Finding a PCOS treatment plan that works for you is easier said than done. It can take time, as well as trial and error, to find both natural PCOS treatments and medical PCOS treatments that fit your lifestyle, schedule, and personal preferences. That being said, there are some easy, accessible options (and others that are unfortunately less accessible) that can mitigate popular PCOS symptoms that are known to cause emotional and physical distress to women suffering from this condition.
These PCOS treatments won’t cure PCOS - since there is currently no known cure for this syndrome - but they may make living with symptoms easier overall.
In this article, we’ll be diving into both natural, medical, and cosmetic PCOS treatments that show promise in helping relieve hair loss. This article will be part of a series which will tackle PCOS treatments for the following symptoms:
- Hair loss
- Excess hair growth
- Acne
- Unintentional weight gain
- Irregular or missed periods
Let’s dive into various PCOS treatments available for slowing and helping hair loss.
Four PCOS Treatments for Hair Loss
Hair loss from PCOS, also known as androgenic alopecia, is often the result of extra androgen production. These excess androgens trigger excess hair growth (aka hirsutism) in undesired places, such as the face, back, and chest, and are responsible for thinning hair or hair loss on the head, particularly around the front of your scalp.
It’s important to note that testosterone-related hair loss is different from age-related hair loss in women. Most women experience at least some hair loss around menopause, thanks to a shift in hormones, as well as a shift in the hair’s overall lifecycle. Specifically, as we age, the hair has a shorter life cycle, and when it falls out, it is often then replaced with hair fibers that are thinner than before. On the other hand, testosterone-related hair loss need not be age dependent, and can occur as early as your teenage years and mid-20s for men and women. Unfortunately, according to research, it may not be the testosterone that is necessarily to blame (or more accurately, DHT, which is made from testosterone by an enzyme called 5-alpha reductase) for hair loss. Instead, it is the hair follicle’s reaction to it. As such, you can have balanced hormones, but still experience hair loss because of how reactive your hair follicle may be to DHT. This sensitivity seems to be dictated by genetics.
Though hair loss is often associated with men, it can occur in women, but it takes a different form. Men’s hairlines often recede, whereas women’s hairlines remain approximately the same, but with a gradually widening part.
Hair loss in women, thanks to societal pressures and unrealistic, problematic beauty standards, can be extremely emotionally distressing. Know that, whatever treatment option you are interested in, or if you decide to forgo treating this symptom altogether, you are just as valuable as always.
- Minoxidil (aka Rogaine)
Minoxidil is the only FDA-approved drug for treating androgenic alopecia, or female-pattern hair loss. It can be bought or prescribed at 2% and 5% strength. Once prescribed as a medication for blood pressure, participants found that it caused unwanted hair growth. From that point, it has been issued as a topical foam or liquid, which is applied once or twice a day (depending on the strength your doctor prescribes you). Though researchers aren’t exactly sure how it works, they think that it stimulates hair follicles from the resting phase to the growth phase, and then prolongs the length of time the hair spends in the growth phase.
Unfortunately, minoxidil can’t bring back hair that is going to fall out, and it is not the quickest-fix solution. In fact, there is sometimes a ‘shedding’ period associated with the first 8 weeks use of minoxidil, in which old hair that is going to fall out is pushed out to make room for the growth of new hair. You would also need to consistently use this drug over a period of 4 to 6 months to see potential results, since hair grows slowly, and the hair that grows is likely to be fine. From there, you need to keep using minoxidil indefinitely, in order to keep seeing results.
Finally, it’s worth touching on the possibility that minoxidil won’t work, or that it will only work to slow down hair loss, as opposed to trigger new hair growth. However, for those who are struggling with hair loss, minoxidil can offer a worthwhile solution, despite its drawbacks.
- Supplementation
We’ve written a whole article on supplements to help naturally heal PCOS in general, but there are certain vitamins and nutrients that can help tackle hair thinning or hair loss in particular.
Vitamin D is a critical nutrient essential to overall health. It helps in keeping bones strong, stimulating cell growth, creating new hair follicles, and boosting our body’s immune system.
