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Hirsutism is a condition characterized by excessive growth of body hair and it’s one of the most common symptoms of PCOS (Polycystic Ovary Syndrome). This visible feature of PCOS can be particularly distressing and it may seriously impact the quality of life and mental well-being of women with this condition. As a result, many of them decide to seek effective strategies to reduce abnormal hair growth and keep hirsutism under control. But is this condition reversible? And why do women with PCOS develop it in the first place? That’s what I’ll break down for you in this evidence-based article explaining the mechanism behind PCOS hirsutism and how to reverse it naturally. I’ll also give some tips on my favorite beauty products, supplements and hair removal methods that worked for me. What causes hirsutism in PCOS? Hirsutism in PCOS is predominately caused by sex hormone imbalances and excessive amounts of androgens in the blood. Insulin resistance, chronic stress and inflammation are considered to be the main contributors to hyperandrogenism in women with PCOS. While there are many different factors that can contribute to excessive growth of facial and body hair in women, the root cause of PCOS-related hirsutism is the overproduction of androgens (the ‘male’ hormones’). DHT (dihydrotestosterone) is the main androgenic hormone responsible for abnormal hair growth in women as it binds to receptors in your hair follicles and regulates the hair growth cycle. High levels of DHT can therefore stimulate the growth of terminal hair (dark and thick) in androgen-sensitive areas of the body (typical for men). Hyperandrogenism Increased levels of androgens (hyperandrogenism) are one of the three official Rotterdam criteria to be diagnosed with PCOS (the other two are irregular periods and polycystic ovaries). But what is the root cause of hyperandrogenism in women with PCOS? According to research, one of the main drivers of this condition appears to be insulin resistance (your body’s inability to respond to insulin effectively) which occurs in up to 80% of women with PCOS. However, chronic stress and inflammation are also recognized as major contributors to hormone imbalances in women with PCOS. Insulin resistance If you’d like to know more about the role of insulin resistance in the development of hyperandrogenism in women with PCOS, make sure to check out my previous article ‘PCOS Insulin Resistance Explained & How To Reverse It’. The key thing to remember is that high levels of insulin in the blood can trigger your ovaries to produce excessive levels of androgens. Chronically elevated cortisol (the ‘stress’ hormone) can have a similar effect on your adrenal glands that also produce androgens. In addition, inflammation contributes to both insulin resistance and chronic stress (the main drivers of hyperandrogenism). Is hirsutism in PCOS reversible? Hirsutism in PCOS is reversible in most women once they address the root cause of their condition, make relevant changes and balance their hormones. However, it is a very slow process requiring a lot of patience as it can take up anywhere between several months to years. While it is possible to reverse hirsutism and prevent the reoccurrence of excessive body hair in the future, it should be noted that this might take some time. That’s because your body hair cycle goes through different stages (one hair cycle can last 5-14 months depending on the area). For this reason, you shouldn’t expect any immediate effects as your body requires enough time to adapt to new treatment strategies. However, there are also some great hair removal methods that you can use during this period to reduce your body hair topically. Where does hair grow in PCOS? Women with PCOS and hirsutism can experience excessive hair growth in androgen-sensitive areas of the body such as the face, chest, abdomen, back and inner tights. Growing terminal hair in those body parts is more typical for men due to their different hormonal profile. Things to consider If you suffer from PCOS there’s a high probability that the root cause of your hirsutism is related to this disorder. However, keep in mind that it’s not the only possible cause and that there might be some other underlying conditions (such as thyroid dysfunction, malnutrition) stimulating excessive hair growth. For this reason, I always recommend working with a professional, getting relevant health assessments and adapting an individual approach in the treatment of PCOS. That being said, most women with PCOS-related hirsutism are able to successfully improve this condition by addressing and managing these three main elements: insulin resistance, chronic stress and inflammation. And here is how to do it. How to reverse PCOS hirsutism naturally: make dietary changesexerciseimprove sleepreduce stresslimit environmental toxinsquit smokinginclude dietary supplementsuse appropriate hair removals 1. Diet Nutrition, in general, is one of the most powerful tools that can massively influence all aspects of your health. That’s because food is not just a source of energy for your body but it’s also a source of information. Because different types of food consist of different chemical compounds and structures, their function in the body will also be different. That’s why your