Research
PCOS Hair Loss: Causes and Solutions
Learn how hormonal imbalances and lifestyle choices contribute to PCOS-related hair loss and explore effective treatments and care strategies.
June 7, 2025
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Learn how hormonal imbalances and lifestyle choices contribute to PCOS-related hair loss and explore effective treatments and care strategies.
Did you know up to 70% of women with PCOS experience hair loss? This condition, called androgenic alopecia, is caused by hormonal imbalances, insulin resistance, and inflammation. The good news? It’s manageable with the right combination of medical treatments, lifestyle changes, and hair care practices.
Here’s what you need to know:
Key takeaway: Early intervention with a tailored approach can slow hair loss and improve overall hair health. Keep reading for a detailed guide on solutions that work.
To understand why PCOS leads to hair loss, it's important to look at the hormonal disruptions happening in the body. Several interconnected factors - like hormonal imbalances, insulin resistance, and low SHBG levels - can interfere with normal hair growth and contribute to this issue.
One of the main reasons for hair loss in PCOS is hyperandrogenism, which refers to an overproduction of male hormones like testosterone. This is a common feature of PCOS.
When testosterone levels rise, the body converts some of it into dihydrotestosterone (DHT). High levels of DHT can shrink hair follicles, shorten the growth phase of hair, and weaken individual strands. This type of hair loss often begins at the mid-scalp or hairline and gradually spreads backward. Interestingly, while up to 70% of individuals with PCOS experience abnormal hair growth, studies also show that androgenic alopecia affects 67% of males compared to 24% of females.
Insulin resistance, which affects between 50% and 75% of people with PCOS, plays a significant role in worsening hair loss. When cells become resistant to insulin, the body compensates by producing even more of it. This excess insulin stimulates higher androgen production, while chronic inflammation and oxidative stress further disrupt hair growth.
Women with PCOS often have elevated levels of C-reactive protein (CRP), an inflammatory marker that interferes with the natural hair growth cycle by pushing more hair into the resting phase. Additionally, frequent blood sugar spikes increase oxidative stress, which can damage hair follicles. Low SHBG levels compound the issue by amplifying the effects of androgens on hair.
SHBG is a protein that helps regulate hormone activity by binding to excess hormones in the bloodstream. In PCOS, SHBG levels often drop, leaving more free testosterone available to act on hair follicles. This creates a double problem: not only are androgen levels elevated, but the body also lacks enough SHBG to keep them in check.
Estrogen plays a role in boosting SHBG production, but PCOS-related anovulation reduces estrogen levels, which in turn lowers SHBG production. This allows even normal testosterone levels to cause noticeable hair thinning.
The combination of high androgen levels, insulin resistance, inflammation, and low SHBG levels explains why hair loss in PCOS can be so persistent. Addressing these multiple factors is often necessary to manage the condition effectively.
Addressing PCOS-related hair loss often means tackling the underlying hormonal imbalances. Here's a closer look at how specific medical treatments target these hormonal drivers.
Spironolactone is a popular choice for managing PCOS-related hair loss. While originally designed as a diuretic for high blood pressure, it also lowers androgen levels by curbing the production of male hormones. Typical doses range from 100–200 mg daily, though some patients start at 25 mg to minimize side effects. Results usually begin to show after six months, with full effects noticeable by the one-year mark. According to a 2023 review, 43% of individuals with female pattern hair loss saw improvement with spironolactone alone, and up to 66% benefited when it was combined with other treatments. Another study found that over 74% of patients experienced improvement or stability in their hair loss.
Common side effects include nausea, dizziness, irregular periods, and drowsiness. More serious risks involve elevated potassium levels, so it's important to avoid potassium-rich foods and stay hydrated while on this medication. Since spironolactone is unsafe during pregnancy, effective birth control is essential. Discuss options with your doctor to ensure safety and effectiveness.
Minoxidil is the only FDA-approved topical treatment for female pattern hair loss. Originally developed to manage high blood pressure, it promotes hair growth by extending the anagen (growth) phase of hair follicles.
"In people with female pattern hair loss, the hairs shift out of the anagen phase." – Dr. Erika Elliott, Associate Program Director of Dermatology at Tufts University School of Medicine.
