PCOS Hair Loss Explained & How To Reverse It

Written by Martina S. in Beauty

Hair loss is one of the most common symptoms of PCOS (Polycystic Ovary Syndrome) that a large proportion of women with this condition suffer from. Unfortunately, losing hair in excess amounts can also seriously impact the confidence, self-esteem, mental health and overall quality of life of those individuals. 

Many women are therefore looking for effective methods and treatment strategies to combat this difficult challenge and regrow their hair naturally. But is PCOS hair loss reversible? And what causes it in the first place? That’s what you’ll find out in this article based on the latest evidence as well as my personal experience with PCOS hair loss.

I’ll share with you the most effective natural treatment strategies for reversing PCOS hair loss and also give you some tips on my favorite hair products, home remedies and supplements.

What causes PCOS hair loss?

PCOS hair loss 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.

It should be noted that there are many different factors that can cause androgenic alopecia (female baldness) in women but when it comes to PCOS the root cause of hair loss is usually due to high levels of androgens (the ‘male’ hormones) in the blood.

The main hormone (androgen) responsible for hair loss is called DHT (dihydrotestosterone) which can bind to receptors in hair follicles on your scalp, reduce their size and decrease or inhibit their function of the hair-growth cycle. As a result, your hair becomes thinner, more brittle and more likely to fall out faster.

Hyperandrogenism

But what causes hyperandrogenism (high levels of androgens) in women with PCOS? While it appears to be a combination of several factors (including genes, lifestyle and environment), the current evidence suggests that insulin resistance is the main driver in most women with PCOS (up to 70%).

Chronic stress and inflammation are also recognized as major contributors to this condition affecting between 20-30% of women.

Insulin resistance

To fully understand the process in which insulin resistance results in hyperandrogenism, I highly suggest you read my previous article ‘PCOS Insulin Resistance Explained & How To Reverse It’.

In summary, high levels of insulin in your blood (caused by insulin resistance) can make your ovaries produce excessive amounts of androgens. Since inflammation can even worsen insulin resistance and chronic stress can make your adrenals overproduce androgens, both of those factors can also contribute to hyperandrogenism in women with PCOS.

Is PCOS hair loss reversible?

PCOS hair loss 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 a few weeks to several months or years.

When it comes to reversing hair loss it is important to realize that your hair cycle goes through different stages and at one point it is natural to fall out (one hair cycle lasts between 2-6 years). In fact, losing around 50-100 hairs every day is completely normal and you shouldn’t be concerned with it. 

If your hair is longer you may find ‘bigger’ patches of hair which doesn’t necessarily mean you’re losing more hair but that there is just bigger volume due to your hair length. 

If, however, you start experiencing changes in the quality of your hair (thinner, brittle) and losing excess amounts of hair (especially around the center and front of your scalp) you may need to address the root cause of your PCOS to stop this process.

Things to consider

As I already mentioned, there might be several different factors contributing to PCOS hyperandrogenism causing hair loss but there might also be some other underlying conditions (such as hypothyroidism, hyperthyroidism, malnutrition) that also need to be considered.

That’s why individual approach in the treatment of PCOS is so important and I highly suggest you work with a professional. Nonetheless, in the vast majority of women, PCOS hair loss can be successfully reversed by addressing and managing these three main components: insulin resistance, inflammation and chronic stress.

And here is how to do it naturally.

How to reverse PCOS hair loss naturally:

  • make dietary changes
  • exercise
  • improve sleep
  • reduce stress
  • limit environmental toxins
  • quit smoking
  • include dietary supplements
  • use appropriate haircare

1. Diet

Nutrition is one of the most important factors that can be modified to help you restore hormonal balance and reverse PCOS hair loss. And I’m not saying this only because of my nutritional background but also because of my own experience.

The way to think about it is to picture food not only as a source of energy (calories) but more as information (chemical compounds) that can affect your bodily function and overall health. 

Since different types of food consist of different chemicals with different structures and functions, they will also affect your body differently. So it only makes sense how the selection of what you put into your body can help you either improve or worsen your condition.

When it comes to PCOS hair loss and its connection to insulin resistance, it is clear that diet will be the main player. That’s because insulin resistance is a condition directly related to your dietary choices.

In most cases, insulin resistance is caused by having constantly too much glucose in the blood. Being overweight or obese can also contribute to insulin resistance and inflammation in the body.

“Insulin resistance is a condition directly related to your dietary choices.”

For this reason, dietary strategies focused on weight management and balancing blood sugar and insulin levels in the blood can be extremely effective when combating PCOS hair loss. Anti-inflammatory foods can also play a huge role in reducing insulin resistance and other foods (especially antioxidant-rich) can help you manage stress and regulate hormones.

