How Does PCOS Cause Hair Loss?

The role of PCOS in hair loss is multilayered, with several underlying factors. In short, PCOS hair loss may be caused by a combination of too many androgens, too little oestrogen, and the body’s inability to handle insulin well. 

Too many androgens

In 2019, the Multidisciplinary Androgen Excess and PCOS Committee appointed a team of dermatology, endocrinology, and reproductive endocrinology specialists to complete a major report on androgen excess, PCOS, and hair loss. 

This report found that women with hyperandrogenism (too many male hormones) have higher levels of potent androgens like DHT that may play a role in female pattern hair loss.

But even with this evidence, scientists don’t yet know exactly what role these androgens play in women’s hair loss. 

It may have something to do with the way these androgens can shorten the growth phase of the hair growth cycle and delay regrowth. 

Find out how DHT causes hair loss. 

Insulin resistance

According to Associate Professor of Endocrinology Paolo Moghetti, up to 70% of women with PCOS may be insulin resistant — meaning the body can’t handle insulin the way it should. 

When your body struggles with insulin, your blood sugar levels rise, damaging blood vessels — including those that deliver nutrients and oxygen to your hair follicles. 

This can disrupt the hair growth cycle, slow hair growth, and cause follicles to shed hair prematurely. 

To make matters worse, high insulin levels (caused by insulin resistance) can trigger the body to make more androgens, creating a vicious cycle that does no favours to your hair follicles. 

Lower oestrogen levels

Women with PCOS may also have lower oestrogen levels, which can be a setback since oestrogen is known to protect hair follicles from androgens.

Recognising the Symptoms of PCOS-Related Hair Loss

PCOS hair loss symptoms will be different for everyone, and not all women with PCOS will experience hair loss at all. But here are some of the  most common signs of hair loss from PCOS:

• Gradual thinning across the scalp, especially on the crown and hairline
• A noticeably wider central part
• Increased hair shedding when brushing or washing
• Brittle, lacklustre hair prone to breakage
• Dry, damaged, or frizzy hair
• Dandruff

If you haven’t been diagnosed with PCOS but you suspect you may have it, look out for other symptoms that may coincide with hair loss, including:

• Acne
• Excess sebum (oil) on the skin
• Dark, dry patches of skin
• Weight gain
• Irregular periods
• Infertility
• Excess body hair growth (hirsutism)
• Pelvic pain

While PCOS hair loss is generally slow, it can worsen over time, which is why getting early treatment is so important.

Effective Treatments for PCOS Hair Loss

The best treatment for PCOS and hair loss is one that’s personalised to your needs. Wondering how to reverse PCOS hair loss? It often combines medication with lifestyle changes to address both the underlying cause and the symptoms. 

Medical Interventions

If PCOS is the root cause of your hair loss, treating the condition may indirectly help stop or reverse the hair loss. It’s best to work with a healthcare provider or specialist to find the right treatment plan for you.

Many women with PCOS are prescribed hormonal birth control pills to help lower their testosterone levels. This may help manage hair thinning, although the pill is generally more helpful for treating hirsutism than hair loss. 

PCOS hair loss treatments are often the same as those used for female pattern hair loss, since this is the hair loss condition most commonly associated with PCOS. 

Antiandrogens are the most common hair loss treatment. They help block the conversion of testosterone into DHT, the hormone responsible for hair loss. But there’s a catch — they’re not usually prescribed to premenopausal women. 

That’s because they’re generally not safe for women who are pregnant or may become pregnant, as they can cause birth defects in male babies.

Despite this, spironolactone is an off-label antiandrogen drug that’s sometimes used to treat female pattern hair loss. 

Research from the Harvard Medical School shows it can prevent further hair loss and contribute to thicker hair for about 40% of women with female pattern hair loss.

Spironolactone can help stop hair loss but it’s often prescribed in combination with a topical medical treatment like minoxidil to also help stimulate hair regrowth.

Topical Treatments

Specialists from the Multidisciplinary Androgen Excess and PCOS Committee have outlined their recommendations for treating female pattern hair loss associated with androgen excess. This is what they say:

‘Treatment of FPHL should start with minoxidil (5%), adding 5a-reductase inhibitors or antiandrogens when there is severe hair loss or hyperandrogenism.’

Minoxidil is an over-the-counter topical solution you apply to your scalp once or twice daily. It relaxes and enlarges blood vessels in the scalp, improving the flow of oxygen and nutrients to your hair follicles. 

While it’s more commonly used for male pattern baldness, it can also be used for female hair loss at a lower dose — but it’s still important to avoid it if you are pregnant, planning to get pregnant, or breastfeeding.