Available as a topical solution (like Rogaine) and as an off-label oral medication, minoxidil offers flexibility in treatment. For the topical form, apply it twice daily to a dry scalp, massaging it in thoroughly, and avoid washing your hair for at least four hours afterward. Clinical studies show that about 80% of patients using oral minoxidil experienced hair growth within six weeks. Doses ranging from 0.25–1.25 mg daily have demonstrated improvement in 61–86% of patients with female pattern hair loss.
Topical minoxidil may cause scalp irritation or itching, while oral forms can lead to side effects like unwanted hair growth on the face and temples, as well as cardiovascular symptoms such as a rapid heartbeat or swollen ankles.
Birth control pills are often recommended for PCOS-related hair loss because they address multiple symptoms simultaneously. Combined oral contraceptives, which include both estrogen and progestin, help regulate menstrual cycles, prevent ovulation, and lower androgen levels. As Dr. Jane Frederick, an OB-GYN and reproductive endocrinologist at HRC Fertility, notes:
"Combining medications often yields the best results."
Choosing the right pill is critical. Options with a higher estrogen-to-progestin ratio are often preferred, especially if there is a family history of hair thinning. However, progestin-only pills or hormonal IUDs with androgenic effects could potentially worsen hair loss.
Metformin, a drug commonly used for type 2 diabetes, can also play a role in tackling PCOS-related hair loss. By improving insulin sensitivity, metformin helps reduce the insulin resistance that contributes to elevated androgen levels. This, in turn, can support better hair health. Some studies even suggest a reduced risk of hair loss with metformin use. However, metformin may interfere with vitamin B‑12 absorption, so it’s worth checking your levels if hair loss persists.
For the best results, these treatments are most effective when paired with lifestyle changes. Your doctor can guide you in finding the right combination of therapies tailored to your hormone levels and specific needs.
In addition to medical treatments, making adjustments to your daily habits can significantly improve results. Lifestyle and diet changes can directly influence hair growth and help reduce PCOS-related hair loss. Since insulin resistance is a common issue in PCOS, tackling these metabolic challenges through a thoughtful diet and lifestyle approach is key to supporting healthier hair. Below, we’ll explore how nutrient intake, weight management, and blood sugar control can contribute to better hair health.
Hair follicles thrive on specific nutrients like zinc, iron, biotin, omega-3 fatty acids, vitamin D, vitamin C, niacin, and vitamin E. Deficiencies in these nutrients can worsen hair loss, and women with PCOS are especially prone to missing key minerals like zinc. These nutrients are essential for maintaining healthy hair follicle function.
| Nutrient | Benefits for Hair | Food Sources |
|---|---|---|
| Zinc | Regulates androgen levels, reduces hair loss | Nuts, shellfish |
| Iron | Carries oxygen to hair follicles | Red meat, spinach, lentils |
| Biotin | Supports keratin production | Eggs, salmon, avocados |
| Omega-3 Fatty Acids | Reduces inflammation, improves insulin resistance | Fatty fish, walnuts, flaxseeds |
| Vitamin D | Reduces inflammation, supports follicle cycling | Fatty fish, fortified dairy, sunlight |
| Vitamin C | Lowers testosterone, boosts iron absorption | Citrus fruits, berries, bell peppers |
Beyond nutrients, addressing weight and inflammation can further aid in hair regrowth.
Losing even a small amount of weight - just 5% of your body weight - can improve hormone levels and hair health. For example, if you weigh 160 pounds, losing 8 pounds could make a noticeable difference.
Inflammation is another factor closely linked to hair loss in PCOS. Amanda Stathos, M.S., R.D., L.D.N., explains:
"Research shows that people with PCOS show evidence of all-over inflammation, which is associated with heart disease and other illness. The Mediterranean diet eliminates saturated fats, processed meats and refined sugar, which makes it a powerful tool to address inflammation".
Incorporating anti-inflammatory foods into your diet can help. Focus on options like omega-3-rich fish (salmon, sardines), olive oil, beans, non-starchy vegetables, whole grains, and fresh fruits. At the same time, limit foods that promote inflammation, such as fried items, processed meats, sugary snacks and drinks, refined flour products, and excessive alcohol.
Exercise is another tool to improve insulin sensitivity and overall health. Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous exercise per week, paired with resistance training twice a week.
Since insulin resistance affects up to 80% of people with PCOS, managing blood sugar is crucial for reducing hair loss. When blood sugar spikes and crashes, insulin levels increase, which can elevate androgen levels and worsen hair loss.