Lack of vitamin D has been linked to alopecia, as well as other health conditions. One study found that low serum ferritin (ferritin is a blood protein that contains iron) and low vitamin D2 are associated with telogen effluvium (TE) and female pattern hair loss (FPHL). A great way to naturally get vitamin D is to spend more time outside in the sun: consider taking a 15 minute walk outside on your lunch break, going for a run after work while it’s still light, or having one of your meals outside. Bonus points if this meal contains high levels of vitamin D! Excellent nutritional sources of this vitamin include:
- Oily fish
- Salmon, sardines, and mackerel are great options
- Liver
- Egg yolks
- Mushrooms
- Fortified foods
Of course, a lack of sun can be difficult to overcome depending on your location, and so gaining vitamin D through supplementation is another option.
Many multivitamin options you see in store will contain 400 IU of vitamin D, which is not enough for keeping vitamin D at optimal levels. Many people need IUs in the thousands to prevent deficiency.. Be careful not to go overboard, though: vitamin D toxicity is a real thing, vitamin D can cause a build up of calcium in the blood.
Supplementing with zinc is a good idea if you have zinc-related hair loss (which can be found out via a blood test), or if you take hormonal birth control, since birth control pills can deplete this mineral (as well as other key vitamins and minerals) in your body. Zinc plays an important role in hair growth since it assists in hair tissue growth, as well as repair, and keeps oil glands around the follicles operating properly.
Again, quantity matters here as well, since too much zinc is bad for your health, and can trigger low levels of copper. Try to get zinc from unprocessed foods, such as:
- Shellfish
- Red meat
- Legumes
- Whole grains
- Dark chocolate
If you do decide to supplement with zinc, be sure to opt for zinc picolinate or zinc citrate since these are bioavailable (compared to other types of zinc), and don’t exceed the recommended daily intake without the supervision of your doctor. This will be dependent on your age, gender, and if you are pregnant, but generally it is between 9 mg and 11 mg for adults.
As a bonus, zinc is linked to improved skin and reduction in acne, thanks to its anti-inflammatory properties!
Finally, saw palmetto is a remedy which shows promise in improving hair loss. Saw palmetto is a plant with small berries that has been used as both food and remedy for a long time by Native Americans. Researchers don’t know exactly how it combats hair loss just yet, but they hypothesize that the palmetto berries interact to block 5-alpha reductase, the enzyme that converts testosterone into DHT (a conversion that causes the hair follicle to shrink in some individuals). The data behind this remedy’s efficacy is still growing, and we need to learn more, but one study showed that in one quarter of men using saw palmetto, their hair count grew by almost 12% over the course of 4 months. Since tablets and capsules have been the only forms researched, it’s suggested that you supplement (under the guidance of a physician) with this form of the plant. It is also recommended if you are pregnant, on birth control pills, or antiogulants, that you don’t supplement with saw palmetto, since it can interact with hormones.
- Spironolactone
Spironolactone is used for treating high blood pressure and heart failure, and - perhaps surprisingly - androgenic alopecia, or female-pattern hair loss (FPHL). So how does it work? Well, it’s thought to slow down the production of androgens, which in turn slows down the hair loss caused by androgenic alopecia, and in some cases, it can even encourage hair to regrow.
One retrospective study found that 75% of participants with FPHL noticed an improvement after taking spironolactone. As an added benefit, spironolactone can be used in conjunction with minoxidil for increased benefits. Similar to minoxidil, though, spironolactone is not a quick fix: most women need to take it for at least 6 months before they start seeing results, but it could even take up to a year. This time can be filled with stress, uncertainty, and a sense of powerlessness that can be difficult to overcome when first prescribed this drug, but if it works for you, then the results can feel worth it to some users.
- Low level light therapy
This advancement in technology presents an exciting option for those wanting to battle androgenic alopecia. The theory behind this technology is that it extends the anagen phase (growth phase) of the hair follicles, while stimulating follicles in the telogen (shed) and catagen (transition) phases. Potentially, it may also increase blood flow to the scalp and enhance the cell metabolism rate to get hair to grow quicker, too.
iRestore’s low level light therapy may seem expensive (it costs over $1000 for the newest model, but $695 for the traditional one), but it can be an option for those who want to explore this treatment. Their own clinical trial showed 100% of patients experienced hair growth, with an average hair growth of 43% on average. They also have a 12 month money back guarantee, so this is a relatively risk-free way to explore this treatment plan.