Read more: ‘The Best PCOS Diet (Ultimate Guide)’

There are also several nutrients that play a major role in the quality of your hair in particular protein (collagen), zinc and biotin which is why food rich in such nutrients may also help you support hair growth. Here’s a list of some of the best foods for PCOS hair loss.

Best foods for PCOS hair loss:

2. Exercise

Exercise is another major component that has a direct impact on all the three main drivers of PCOS hair loss (insulin resistance, inflammation, chronic stress). Despite the obvious benefits of exercise for weight loss and weight management, it has a huge impact on your body’s metabolism and insulin regulation.

Exercise can not only immediately decrease your insulin levels in the blood (by uptaking glucose into working muscles) but regular exercise can also significantly improve your body’s overall sensitivity to insulin long-term. This means a reduction of insulin resistance and improvement of hyperandrogenism.

Additionally, exercise has some serious benefits for stress management and mental health that, as you now know, can also drastically help with androgen overproduction and therefore hair loss.

You can find the best types of exercise and their different effects on PCOS in my previous article ‘What Is The Best Exercise For PCOS & Why?’

3. Sleep

Sleep is another key pillar of optimal health as it’s involved in numerous vital processes including repair, detoxication, regeneration and hormone regulation. All of those (and many more) processes can therefore directly impact PCOS and PCOS-related hair loss.

It’s been demonstrated that insufficient sleep (in terms of both quality and quantity) can quite quickly result in hormone disturbances. It is especially true for the hormones insulin and cortisol (the ‘stress’ hormone) that can both contribute to insulin resistance, chronic stress and inflammation.

It is therefore apparent why sufficient high-quality sleep needs to be prioritized if you wish to restore hormonal balance, manage hyperandrogenism and successfully reverse PCOS hair loss.

4. Stress

As I already mentioned, chronic stress is one of the main contributors to hyperandrogenism in women with PCOS that may result in excess hair loss. Unfortunately, stress and chronically elevated levels of cortisol are also some of the common symptoms of PCOS.

This is partly due to the fact that many of the PCOS symptoms (including hair loss) can seriously impact the quality of life and mental health of women with this condition. However, there are many different factors that can impact your stress levels and your body’s ability to respond to stress.

Developing effective stress management strategies is much easier said than done since we are all different individuals with different needs and circumstances. Nonetheless, it’s important to find a stress-relieving method that works for you so you can minimize the negative outcomes (such as hair loss) associated with having constantly elevated stress levels.

5. Environmental toxins

Environmental toxins have now become a part of our normal lives and it is almost impossible to completely avoid them. As you may expect, they can also seriously affect our hormonal health, especially a group of toxins called EDCs (endocrine-disrupting chemicals).

Once such chemicals enter our bodies they can either mimic, block or interfere with our natural hormones and therefore lead to endocrine disorders such as PCOS. There is now solid evidence showing that high exposure to EDCs can contribute to infertility, metabolic abnormalities (such as insulin resistance) and hyperandrogenism in women with PCOS.

For this reason, you should try to minimize your exposure to EDCs if your goal is to reverse PCOS hair loss and restore hormonal balance. To do so, you may need to change and carefully choose some of the everyday products that you use on a regular basis since EDCs are basically everywhere (including food, packaging, skincare, haircare, fragrances, plastics).

Some of my favorite EDC-free hair products for PCOS are listed later in this post.

6. Smoking

It is well known that smoking can seriously affect your health and that it can massively increase the risks of developing several diseases. But if suffer from excessive hair loss due to PCOS you should know that smoking is another major driver of this symptom.

Not only does smoking increase the risk of insulin resistance and inflammation but nicotine has been repeatedly shown to increase the levels of androgens in the body, especially free testosterone.

Read more: ‘Does Smoking Affect PCOS & How? All You Need To Know‘

Quitting smoking could therefore be one of the most important steps in the process of restoring your hormonal health and reversing hair loss.

7. Supplements

It is true that hair loss supplements can be extremely effective (when carefully selected) but it’s important to realize that they won’t work miracles on their own. Supplements can be a great tool in improving health and even treating several conditions but your dietary and lifestyle choices should remain your priority. 

Since dietary supplements are very poorly regulated and their content is often not what it claims to be, it can become extremely challenging to find hair loss supplements that actually work. Additionally, different supplements may work for different people based on their individual conditions and root causes of their hair loss.

“Different supplements may work for different people.”

That’s why it’s so important to fully understand your condition and try to get to the very bottom of it if you want to match the right supplements to your targeted goal. I always recommend working with a qualified professional who can make this task much easier and help you create your personalized supplemental plan.

Having enough data from different blood tests and other health screening assessments is also extremely helpful when choosing the right supplements, however, such data may not be accessible for everyone.