dietary choices will play such an important role in restoring your hormonal balance and reversing hirsutism. As I’ve already discussed, insulin resistance is one of the key players in the development of PCOS hirsutism and this metabolic condition is predominantly affected by your diet (especially your glucose levels). Keeping a healthy weight and controlling your blood sugar levels (through dietary changes) are some of the most effective strategies for improving insulin resistance and reducing inflammation in the body. In addition, certain foods (rich in antioxidants and phytonutrients) are also associated with strong anti-inflammatory and stress-reducing properties. Obtaining sufficient amounts of essential nutrients from your diet is also crucial for your hormonal health and there are even some specific foods with anti-androgenic effects (DHT blockers). You can find a detailed easy-to-follow nutrition plan for reversing PCOS here: ‘The Best PCOS Diet (Ultimate Guide)’. But here are some of the best foods to eat for PCOS hirsutism. Best foods for PCOS hirsutism: Proteins (eggs, fish, meat, soy, beans, bone broth)Anti-inflammatory foods (whole fruits, vegetables)Herbs and spices (cinnamon, turmeric, spearmint, licorice)Healthy fats (avocado, olives, oily fish, nuts, seeds)Seaweed (kelp)Adaptogenic mushrooms (reishi, chaga)Natural DHT blockers (pumpkin seeds, coffee, green tea)Low GI foods (wholefoods, unprocessed foods)Herbal tea (Best Teas For PCOS) 2. Exercise Another important factor that can massively affect all of the three main drivers of PCOS hirsutism (insulin resistance, inflammation, chronic stress) is exercise. Not only does it help manage weight and improve metabolism, but it has some major effects on insulin regulation. Physical activity can immediately lower your blood sugar levels (by uptaking glucose into your working muscles) and regular exercise can significantly improve your body’s insulin sensitivity over time. As a result, you’re likely to see improvements in insulin resistance and therefore in hyperandrogenism. Furthermore, exercise is particularly effective in managing stress and improving mental health both of which can also massively impact your androgen production and hirsutism. You learn more about different types of exercise and their effects on PCOS here: ‘What Is The Best Exercise For PCOS & Why?’. 3. Sleep You may already know that sleep is an essential aspect of optimal health and well-being as it’s involved in almost all bodily functions and processes. Such processes (hormone regulation, detoxification, repair, regeneration) can therefore drastically affect your PCOS and hormone-related hirsutism. There is strong evidence demonstrating how insufficient and low-quality sleep can almost immediately (after only one night) cause severe hormone disturbances and metabolic dysfunctions. Insulin and cortisol levels appear to be particularly affected by your sleeping habits which is why poor sleep hygiene can aggravate insulin resistance, chronic stress and inflammation. If your goal is to restore hormonal balance, improve hyperandrogenism and reverse PCOS hirsutism, getting sufficient high-quality sleep on a regular basis should always remain your priority. 4. Stress PCOS is a very mentally challenging condition that is considered to be a risk factor for increased stress and poor mental health. However, chronic stress (and chronically elevated cortisol) is also one of the main drivers of hyperandrogenism responsible for most of the stressful PCOS symptoms (including hirsutism). This vicious cycle can be particularly difficult to break without appropriate stress management strategies in place. While keeping your stress levels under control is not an easy task to do (especially with PCOS) there are many ways that can help you do that. The most important thing is to find what works for you as we all respond to stress differently. This also means that different stress-relieving methods will work for different individuals so there is no universal technique. You may want to start with yoga, meditation, breathing exercises or spending time in nature as those methods have been shown to lower cortisol in the research. However, it can be something totally different for you. 5. Environmental toxins According to research, increased exposure to environmental toxins can contribute to the development and progression of PCOS. This is particularly true for a group of toxins called EDCs (endocrine-disrupting chemicals) which have been associated with infertility issues, metabolic dysfunctions (such as insulin resistance) and hyperandrogenism in women with PCOS. That’s because once EDCs enter the bloodstream, they can either block, mimic or interfere with our natural hormones, hence disrupting our endocrine system. Unfortunately, the environment we live in today is oversaturated with such chemicals, making it difficult to completely avoid them. Even though EDCs can be found almost everywhere (including our food, water, air and personal products) you can still make some meaningful changes to at least minimize your exposure to them. Pay extra attention to your cosmetic products as they are typically filled with such chemicals that get absorbed into the bloodstream through your skin. 6. Smoking It is clear that smoking is not a healthy habit to have as it drastically increases your risk of multiple diseases. But did you know that smoking can also massively affect PCOS and contribute to hirsutism? Read more: ‘Does Smoking Affect PCOS & How? All You Need To Know‘ It’s been shown that smoking cigarettes and nicotine-containing products contribute to insulin resistance, inflammation and high levels of androgens in the body. Even studies involving women with PCOS have demonstrated the association between smoking and high levels of androgens. For this reason, quitting smoking could be particularly effective in improving your PCOS symptoms and restoring hormonal balance. 