- Hair oils
There is much research still to be conducted in this area, but early studies indicate some oils could have a positive effect on hair loss.
For instance, in a randomized, double-blind, placebo-controlled trial, pumpkin seed oil (PSO) was shown to have a positive impact on hair growth in men with androgenic alopecia. Mean hair count increased by 40% in men treated with 400mg of pumpkin seed oil, taken daily, at the end of 24 weeks, compared to a 10% increase in placebo-treated men. Interestingly, researchers noted adverse effects were not different for the two groups. Though the jury is still out on the ‘why’ behind pumpkin seed oil’s efficacy, it is known that PCO has been shown to block the action of 5-alpha reductase and to have antiandrogenic effects on rats. It’s important to note this study wasn’t without issue: it was only performed on men, and it had a small sample size, but its results may be promising.
In a randomized comparative trial, rosemary oil was shown to be as effective at promoting hair growth in men with androgenic alopecia as minoxidil after 6 months. At month 3 in the study, both groups showed no improvement, but by month 6, both groups had “a significant increase in hair count” compared to the baseline check in and 3 month check in. Interestingly, both groups experienced increased hair itchiness as a side effect, though the group who used minoxidil reported higher instances of this than the rosemary oil group. So why might rosemary oil be effective? Well, it has the ability to benefit nerve tissue. Specifically carsonic acid, an active ingredient in the plant, is thought to heal tissue and mend nerve damage, which may rejuvenate the scalp. Rosemary oil is also anti-inflammatory and offers antioxidant benefits, too.
What are the drawbacks of this study, then? Well, it’s important to point out that the group in the above trial used a branded rosemary oil (Barij essence Pharmaceutical Co) which contained a certain compilation of active ingredients. In contrast there are plenty of essential oils sold in stores that claim to include rosemary oil, but may have aggravating added ingredients that do more harm than good. In short? Be careful when using rosemary oil for hair loss, and always consult with your doctor or dermatologist before starting treatment.
There is much research still to be conducted in this area, but needless to say, the potential plant and seed oils above have as natural outlets to mitigating PCOS symptoms are exciting and well worth reading into!
Next Steps When Considering Hair Loss Treatments
Like we’ve mentioned already, hair thinning and hair loss can feel particularly distressing and alarming for women. Androgenic alopecia is not spoken about enough, and so if you are experiencing feelings of shame or embarrassment, know that you are not alone: up to 13% of premenopausal women have AGA, and by the age of retirement, 40% of women will have some kind of female pattern hair loss. There is absolutely nothing to feel shame or embarrassment about if you show signs of hair loss: scientists believe this, similar to PCOS, has a genetic cause, and is the result of hair follicles being particularly sensitive to the presence of excess androgens in the body. As such, we recommend the first step is to make an appointment with a healthcare professional. They can identify the root cause of your hair loss. It may be PCOS-induced, or it could be to do with a vitamin deficiency, thyroid issue, or it may even be stress-related: nailing down the reason behind any hair loss or thinning is integral to treating it.
Next, as you’re waiting for your appointment, remember to be kind to yourself. Use kind words when you speak to yourself (both about your physical appearance, and all your other wonderful non-physical traits); give yourself permission to be upset when you need to be; and seek out others who understand what you’re going through (Allara’s PCOS Community is a great start, while there are plenty of online forums and subReddits which have entire threads dedicated to common questions). For instance, in Allara’s Private Community, we have entire discussions related to specific PCOS symptoms - such as unwanted hair loss - in which you can vent, ask questions, seek out recommendations, and get advice from others who know exactly what you’re going through (because they’ve gone through it too!).
Finally, make sure to choose a professional or healthcare partner who understands your concerns and listens to you. If your physician has a propensity to brush off your questions, rush you out the door during your visits, or refuse to dive deeper into what may be behind this unexpected physiological change - this is a red flag. In that case, you should seek a second opinion. Remember that you deserve to be heard and supported as you figure out the best treatment for your hair loss.
Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.