PCOS & Hair Loss

PCOS symptoms are no fun to live with. Hair loss is a common side effect that comes along with high androgens experienced by a majority of PCOSers. It is one of the more frustrating symptoms to deal with.

Everyone sheds hair: in fact, it is normal to lose around 50 to 100 strands each day (1). And,  women tend to lose more hair than men due to heat, styling, and hair colorings. That can make it difficult to diagnose and treat hair loss; many factors can contribute to increased shedding, and it often takes months to see an improvement once you make a change. For that reason, patience is key.

In this article we’ll be exploring:

• What are signs I am experiencing atypical hair loss, also known as male-pattern hair loss or androgenic alopecia?
• Why may I be experiencing male-pattern hair loss?
• What is the connection between our hair and hormones? How can PCOS contribute to male-pattern hair loss?
• What are my treatment options?

Signs of atypical hair loss

As mentioned, we all lose hair daily, and it can be difficult to determine when we verge from “normal” shedding into an “atypical” realm. That said, general signs that we may be experiencing an atypical amount of shedding include:

• Visible thinning: Gradual thinning on the top of your head, either at the hairline or a broadening part in the hair.
• Visible bald patches: Circular or patchy bald spots on the scalp or eyebrows, which may be itchy or painful before the hair falls out.
• Increased shedding: Handfuls of hair coming out while combing, washing, or gently tugging. Losing over 100 strands per day is considered higher than normal.

Why is this hair loss happening?

PCOS can contribute to hair loss, but so can other triggers. Let’s take a look at the various causes of hair loss below:

• Family history: Androgenic alopecia is the term used for gradual baldness that occurs in predictable patterns with aging.
• Stress or illness: Oftentimes, people experience a period of intense shedding about three months after a stressful event, which can trigger a large proportion of our locks to go into their “resting mode” prematurely and all shed at a relatively similar time. This is called telogen effluvium and is distinct from androgenic alopecia; in most cases of telogen effluvium, one’s hair will return in time. That said, chronic stress over a longer period of time, as well as overexercising or under-eating, illness, and radiation can all contribute to more gradual hair thinning or loss. This illustrates how stress on our body can be reflected in our hair: energy is diverted away from growth and toward survival if we are under high amounts of pressure.
• Hormonal changes: Hormonal changes and medical conditions such as pregnancy, childbirth, menopause, thyroid problems, and immune disorders are common culprits for temporary and permanent hair loss. PCOS falls into this bucket.
• Nutrient deficiencies: Oftentimes seen alongside hair loss that accompanies stress or hormonal changes, nutrient deficiencies can also contribute to increased hair shedding. Several nutrients that are key to hair health include ferritin (iron), B vitamins, and Vitamin D. Be sure to work with a medical provider before beginning any supplementation.
• Styling: Sometimes harsh products, bleaches, and styling products can damage our hair or scalp and lead to hair loss. In these cases, discontinuing use of the products or treatments that are aggravating your body should result in increased hair growth.

The hormones and hair connection

Our hormones have a strong effect on our hair. Below is a quick overview of how female reproductive hormones impact hair growth and loss:

• Estrogen and progesterone help to keep our hair thick and strong by stimulating and prolonging growth.
• During pregnancy, the increased supply of estrogen and progesterone stimulates the anagen (rapid growth) phase. This is often why pregnant women sometimes appear to have shinier and fuller hair during pregnancy.
• During the postpartum period, our bodies have to re-equilibrate to lower estrogen and progesterone levels, therefore hair loss and slowed growth is more common.
• Just like the postpartum hormonal drop can cause hair loss or thinning, so can menopause. Estrogen and progesterone fall, decreasing the period in which hair, skin, brain cells, bones, heart, and other tissues grow.
• Dihydrotestosterone (DHT), a derivative of testosterone, can induce hair follicles to become progressively weaker by stimulating the telogen (shedding) phase in the scalp.
• Individuals with higher testosterone levels, such as people with PCOS, can lose hair on their scalp, and grow hair in alternative places such as the face, chest, and back.
• During hypothyroidism, or underactive thyroid activity, non-essential processes such as hair growth can be stunted. This can lead to dry, brittle, thinned hair.

Treatment Options:

Hair loss can be a difficult symptom to see improvement with because of how long it takes our hair to grow. That said, with patience and consistency many people with PCOS are able to improve their hair loss and in many cases reverse this symptom with increased hair growth.

In general, there are two main treatment methods you can pursue: hormonal therapy, addressing nutritional deficiencies, and more holistic treatments. If you would like to explore any of these treatment options, be sure to bring it up with your Pollie care team!

Hormonal Therapy: Supplementing hormones, such as estrogen, progesterone, or thyroid hormone can help stimulate growth periods at the follicular level and counteract hormonal imbalances. Before beginning hormonal treatments, it is important to confirm with laboratory tests and your healthcare provider.

Essential Vitamins from Nutritional Deficiencies: Nutritional deficiencies can result from poor diet or under-fueling, gut issues, hormonal imbalances, and stress. Several common deficiencies that can lead to hair loss include inadequate levels of ferritin, Vitamin B12, and Vitamin D.

• Iron / Ferritin: Ferritin, a derivative of iron, is a part of the structure that holds hair into their follicles. When the body is low in iron or ferritin it can strip the substance from nonessential locations such as hair follicles and lead to hair loss.

• Vitamin B12 / Cobalamin: Similar to ferritin, vitamin B12 is essential for maintaining strong hair follicles. A deficiency in B12 can lead to stunted hair growth, and can be counteracted with supplementation.
• Vitamin B7: Also known as biotin, this vitamin can stimulate keratin production and increase rate of follicle growth for the hair.

• Vitamin D3: Along with many other functions, vitamin D3 plays an important role in stimulating new hair follicle growth. Studies have shown that women with significant hair loss conditions also have vitamin D deficiencies. When taking fat soluble vitamins such as vitamin D3, be sure to speak with your physician first and even get your labs drawn. Unlike water soluble vitamins, fat soluble vitamins are not excreted in our urine and an excess can lead to additional problems! 

Holistic treatments: There are bountiful options for treating hair loss that center on lifestyle and more “woo woo” treatments. From a lifestyle perspective, diet optimization and stress management are key. Holistic treatments such as acupuncture, energy healing, and vitamin IV drips have also been said to help hair loss. Be aware that these methods can sometimes require more patience, but are a good path to pursue if you do not want to be on medication. Your coach can help you adjust your lifestyle with the goal of improving your hair health, and your Pollie care coordinator can help you find holistic providers if you would like to dip your toes into alternative treatments.

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