7. Supplements Dietary supplements are tricky. On one hand, they can be extremely effective, but on the other hand, supplements alone won’t work miracles (without relevant dietary and lifestyle changes). You should always think of supplements as an addition to your diet rather than the primary strategy. Another thing to keep in mind is that supplements, in general, are very poorly regulated (not by governmental bodies) so their actual content and quality are not always guaranteed. This means that not all supplements will be as effective (or safe) as they claim to be. "Not all supplements will be as effective (or safe) as they claim to be." For this reason, I always recommend choosing only the highest-quality supplements from trusted brands and preferably third-party tested (some of my favorites are listed down below). You should also choose them based on your individual needs (rather than general recommendations) if you want to gain the most benefits. In order to do so, you may want to work with a professional who is able to develop a personalized supplement plan specifically tailored to your needs. Try to obtain as much data as possible (blood tests, health assessments, labs) to fully understand your condition and select the right supplements for you. However, if that’s not an option for you I’ve created a list of some of the most effective dietary and herbal supplements that have been shown to improve hirsutism in women with PCOS. Best supplements for PCOS hirsutism: Saw palmettoStinging nettleGreen teaPumpkin seed oilReishiSpearmintLicorice rootVitexDIMZincMagnesiumVitamin DNAC DHT blockers One of the most effective ways to improve hirsutism and prevent abnormal hair growth in the future is to decrease your levels of DHT. This hormone is converted from blood testosterone by the enzyme 5-AR (5-alpha reductase). Interestingly, there are several natural supplements that appear to block the conversion of testosterone to DHT by inhibiting 5-AR. It is believed that saw palmetto, green tea, stinging nettle, reishi mushroom and pumpkin seed oil are some of the most effective natural DHT blockers. You can find them in many different forms (tea, capsules, liquid) either separately or combined in supplemental formulas. Here are some of my favorite brands: Natural DHT Blocker by Herbtonics (available on Amazon)Organic Reishi Capsules by Host Defense (available on Amazon)Saw Palmetto by Havasu Nutrition (available on Amazon)Organic Stinging Nettle by Pure Mountain Botanicals (available on Amazon)Pumpkin Seed Oil by Carlyle (available on Amazon) Anti-androgenic herbs There are certain herbs that have been shown to be effective in lowering androgens and improving hirsutism in women with PCOS. Spearmint is perhaps the most researched one but other herbal remedies are also associated with anti-androgenic effects. VItex may help lower prolactin (which can also cause androgen excess), licorice root (in combination with peony) appears to downregulate the production of androgens and DIM is a powerful phytonutrient (derived from cruciferous vegetable) that helps block androgen receptors. Just bear in mind that those herbs can also affect other important hormones (prolactin, estrogen) so they may not be suitable for everyone. For this reason, it is important to know your own hormone levels and PCOS type so you can choose accordingly. Here are some of my favorite brands: Spearmint Tea by FGO (available on Amazon)Licorice Root Tea by Traditional Medicinals (available on Amazon)Vitex by Nature’s Way (available on Amazon)DIM Supplement by MS Nutrition (available on Amazon) Essential nutrients Obtaining sufficient amounts of essential nutrients from your diet also plays an important role in restoring hormonal balance and reversing hirsutism. It’s been demonstrated that deficiencies in certain nutrients (zinc, vitamin D, magnesium) may increase the risk of PCOS and hyperandrogenism. While you should always aim to get those nutrients from a healthy balanced diet, you may still benefit from additional supplements. Multiple studies have shown improvements in PCOS symptoms (including hirsutism) after supplemental therapy with NAC (n-acetyl cysteine), zinc, vitamin D and magnesium. Here are some of my favorite brands: Vitamin D3 by Naturewise (available on Amazon)Zinc by Solgar (available on Amazon)Magnesium by Doctor’s Best (available on Amazon)NAC by Life Extension (available on Amazon) 8. Hair removals If your goal is to reverse PCOS hirsutism and achieve some long-term results, it is crucial to address the root cause of this condition and treat it from the inside out. However, restoring your hormonal balance is a complicated process and it’s definitely not a quick fix. Fortunately, there