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PCOS and Female Hair Loss

About 15 per cent of women have hair loss. This condition is also known as alopecia or baldness. Hair loss usually develops gradually and may be patchy or diffuse (all over). In women, androgenic alopecia is probably the most common.

Loss of hair is more than a minor cosmetic problem. It has the potential to make you feel vulnerable (naked), and can cause unfavourable changes in how you feel about yourself.

Roughly 100 hairs are lost from your head every day. The average scalp contains about 100,000 hairs. Hair grows from its follicle at an average rate of about 1/2 inch per month. Each hair grows for 2 to 6 years, then rests, and then falls out. A new hair soon begins growing in its place. At any one time, about 85% of the hair is growing and 15% is resting.

Loss of hair or baldness occurs when hair falls out but new hair does not grow in its place.

Know the cause

The cause of the failure to grow new hair is not well understood, but in the case of women with PCOS (polycystic ovarian syndrome), excessively high levels of androgens (male hormones) are thought to be primarily responsible.

A male hormone called dihydrotestosterone (DHT), which is converted from testosterone, binds to sites on hair follicles and appears to make the follicles go into their "resting" phase sooner, which in turn starts to cause the hairs produced by those follicles to become thinner and thinner with each growth cycle.

Women with high or increasing levels of androgens, such as women with PCOS or who are menopausal, may find that the hair on the head is thinned, while facial hair is coarser. Although new hair is not produced, the follicles remain alive, suggesting the possibility of new hair growth.

It appears that sex hormone imbalances or fluctuations are responsible for most female hair loss, including those who have PCOS, recent pregnancy, menopause, postmenopausal trauma, or birth control side effects.

"Androgenic alopecia" is hair loss due to a male hormone imbalance, and is probably the most common cause for hair thinning and loss in PCOS women.

However, androgenic alopecia is not to be confused with estrogenic alopecia, which is due to a fall in estrogens.

In contrast to testosterone, estrogen helps hair grow faster and stay on the head longer, resulting in thicker hair. This is the reason women's hair gets fuller during pregnancy when estrogen levels are quite high, then sheds several weeks after the baby is born. Estrogen-deficiency alopecia generally starts around menopause. Because estrogen levels start to fall before periods stop, this form of female hair loss can be the first sign of approaching menopause. But sometimes the alopecia does begin until a few months or even a few years after menstruation has ended. Not all women get noticeable alopecia after menopause but most have at least mild thinning.

Many PCOS women also have thyroid problems, usually hypothyroidism (low thyroid function). Not only does hypothyroidism contribute to weight problems, it can also contribute to hair thinning. Some women with PCOS have both an excessively high level of testosterone and an underactive thyroid. It's not uncommon to have multiple factors involved in female hair loss.

Insidious poisoning with heavy metals such as lead, mercury or cadmium can show up as hair thinning. Sources are everywhere in the environment. Be particularly interested in this if you have lived near a mining site, or worked or lived with someone who works in an industry that uses metals. If you smoke tobacco, you get a lot of cadmium. A hair analysis can indicate abnormally high levels of these heavy metal toxins.

Other possible contributors to female hair loss or hair thinning in women may include:

  • Anaemia
  • Any hypothalamic or pituitary disorder (glands in the brain)
  • Any thyroid, liver, adrenal or ovarian disorder
  • Childbirth
  • Drug toxicity like anaesthesia or chemotherapy
  • Eating disorder such as anorexia or bulimia
  • Essential fatty acid deficiency
  • Protein deficiency which is common with vegetarian diets
  • Severe infection
  • Severe stress
  • Various medications, including bromocriptine, beta blockers, ACE inhibitors, amphetamines, anticholesterol agents
  • Mineral or vitamin deficiency - zinc, manganese, iron, vitamin B6, biotin
  • Perms, hair colour, bleach, improper brushing/combing, hair styles that pull on the hair
  • Autoimmune disease such as lupus
  • Any sex steroid imbalance such as low progesterone, oestrogen dominance
  • Allergies

Acne problem may worsen during the winter months and improve in summer due to the beneficial effects of the sun.