That’s why I created a list of some of the most effective supplements and herbal remedies that have been supported by science and that are most likely to help with your PCOS hair loss.

Best supplements for PCOS hair loss:

  • Saw Palmetto
  • Stinging Nettle
  • Pumpkin Seed Oil
  • Green Tea
  • Collagen
  • Zinc
  • Biotin
  • Vitamin D

DHT blockers

As I already discussed, hormone-related hair loss is usually caused by excessive amounts of DHT in the blood. DHT is an androgenic hormone that is converted by the enzyme 5-AR (5-alpha reductase) from blood testosterone.

So one of the most effective ways of reversing hair loss is to block the production of DHT by inhibiting 5-AR. It is also the principle on which most of the common hair loss medications are based. The good news is that there are also several natural DHT blockers that can help with this process. 

Saw palmetto, stinging nettle, pumpkin seed oil and green tea are some of the most effective natural DHT blockers and herbal remedies for hair loss. You can either find them as individual supplements but there are also many hair loss formulas that contain a combination of those herbs. I find those much more practical.

Here are some of my favorite brands:

Essential nutrients

When it comes to reversing hair loss it is also important to ensure that you have a sufficient intake of nutrients essential for hair growth and good hair quality. There are many nutrients involved in this process but protein (collagen), biotin, zinc and vitamin D appear to be the most vital.

While all of those nutrients can be sufficiently obtained from a healthy balanced diet (and sunshine), for some individuals, additional supplementation may be extremely helpful and sometimes even necessary. 

However, you should always aim for the ‘food first’ approach and when supplementing your diet with extra nutrients, opt for high-quality products (preferably third-party tested) with high bioavailability to gain the most benefits.

Here are some of my favorite brands:

You can also find more information and tips on how to choose the best protein powder for PCOS in my previous article ‘What Protein Powder Is Best For PCOS? (The Ultimate Guide)‘.

8. Haircare

Despite the root cause of PCOS hair loss (which is hormone-related) the way you care for your hair is equally important. There is no question that you should treat this condition from the inside and restore your hormonal balance if you want to achieve some permanent effects. 

However, some topical treatments can also be very effective in helping you stimulate new hair growth, improve your hair quality and prevent further hair loss. But again, there is no overnight miracle treatment and you should rather think of those products and techniques as an additional way of supporting your hair health.

Best hair products for PCOS hair loss:

  • Organic (EDC-free) shampoo
  • Organic (EDC-free) conditioner
  • Rosemary essential oil
  • Castor oil
  • Aloe vera
  • Keratin
  • Scalp massager
  • Anti-dandruff shampoo

Hair cosmetics

For any hair products you decide to use, I highly suggest looking for those with more natural ingredients and preferably certified organic. The reason for this is that most commercial hair products contain parabens, silicons and other types of endocrine-disrupting chemicals (EDCs).

Such chemicals can easily enter your body through your skin (especially through the large pores on your scalp) and lead to hormone imbalances contributing to even greater hair loss. Organic and EDC-free products are therefore a much better option for your everyday hair care.

In terms of improving your hair quality, you may want to look for products that contain keratin and caffeine as those ingredients appear to be most effective (according to evidence). Anti-dandruff shampoo (such as Nizoral) can also help you reduce inflammation on your scalp and prevent further damage to your hair follicles responsible for hair loss.

Here are some of my favorite brands:

Natural remedies

There are also several natural products that are also effective in regrowing healthy hair when applied topically. Rosemary essential oil, aloe vera, castor oil and onion juice are the most well-known hair loss remedies that are supported by evidence. 

You can either use them separately (I love adding a few drops of rosemary oil to my regular hair products) or you can try making homemade masks and treatments by combining multiple ingredients (recipe later in this post).

Here are some of my favorite brands:

Massage

Additionally, massaging your scalp has also been shown to stimulate hair growth and increase the thickness of new hair. This can be easily done just by your fingertips but you can also find some great tools specifically designed for hair growth stimulation.

Scalp massagers, derma rollers and hair growth stimulators (including red light therapy) have become particularly popular in recent years due to their high effectiveness as well as their relaxing properties. I personally use it as my stress-relieving method and it works wonders.