are some great topical treatments that can also help you remove unwanted hair in certain body parts. Some of them can even give you long-lasting results while others are only temporary solutions. You can find a detailed comparison of some of the most popular hair removal methods in my other article ‘The Best Hair Removals For PCOS & Hirsutism' where I also give some tips on how to choose the best one for you. Best hair removals for PCOS: ElectrolysisLaserIPL hair removerEpilatorTweezing Long-term Electrolysis and laser treatments are considered to be the best hair removal methods in terms of their duration of lasting results. That’s because both methods are based on destroying the whole hair follicle (either by electric current or laser heat) preventing the regrowth of new hair. After certain amounts of treatments, electrolysis can lead to even permanent results while laser removal may require maintenance sessions on a yearly basis (or every half a year). Nonetheless, both methods can be relatively expensive and for some individuals quite painful (especially electrolysis). However, this depends on your personal pain tolerance. While both of those treatments are typically done in professional beauty salons, there are now some home devices using IPL (intense pulse light) technology that works on the same basis as laser treatment. Here is the one that I use. Best home laser hair removal for PCOS: IPL Hair Remover Silk Expert Pro 5 by Braun (available on Amazon) Medium-term There are also certain methods that focus on removing the whole hair from underneath the skin (epilation) which means that it takes longer to grow back (around a month). This can be done by waxing, sugaring, tweezing or with the use of electric epilators. Unfortunately, those methods are also not completely pain-free and considering they need to be repeated on a monthly basis, they may not be suitable for all individuals. Other than that, epilation can be a great low-cost option for women with PCOS as it makes your skin smooth and stubble-free (unlike some other temporary solutions). However, I don’t recommend waxing and sugaring in certain body parts (especially the face) as this method can be very irritating for sensitive and acne-prone skin. Additionally, monthly waxing treatments can also be relatively costly so my best tip is to get a high-quality electric epilator (suitable also for the face) that will last you forever. I have the best experience with this one. Best epilator for PCOS: Epilator Silk Epil 9 by Braun (available on Amazon) Short-term Several hair removal methods are completely painless (shaving, hair removal creams) as they only remove the visible part of the hair from your skin’s surface. However, those methods are some of the worst options for women with hirsutism as they need to be repeated sometimes on a daily basis. More importantly, they are associated with a number of negative side effects (such as skin irritations, ingrown hairs, discoloration) and will never result in completely smooth and stubble-free skin. I personally don’t recommend any of those methods for removing facial and body hair. But, if you still want to opt for this short-term solution, I highly suggest avoiding hair removal creams at all cost. They are filled with harsh chemicals (including EDCs) that can get easily absorbed into the bloodstream through your skin. Leaving them on for too long can also cause severe skin damage and skin burns. If you decide to opt for shaving (it is the better option of the two) try to pick a high-quality razor and be gentle to your skin. Don’t forget to keep your skin hydrated (shaving can be very drying) and avoid using irritating skincare products afterward. Best razors for PCOS: Flawless Hair Removal by Finishing Touch (available on Amazon)Hydro Silk Touch-up Razors by Schick (available on Amazon)Sensitive Disposable Razors by Gillette Venus (available on Amazon) Pro tips: Prioritize skincare – make sure you keep your skin clean, healthy and hydrated at all times but especially after your hair removal treatments, don’t use any skincare or makeup products that might irritate your skin (I personally like to use pure Aloe Vera gel)Warm your skin – if you want to minimize the pain from plucking and tweezing, make sure you warm your skin first (by hot shower, wet washcloth, steaming) to open up your pores and relax hair folliclesBe gentle – regardless of the method you decide to use to remove hair, always be gentle to your skin (especially in sensitive areas) to get the best results and prevent any negative side effects (razors and depilatory creams can be particularly dangerous)Keep it clean– make sure your hair removal devices and tools (epilators, tweezers, razors) remain clean and that you sanitize them before every use to prevent infection and the spread of bacteriaBe patient – keep in mind that our endocrine system is very complex and once you introduce new treatment strategies, it usually takes a minimum of 3-6 months before you start seeing some results (especially when it comes to hair growth)Get tested – get your hormones and other important health metrics tested regularly so you can better understand your condition, find appropriate treatment strategies and track your progress Resources: Agrawal N. 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