Lifestyle Modifications

Managing PCOS is key to preventing PCOS-related hair loss. But you can further reduce the risk of hair loss and better support your long-term hair health with a few simple lifestyle changes. 

Nutrition plays a big role in both managing the syndrome and supporting hair health. A balanced diet that limits processed foods can help manage insulin levels and reduce the hormonal imbalances that exacerbate PCOS-related hair thinning. 

Another important factor is exercise. 

In 2024, Exercise and Sports Science Australia stated that exercise routines “are considered first-line strategies in PCOS management due to their therapeutic effects on various health outcomes and quality of life”.

While exercise is naturally great for overall health, for women with PCOS, it can also help improve insulin sensitivity, which may have a flow-on effect on your hair. 

Lastly, stress is a known hormone disruptor and can worsen PCOS symptoms, including hair loss. Practices like yoga, meditation, and deep breathing can help regulate cortisol levels and support your overall wellbeing — both inside and out.

Preventing and Reversing PCOS Hair Loss

Alongside professional PCOS hair loss treatment, some simple lifestyle tweaks may help support your body, prevent further hair loss, and create the best conditions for hair to grow. 

So, how to manage PCOS hair loss — or even prevent it in the first place?

Nutrition is really important here because PCOS isn’t just about hormonal challenges; it also messes with the metabolism. 

That means women with PCOS are more likely to deal with things like obesity, insulin resistance, systemic inflammation, and metabolic syndrome — or even a combination of these. 

Your nutritional intake doesn’t just impact your overall health. It even influences your hair’s health. That’s why diet may have a big role not just in managing PCOS but also in improving the health of your hair. 

Clinical dietitian Amanda Stathos from Johns Hopkins’ Sibley Memorial Hospital recommends a Mediterranean diet for women with PCOS. 

Focus on whole, unprocessed foods — especially those rich in biotin, zinc, and protein. Inflammation can exacerbate PCOS hair loss, so focus on foods rich in anti-inflammatory omega-3 fatty acids like fatty fish, flaxseeds, and walnuts.

But before you start popping supplements like there’s no tomorrow, be sure to consult with your doctor. You should only take supplements if you have a nutrient deficiency, which a blood test can help identify. 

Your daily haircare routine can also play a role in your hair health. Some things to consider to nurture your strands:

• Minimise heat styling tool usage, which can weaken hair strands and accelerate breakage.
• Avoid harsh chemical treatments like colouring and bleaching.
• Switch to sulphate-free, gentle shampoos designed for thinning hair.
• Use wide-toothed combs and natural bristle brushes to prevent unnecessary pulling.
• Avoid tight hairstyles that place tension on hair follicles.
• Allow hair to air dry whenever possible to reduce heat damage.

Some home remedies can help support follicle health. But for many women, clinical solutions are still the missing piece. 

One of the most important steps in combating PCOS-related hair loss is seeking professional medical advice at the first signs of hair thinning. 

A doctor can help you address any underlying hormonal imbalances (particularly excess androgens) before you experience major hair loss — which is a good thing because catching it early can dramatically improve your outcome.

A doctor can also create a treatment plan to address PCOS-related hair loss — one that incorporates prescription medication as well as lifestyle changes. The Hairy Pill® may be another option for you, providing a personalised, medically-backed treatment for female pattern hair loss. Find out if it’s right for you.

PCOS Hair Loss Regrowth Success: What to Expect?

The journey to healthier hair with PCOS requires patience, consistency, and a multi-faceted approach that usually combines medical intervention, nutrition, and proper scalp care. 

If you aim to nurture your hair follicles back to good health, it’s important to remember that this takes time.

A big part of any successful treatment will depend on how well you can manage hormonal imbalances, which can require some trial and error with a doctor in the beginning. 

It takes time for your hair growth cycle to correct course once your hormones are managed, and then more time again before you start to notice any new growth. 

Think watching grass grow or paint dry is bad? Hair growth takes much, much longer — it may take 3–6 months, or even longer, before you see any improvement.

When to See a Doctor?

Thinning hair caused by PCOS can be stubborn, but while some amount of hair shedding is normal, significant hair loss or visible patches of scalp may signal that something else is going on. 

Here are some signs that it’s time to see a doctor about your PCOS hair loss:

• Persistent hair loss — despite lifestyle changes, hormonal treatments, or topical solutions
• Bald patches — your scalp becomes visible through your hair
• Excess shedding — excessive amounts of hair on the pillow and brush or in the shower drain
• Worsening PCOS symptoms — such as irregular menstrual cycles, unexplained weight fluctuations, increased facial or body hair growth, or acne flare-ups

Recognising these warning signs can help you take timely action before your hair loss progresses too far.

