PCOS and hair loss: the hormone link explained

Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects how the ovaries work. The NHS lists irregular periods, difficulty getting pregnant, excess hair on the face or body, oily skin or acne, weight gain and thinning hair or hair loss from the head among its symptoms ¹. If you have PCOS and your parting is widening or your ponytail feels thinner, this article explains why it can happen and what may help.

The hormone link

In PCOS, the ovaries and other tissues may make higher levels of androgens, the group of hormones that includes testosterone. Women normally make small amounts of androgens. Insulin resistance, which is common in PCOS, can push androgen levels up further ².

Androgens affect hair differently depending on where it grows. On the face and body they can make hair thicker and darker, which is why excess facial hair is a common PCOS symptom. On the scalp, in people who are genetically sensitive, androgens can gradually shrink hair follicles so that each new hair grows back finer and shorter. This process is the same one behind pattern hair loss ³. Our explainer on DHT and hair loss covers the hormone in more detail.

What PCOS-related thinning looks like

Hair loss linked to PCOS usually follows the pattern of female pattern hair loss:

• Gradual thinning over the top and crown of the head
• A central part that looks wider over time
• The front hairline usually stays in place ⁴

It is usually gradual rather than sudden. Sudden heavy shedding is more often caused by something else, such as illness, stress or a recent change in medicines. See hair fall after stress or illness.

Getting a diagnosis

PCOS is diagnosed by a doctor based on symptoms, blood tests and sometimes an ultrasound scan. A doctor will usually look for at least two of these: irregular or absent periods, signs of high androgens (on blood tests or as symptoms such as excess hair or acne), and polycystic ovaries on a scan ¹. Other conditions with similar symptoms, such as thyroid problems, may need to be ruled out. See thyroid problems and hair loss.

If you have hair thinning plus irregular periods, acne or new facial hair, mention all of these together, as the combination is a useful clue.

Treatment options

There is no cure for PCOS, but its symptoms can be managed. Treatment for scalp thinning usually combines general PCOS care with hair-specific options.

Lifestyle. For women who are overweight, losing even a modest amount of weight can improve hormone balance and symptoms of PCOS ¹. Regular exercise and a balanced diet also help insulin sensitivity. Avoid crash diets, as rapid weight loss can itself trigger shedding. See hair loss after weight loss.

Topical minoxidil. Minoxidil is the main hair treatment with good evidence for female pattern hair loss, whatever the cause ⁵. It usually takes several months to show an effect and only works while it is used. See minoxidil.

Hormonal treatments. A doctor may suggest a combined contraceptive pill to regulate periods and lower androgen effects ¹. See birth control and hair loss.

Anti-androgen medicines. Medicines such as spironolactone are sometimes prescribed by dermatologists for female pattern hair loss, especially when there are signs of high androgens ^{6 7}. They are not suitable during pregnancy, so reliable contraception is needed, and they require medical supervision.

Our article on female pattern hair loss treatment compares these options.

What to expect

Treatment is long-term. Hair cycles are slow, so it often takes six months or more to judge whether a treatment is helping. The aim is usually to slow further thinning and improve density where possible, rather than a complete reversal. Stopping treatment usually means any benefit fades over the following months ⁸.

Gentle hair care

While you work on treatment, gentle care reduces breakage ⁹:

• Use a mild shampoo and conditioner
• Avoid tight styles and frequent high heat
• Choose a cut and parting that suits your density

Emotional impact

PCOS can affect self-esteem through several visible symptoms at once, including acne, facial hair, weight and scalp thinning. Feeling low or anxious is common, and it is worth telling your doctor. Support and treatment are available.

When to see a doctor

See a GP if you have hair thinning together with irregular periods, acne, excess facial or body hair or difficulty getting pregnant. See a doctor sooner if hair fall is sudden or patchy, or the scalp is sore or scaly.

The bottom line

PCOS can cause scalp thinning through higher androgen levels, usually in a female pattern. Diagnosis involves symptoms and blood tests. Managing PCOS overall, plus treatments such as minoxidil or anti-androgen medicines under medical advice, may help slow thinning. For more on women's hair loss, read hair loss in women.

Frequently asked questions

Can PCOS cause hair loss?

Yes. The NHS lists thinning hair or hair loss from the head as a PCOS symptom, linked to higher androgen levels ^{1 2}.

Will my hair grow back if my PCOS is treated?

Some women see less shedding and better density with treatment, but results vary and take months. Pattern thinning is long-term, so treatment usually needs to continue ⁸.

Does the pill help PCOS hair loss?

A combined pill is sometimes used in PCOS to regulate periods and reduce androgen effects. Whether it suits you depends on your health, so discuss it with a doctor ^{1 10}.

Is spironolactone safe for PCOS hair loss?

It is sometimes prescribed by dermatologists, but it is not suitable in pregnancy and needs medical supervision, including checks for side effects ⁶.

Educational content. Not medical advice.