Dr. Shruthi Mahalingaiah, MD, MS, offers insight into how timing plays a role:
"Health optimization in people with PCOS is sensitive to a lot of things - especially the things we eat and drink, our sleep-wake cycle, and physical activity".
To stabilize blood sugar, prioritize low glycemic index (GI) foods and balance meals with protein, healthy fats, and fiber. Amanda Stathos, M.S., R.D., L.D.N., recommends eating smaller, balanced meals every four hours:
"The goal is to keep blood sugar stable and avoid large fluctuations. Smaller, more frequent meals can really help, combined with balanced snacks so you're eating about every four hours".
Swap high-GI carbs like white bread or sugary cereals for options like quinoa, sweet potatoes, or steel-cut oats. These choices allow for a gradual rise in blood sugar, improving insulin sensitivity over time. Pairing fruit with a protein or fat source is another effective way to slow glucose release.
Some foods may also offer added benefits. For example, studies suggest spearmint tea can help lower androgen levels, while flaxseeds might reduce testosterone. A cup of spearmint tea or a tablespoon of ground flaxseeds in a smoothie are easy additions to your routine.
Managing PCOS and hair loss is a gradual process. By combining these dietary and lifestyle changes with medical treatments, you can work toward long-term improvements in both hair health and overall PCOS symptoms.
Addressing PCOS-related hair loss goes beyond medical treatments and dietary adjustments. Taking care of your hair and managing stress can play a big role in supporting hair recovery. Small, consistent changes in how you care for your hair and handle stress can complement your overall treatment plan.
Hormonal imbalances already put stress on your hair, so it’s essential to avoid anything that could make things worse. Chemicals, heat styling, and rough handling can weaken your hair further. When washing your hair, be gentle - skip vigorous rubbing or massaging. Instead, use your fingertips to apply shampoo in soft, circular motions.
After washing, pat your hair dry with a cotton towel for 10–20 minutes rather than rubbing it. Use your fingers or a wide-toothed comb to detangle, starting at the ends and working your way up to minimize breakage. Let your hair air-dry whenever possible instead of using heat styling tools. If you have long hair, consider trimming it every six weeks or even opting for a shorter style to reduce strain on your follicles.
The products you use can make a big difference. Look for shampoos that contain DHT-blocking ingredients like saw palmetto or argan oil, as well as strengthening agents like biotin or keratin. Natural extracts like caffeine or rosemary oil can also help by improving scalp circulation. Avoid products with parabens, synthetic fragrances, sulfates, and silicones, which can clog hair follicles and hinder growth. As Dr. Kecia Gaither points out, certain ingredients can "cause the follicles to clog and stop producing new hair".
For a gentle routine, wash your hair 2–3 times a week with an anti-hair fall shampoo. You can even dilute the shampoo with water before applying it to reduce irritation.
A 2023 study published in Cureus examined the effects of Dr. SKS Hair Booster Serum, which contains ingredients like copper, niacinamide, biotin, and hyaluronic acid. In a group of 1,000 women with PCOS and female pattern hair loss, six months of monthly treatments led to noticeable improvements in hair thickness, growth, and overall health.
Stress has a direct impact on hair health. Hormones like cortisol can disrupt hair follicle activity, keeping them in a resting phase for longer periods. Managing stress effectively can help restore balance.
Mindfulness practices, such as meditation or deep breathing exercises, are simple yet powerful tools. Even 10–15 minutes a day can make a difference, and meditation apps can provide helpful guidance. Regular physical activity - about 30 minutes of moderate exercise daily - can also reduce stress and improve your overall well-being.
Other relaxation techniques, like progressive muscle relaxation or guided imagery, can help ease tension. Even small joys, like listening to your favorite music, have been shown to lower stress hormone levels and improve mood. Scalp massages are another great way to relax while also promoting hair health. Using natural oils like rosemary or peppermint oil during a massage can boost blood flow to your scalp and stimulate hair follicles.
Managing PCOS-related hair loss is a marathon, not a sprint. Since PCOS is a lifelong condition, keeping your hair health on track requires ongoing effort, regular monitoring, and adjustments along the way. This section highlights strategies to help you stay proactive.
Your healthcare provider is your partner in managing PCOS symptoms, including hair loss. Routine check-ups are essential to monitor hormone levels, identify nutrient deficiencies, and evaluate how well your current treatments are working. The frequency of these visits should be tailored to your unique needs, factoring in your risk factors, other health conditions, and life events.
