects of PCOS may help you keep the hair you currently have (Cutler, 2019). 

Weight loss 

If you have excess body fat (common with PCOS), losing weight may help to lower androgen levels, reducing PCOS symptoms and decreasing hair loss. Even minimal weight loss can help (Cutler, 2019).

Supplements

Vitamins, including C, D, and biotin, a water-soluble B vitamin, are associated with healthy hair growth (Bassino, 2020). Zinc, a mineral, may also help with PCOS hair loss and hirsutism (Carmina, 2019).

Some people with female pattern hair loss have been found to have low iron levels. While there aren’t many studies showing iron helps with hair loss, it may help to supplement, especially if your iron levels are lower than average (Carmina, 2019). However, iron overdose can have serious consequences, so be sure not to exceed daily recommended levels or speak with a healthcare professional before beginning any supplements. 

Sadly, once you lose hair from PCOS, it is very difficult for it to grow back. If the appearance of your hair bothers you, you may consider using a few of these tricks to help hide thinning hair or hair loss (Jackson, 2019):

• Try a layered hairstyle to add fullness.

• Add highlights and lowlights to add dimension to your hair.

• Use volumizing hair products, including shampoo, conditioner, and styling products, to make your hair look thicker.

• Put hair fibers or root cover-up products to match your hair color.

• Part your hair differently or get bangs.

• Use wide, soft, and stretchy headbands to cover thinning or balding areas.

• Wear scarves, caps, or hats.

• Match your hair color with a partial wig (also called a fall or a topper) to put on top of your thinning areas. They come in different sizes and styles to suit your particular needs.

• You may wish to invest in a full wig if your hair loss is very noticeable and it bothers you. 

• Don’t use hair extensions, partial wigs, or full wigs with clips as these may pull out your hair, resulting in more hair loss. Instead, you may want to use a velvet headband called a wig grip to keep the hairpiece on without damaging existing hair.

If you’ve been diagnosed with PCOS-related hair loss, it may feel overwhelming. Hair is a prominent part of many people’s identity. In addition to the tips above, you may even consider finding a support group to help you with the emotional impact of your hair loss. Speak with your healthcare provider about medical treatments and lifestyle modifications that help you look and feel your best. 

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

September 07, 2021

Written by

Tobi Ash, MBA, RN, BSN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.