A good starting point is to book an appointment with your OB-GYN or a reproductive endocrinologist, especially if you’re also noticing other PCOS symptoms worsening.

You might also want to speak with a dermatologist or trichologist (a hair and scalp specialist) if your hair loss is impacting your daily life or self-esteem. 

Finding the right combination of treatments may involve some trial and error, but with the right medical guidance, it is possible to reverse PCOS hair loss.

The key is not to delay seeking professional help since earlier intervention typically leads to a better chance of hair regrowth.

FAQs

1. Can PCOS hair loss be temporary, or will it get worse over time?

Yes, PCOS hair loss can be temporary, especially if caught and treated early. Left untreated, hair loss can gradually worsen over time, especially if excess androgens continue to affect the hair follicles.

That’s why it’s so important to see a doctor as soon as you notice any hair thinning. 

There’s no such thing as a PCOS hair loss cure. But with the right treatment, hair thinning caused by PCOS can be slowed, halted, and even reversed. The key is to treat the underlying cause: hormonal imbalance.

Many women see significant improvement in hair thickness and regrowth once their hormone levels are stabilised. But it’s important to remember that hair regrowth takes time — it may be months before you notice any improvement.

2. How does weight gain impact hair thinning in women with PCOS?

Weight gain doesn’t cause PCOS hair loss, but it can make it worsen by increasing insulin resistance and levels of androgens (male hormones like testosterone). 

A 2006 literature review confirmed that weight gain can increase androgen levels in women. Meanwhile, the 2019 Netherlands Epidemiology of Obesity study found that gaining a lot of weight in adulthood greatly increases your risk for insulin resistance — that is, your body’s ability to manage insulin well. 

Here’s why that matters:

When insulin resistance increases, your body makes more insulin to compensate. These elevated insulin levels stimulate your ovaries to produce excess androgens. 

Some androgens are then converted to dihydrotestosterone (DHT), which causes hair follicles to shrink and produce thinner, weaker hair — eventually leading to more pronounced hair thinning.

Here’s the thing: Insulin resistance is common in PCOS, affecting most women with the condition, regardless of their body weight. 

Weight gain just amplifies the problem. 

That’s why a healthy diet and regular movement can be valuable components of a PCOS management plan. 

3. Are genetics a factor in how severely PCOS affects hair?

Yes, your genes can play a role in how severely PCOS affects your hair — but it’s not the whole story. 

PCOS has a genetic component, with researchers identifying several genes linked to the condition. But the severity of PCOS-related hair thinning depends on a range of factors — both genetic and otherwise — including: 

• Your baseline androgen levels
• Your body’s sensitivity to hormonal fluctuations
• How sensitive your hair follicles are to androgens
• How your body processes and responds to insulin
• Your natural hair growth cycle

It’s also worth noting that some women may inherit both PCOS and a separate genetic predisposition to female pattern hair loss — which might also worsen hair loss symptoms. 

These built-in traits can help explain why some women with PCOS barely notice hair changes, while others find hair thinning to be one of the most distressing symptoms of PCOS.

4. Can scalp massages or microneedling help with PCOS hair regrowth?

Scalp massages and microneedling are popular recommendations for women with PCOS hair loss. But are they effective?

According to a 2021 systematic review, several studies have shown that using microneedling in combination with a topical treatment has helped promote new hair growth. 

Meanwhile, multiple studies have shown that scalp massages help increase blood flow to the scalp, helping deliver much-needed nutrients and oxygen to your follicles. 

Despite this, it’s important to note that such approaches may not work with more severe PCOS hair loss, which may require medical intervention. 

5. Are there any natural ways to balance hormones and reduce PCOS hair thinning?

Yes, you may be able to make some natural changes in your life to better balance your hormones, which may, in turn, reduce PCOS hair thinning. 

To naturally balance your hormones, Healthline recommends a mixture of dietary and lifestyle changes. 

Many of the dietary recommendations for balancing hormones revolve around reducing insulin resistance. These include maintaining healthy gut bacteria, eating foods high in fibre, reducing your intake of refined sugar, and eating more healthy fats.  

Protein is essential both for hair growth and for protein-derived hormones (called peptide hormones).

Other recommendations linked to both hormonal regulation and hair growth include making sure you get enough exercise, reducing stress, and aiming for 7–8 hours of sleep per night.