During these visits, your doctor should discuss how PCOS symptoms are affecting your quality of life, address your main concerns, and prioritize treatments that align with your goals. These conversations ensure your care plan reflects what matters most to you. Comprehensive check-ups that consider both physical and emotional aspects of hair loss are key to effective management.
These regular evaluations set the stage for adjusting treatments and maintaining realistic expectations.
Managing expectations is just as important as managing symptoms. While hair regrowth may not always be possible, slowing or halting hair loss is achievable with the right approach. Keep in mind that hair growth follows a natural cycle, so noticeable changes can take months.
Early intervention and a comprehensive approach can make a significant difference in hair health. The goal isn't necessarily to achieve full regrowth but to see meaningful improvements over time. Staying consistent with your treatment plan, adopting healthy habits, and seeking support when needed can help you manage both the physical and emotional impacts of hair loss.
Patience is key - results take time, and progress may be gradual.
Flexibility is essential when managing PCOS-related hair loss. As your symptoms evolve, new research becomes available, or life circumstances change, your treatment plan may need to be updated. Regular reassessments ensure your care remains effective.
If you notice worsening hair loss, new symptoms, or a lack of results from your current medications, it's time to revisit your plan with your healthcare provider. Treatments like spironolactone or minoxidil often require time to work, but adjustments may be necessary if progress stalls. Your doctor might modify hormone-regulating medications or address other PCOS symptoms, such as insulin resistance or inflammation, to improve overall outcomes.
The goal is to create a treatment plan that adapts as your needs change. What works today might need fine-tuning in the future. Stay connected with your healthcare team, keep an open line of communication, and remain actively involved in your care journey.
Hair loss is a challenge faced by up to 70% of individuals with PCOS. While it can feel overwhelming, the right approach can help you regain control over your hair health and achieve visible progress.
Addressing PCOS-related hair loss requires a well-rounded plan. This often involves combining medical treatments, such as spironolactone and minoxidil, with lifestyle adjustments like stabilizing blood sugar levels, managing stress, and using gentle hair care products. Research indicates that these treatments are generally more effective at slowing the progression of androgenic alopecia than reversing it. That’s why starting early can make a big difference in the outcome.
PCOS impacts up to 15% of females of reproductive age, yet it often goes undiagnosed or untreated for too long. Partnering with healthcare professionals who specialize in PCOS is crucial for developing a treatment plan tailored to your hormonal profile and symptoms.
Managing hair loss tied to PCOS is a journey that requires patience and commitment. Treatment plans may need adjustments over time, and it’s important to remember that hair growth follows natural cycles. It can take several months to see meaningful changes, but persistence pays off in the long run.
Managing PCOS-related hair loss often begins with a few lifestyle adjustments that can have a lasting impact. One of the most important steps is maintaining a healthy weight. Research shows that losing as little as 5% of your body weight can lower insulin and androgen levels, which may, in turn, support healthier hair growth. Pairing this with a nutritious diet - focusing on whole foods, high fiber, and fewer refined carbs - can help regulate insulin levels and promote hormonal balance.
Adding regular exercise to your routine, like brisk walking for 20–30 minutes daily, can also improve insulin sensitivity and boost overall well-being. On top of that, stress management plays a crucial role. Activities like yoga or meditation can help ease PCOS symptoms, including hair loss. While these changes may seem small, they can lead to noticeable improvements in managing hair loss over time.
Spironolactone tackles PCOS-related hair loss by targeting androgen receptors and limiting androgen production. By addressing these hormonal imbalances, it helps reduce hair thinning and loss often associated with PCOS.
Minoxidil, on the other hand, stimulates hair follicles by boosting blood flow to the scalp and extending the hair's growth phase. This encourages regrowth and minimizes shedding, making it a reliable option for women dealing with PCOS-induced hair loss.
Certain nutrients can play an important role in maintaining hair health, especially for those managing PCOS. Adding these to your diet may help address hair loss:
Other nutrients to keep on your radar are zinc, vitamin D, and iron. Zinc helps regulate hormones, vitamin D supports the function of hair follicles, and iron plays a role in delivering oxygen to hair follicles. A balanced diet filled with nutrient-rich foods can go a long way in improving hair health over time.
