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While it’s mostly the dudes out there who feel the cold glare of judgment on their bald scalps, the fact is that hair loss in women is a more common condition than you might suspect, especially when it comes to conditions like female pattern baldness.
Female pattern baldness (which is also known as androgenic alopecia or androgenetic alopecia) is a condition in which your androgen levels begin to damage and eventually kill your hair follicles. One of the things that might cause this condition is polycystic ovary syndrome, or PCOS.
If you’re dealing with both PCOS and hair loss and think they might be connected, you probably have a number of questions. We’ve answered the most common ones below, specifically what PCOS is, why it causes hair loss and how that hair loss can and should be treated.
Polycystic ovary syndrome — sometimes called polycystic ovarian syndrome — is common, with some reports showing it affects five to 10 percent of women between the ages of 15 and 44.
This condition is caused by a hormonal imbalance. With PCOS, your ovaries may produce an abnormally high amount of certain hormones, like male sex hormones (androgens) and insulin.
These hormones can:
Affect your reproductive health
Elevate your risk of type 2 diabetes
Cause a wide range of different symptoms
There are many symptoms of polycystic ovary syndrome — some people may have many, while others only have a few symptoms or minor symptoms. You may need to talk to a dermatology or endocrine specialist if you’re experiencing any of the following:
Darkening skin around the neck, groin and the area under the breasts
Weight gain around your abdomen
Oily skin and frequent acne breakouts
Difficulty becoming pregnant, or infertility
Irregular, very light or missed periods
Large ovaries and the development of cysts on the ovaries
Excess body hair growth (facial hair included) in a male-like pattern, called hirsutism
A higher risk of miscarriage or complications during pregnancy
Skin tags around the neck and/or armpits
PCOS may increase your risk of other health issues like high cholesterol, sleep apnea, diabetes, hypertension (high blood pressure) and endometrial cancer. It’s also associated with mental health disorders like depression and anxiety.
Experts don’t yet know what causes polycystic ovary syndrome, but it may be related to digestive health (specifically insulin resistance), obesity or genetic factors.
If you have PCOS, your testosterone levels could exceed the normal range for women, which tees you up for hair loss.
Androgens like testosterone can cause virilization, or the development of masculine characteristics, such as body hair or a deeper voice. And yes, they can also cause hair loss, — it happens when your body converts testosterone into dihydrotestosterone (DHT), which causes hair follicle miniaturization and, eventually, hair loss.
While this type of hair loss is similar to male pattern baldness, symptoms in women typically include:
Visible thinning near your part line
Diffuse thinning across your entire hairline
There’s no cure for polycystic ovary syndrome and the hair you lose generally won’t grow back on its own — or at all if you leave it untreated for too long. Luckily, there are several medications and other treatment strategies available to help with PCOS symptoms like hair loss.
Your healthcare provider may prescribe one or more of the following medications for PCOS symptoms:
Hormonal birth control. Believe it or not, birth control may help with PCOS. The pill, patch, vaginal ring, injection or hormonal intrauterine device (IUD) may improve acne, reduce body hair and lower your risk of PCOS complications such as endometrial cancer.
Anti-androgen medications. Anti-androgens lower your production of male sex hormones or block their effects. This may prevent hair loss, acne, excessive hair growth and other PCOS symptoms. Spironolactone, for instance, is often used off-label for this reason.
Diabetes medications. If you have insulin issues, medications for diabetes, like metformin, may be used off-label to lower insulin resistance, which can help with symptoms.
Medications that induce ovulation. Meds that induce ovulation may also treat some symptoms — but we need to note they can increase your risk of getting pregnant.
Changing certain habits and lifestyle behaviors may help to make your symptoms of PCOS less severe. You can try:
Managing your weight. If you’re obese, losing weight may help to make your symptoms less severe, as it can lower your levels of androgens and insulin and help regulate your menstrual cycle.
Maintaining a healthy diet. Making certain changes to your diet can facilitate weight loss and generally improve your health.
Exercising on a regular basis. Regular exercise may reduce your risk of developing hypertension, high cholesterol and other issues commonly linked to polycystic ovary syndrome.
If you have noticeable hair loss from polycystic ovary syndrome, treatments that may help include:
Minoxidil. This FDA-approved medication works by stimulating blood flow to your hair follicles, which encourages them to enter the growth phase. We offer a specially formulated 2% minoxidil for women online.
Finasteride. Research says finasteride is effective at treating some aspects of PCOS, but it’s not FDA-approved for women and isn’t typically used for PCOS. Postmenopausal women may safely use products like our topical finasteride and minoxidil spray, though.
Hair transplants. For severe hair loss, a hair transplant takes hairs from other areas of your scalp and moves them to areas with noticeable thinning. This type of procedure can cost thousands of dollars and is typically used to treat severe, easily noticeable hair loss.
The following tips won’t treat polycystic ovary syndrome, but they can help women fighting the hair loss battle make signs of thinning less obvious:
Try parting your hair differently. Moving your part can make thinning hair much less obvious.
Use volumizing hair products. Volumizing conditioners, shampoos, sprays, mousses and other products can create the appearance of thicker hair.
Choose a haircut that makes hair loss less visible. A new hairstyle may help you conceal bald or thinning spots. For example, bangs draw attention away from your forehead and layered cuts can hide thinning hair.
We’re not really the type of folks to hammer on one particular way to handle female pattern hair loss, whether it’s PCOS-related hair loss or not. The fact is that the internet is full of supplements, medications like Rogaine (the brand-name version of minoxidil) and other products claiming to fix everything.
Some may see a lot of benefits and few side effects from an oral contraceptive; others may see their lower androgen levels and the return of healthy hair with other medical treatments.
Here’s what we know for sure:
Polycystic ovary syndrome can cause many symptoms, including hair loss, that may worsen over time.
If you’ve been diagnosed with polycystic ovary syndrome and have noticeable hair loss, it’s best to talk to your healthcare provider as soon as possible.
While many hair loss treatments may help you deal with PCOS symptoms, the right treatment options for your individual needs will ultimately come from the recommendation of a dermatologist or other healthcare professional.
Hair loss treatments are important, but treating the root causes of hair loss is key for the long term. That means that an endocrinologist or OB/GYN may have to help you in your hair health journey by treating your hormone levels.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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