A Patient’s Guide: Managing Hair Loss Treatment In PCOS

Understanding PCOS and Hair Loss

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of childbearing age. Its prevalence ranges from 9.13% to 36% and continues to rise each year. Women with PCOS often experience irregular or prolonged menstrual cycles and elevated levels of androgens (male hormones), leading to various symptoms, including hair loss.

In PCOS, the ovaries may develop multiple small fluid-filled sacs and fail to release eggs regularly. This hormonal imbalance is a key factor in hair thinning and shedding.

Why Does PCOS Cause Hair Loss?

PCOS-related hair loss is primarily due to excess androgen levels. Androgens, including testosterone, contribute to puberty, underarm and pubic hair growth, and other bodily functions. However, when present in excessive amounts, they can shrink hair follicles, leading to hair thinning and increased shedding.

Unlike male-pattern baldness, hair loss in PCOS does not usually result in complete baldness but leads to noticeable thinning, particularly at the crown and parting of the scalp.

Symptoms of PCOS-Related Hair Loss

Women experiencing PCOS-related hair loss may notice:

• Increased hair shedding throughout the day
• Hair accumulation on clothes, furniture, or pillowcases
• Hair coming out in clumps while showering or brushing
• Thinning hair, especially around the crown or hairline

Medical Treatments for PCOS-Related Hair Loss

Since PCOS-related hair loss stems from hormonal imbalances, treatment focuses on regulating hormone levels. Finding the right medication may take time, and a combination of treatments often yields the best results.

1. Oral Contraceptive Pills (OCPs)

Certain birth control pills can help regulate androgen levels, reducing hair loss and excessive hair growth. They also assist in managing other PCOS symptoms like irregular periods and acne. OCPs are often combined with antiandrogen medications for more effective results.

2. OCPs Combined with 5-Alpha Reductase Inhibitors

5-alpha reductase inhibitors block the conversion of testosterone into dihydrotestosterone (DHT), a hormone responsible for hair follicle shrinkage. By preventing DHT from affecting hair follicles, these inhibitors may help reduce hair loss.

3. Multiple Drug Therapy

Experienced endocrinologists may prescribe a combination of antiandrogens and OCPs for severe hair loss. One of the most common combinations includes spironolactone and OCPs, which can effectively manage androgenic alopecia in women.

4. Minoxidil (FDA-Approved Treatment)

Minoxidil is the only FDA-approved topical treatment for female pattern baldness. Applied daily to the scalp, it stimulates hair growth and improves hair density. Consistent use is essential for maintaining results.

5. Diane-35 (Antiandrogen and Progestin Combination)

Diane-35 is a powerful antiandrogen and progestin treatment that combines cyproterone acetate (CPA) with estrogen-like ethinyl estradiol. This combination is widely used in Canada, Europe, and other regions to manage androgen-related PCOS symptoms.

Seeking Professional Guidance

While many treatments can help manage PCOS-related hair loss, it is essential to consult a healthcare professional before starting any medication. A thorough evaluation by a doctor or endocrinologist can rule out underlying conditions and ensure the most effective treatment plan.

Managing PCOS-related hair loss requires patience and a personalised approach. With the right medical guidance and treatment, it is possible to slow down hair loss and restore confidence in your appearance.