Here are some of my favorite brands:

Practical tips:

  • Don’t wash your hair every day – good hair hygiene is essential but washing your hair every day doesn’t necessarily improve the quality of your hair, overwashing can strip your hair of its natural oils (sebum) and make them dry, brittle and damaged
  • Minimize your hair exposure to heat – try using hair styling techniques that don’t require heat (or reduce the temperature) since excessive heat can decrease your hair quality and cause damage to your hair follicles resulting in greater hair loss
  • Don’t wash your hair with hot water – not only does hot water make your hair dry, frizzy and more brittle but it also makes your hair more likely to fall out as it can damage the hair follicles (use lukewarm water instead)
  • Be gentle with your hair – avoid aggressive brushing, towel rubbing, pulling and making your ponytails too tight as it can also cause damage to your hair and make it fall out faster
  • Minimize dying and bleaching your hair – frequent dying and bleaching of your hair can seriously damage not only the structure and quality of your hair but also your scalp and hair follicles (limit the frequency of dying, use more natural hair dyes or consult a professional hairdresser)
  • Make home-made hair masks – based on the information you now have, you can make some highly effective (and relatively cheap) hair masks from the ingredients of your choice (try mixing some onion with aloe vera, castor oil and a few drops of rosemary oil)
  • Be 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 regrowing your hair)
  • 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:

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  • Banihashemi, M., Nahidi, Y., Meibodi, N. T., Jarahi, L., & Dolatkhah, M. (2016). Serum Vitamin D3 Level in Patients with Female Pattern Hair Loss. International journal of trichology, 8(3), 116–120. https://doi.org/10.4103/0974-7753.188965
  • Cho, Y. H., Lee, S. Y., Jeong, D. W., Choi, E. J., Kim, Y. J., Lee, J. G., Yi, Y. H., & Cha, H. S. (2014). Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Evidence-based complementary and alternative medicine : eCAM, 2014, 549721. https://doi.org/10.1155/2014/549721
  • DeUgarte, C. M., Bartolucci, A. A., & Azziz, R. (2005). Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertility and sterility, 83(5), 1454–1460. https://doi.org/10.1016/j.fertnstert.2004.11.070
  • ​​Fabbrocini, G., Cantelli, M., Masarà, A., Annunziata, M. C., Marasca, C., & Cacciapuoti, S. (2018). Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. International journal of women’s dermatology, 4(4), 203–211. https://doi.org/10.1016/j.ijwd.2018.05.001
  • Fischer, T. W., Herczeg-Lisztes, E., Funk, W., Zillikens, D., Bíró, T., & Paus, R. (2014). Differential effects of caffeine on hair shaft elongation, matrix and outer root sheath keratinocyte proliferation, and transforming growth factor-β2/insulin-like growth factor-1-mediated regulation of the hair cycle in male and female human hair follicles in vitro. The British journal of dermatology, 171(5), 1031–1043. https://doi.org/10.1111/bjd.13114
  • Grant, P., & Ramasamy, S. (2012). An update on plant derived anti-androgens. International journal of endocrinology and metabolism, 10(2), 497–502. https://doi.org/10.5812/ijem.3644
  • Jamilian, M., Foroozanfard, F., Bahmani, F., Talaee, R., Monavari, M., & Asemi, Z. (2016). Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biological trace element research, 170(2), 271–278. https://doi.org/10.1007/s12011-015-0480-7
  • Koyama, T., Kobayashi, K., Hama, T., Murakami, K., & Ogawa, R. (2016). Standardized Scalp Massage Results in Increased Hair Thickness by Inducing Stretching Forces to Dermal Papilla Cells in the Subcutaneous Tissue. Eplasty, 16, e8. Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4740347/
  • Moran LJ, et al. (2011). Lifestyle changes in women with polycystic ovary syndrome. DOI:10.1002/14651858.CD007506.pub2
  • Murugusundram S. (2009). Serenoa Repens: Does It have Any Role in the Management of Androgenetic Alopecia?. Journal of cutaneous and aesthetic surgery, 2(1), 31–32. https://doi.org/10.4103/0974-2077.53097
  • Panahi, Y., Taghizadeh, M., Marzony, E. T., & Sahebkar, A. (2015). Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial. Skinmed, 13(1), 15–21. Available at: https://pubmed.ncbi.nlm.nih.gov/25842469/
  • Papalou, O., & Diamanti-Kandarakis, E. (2017). The role of stress in PCOS. Expert review of endocrinology & metabolism, 12(1), 87–95. https://doi.org/10.1080/17446651.2017.1266250
  • ​​Rudnicka, E., Suchta, K., Grymowicz, M., Calik-Ksepka, A., Smolarczyk, K., Duszewska, A. M., Smolarczyk, R., & Meczekalski, B. (2021). Chronic Low Grade Inflammation in Pathogenesis of PCOS. International journal of molecular sciences, 22(7), 3789. https://doi.org/10.3390/ijms22073789
  • Sharquie, K. E., & Al-Obaidi, H. K. (2002). Onion juice (Allium cepa L.), a new topical treatment for alopecia areata. The Journal of dermatology, 29(6), 343–346. https://doi.org/10.1111/j.1346-8138.2002.tb00277.x
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