How to Stop & Prevent PCOS Hair Loss By Balancing Your Hormones

How to Stop & Prevent PCOS Hair Loss By Balancing Your Hormones

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Do you have both PCOS and hair loss or hair thinning?

Have you been unable to stop your hair from thinning or growing slowly?

The reason you may have trouble is that you are focusing on the wrong issue. 

Hair loss in PCOS is driven predominately by your hormones. 

Learn how to stop and prevent PCOS hair loss in this guide. You will learn which hormone imbalances lead to hair loss and how to stop them. 

What Really Causes Hair Loss in PCOS?

One of the most unfortunate symptoms associated with PCOS is hair loss. 

It is well-known and documented that women with PCOS have an increased risk of developing hair loss (1).

In order to understand hair loss, you have to understand some basics. 

There are many conditions that lead to hair loss and each one is slightly different. 

One of the hardest parts about treating hair loss in women with PCOS is that they can present with a combination of conditions that make diagnosis and treatment difficult.  

The most common types of hair loss that you need to know include: 

#1. Female pattern hair loss – 

This is the standard hair loss that may occur in up to 40% of women by the time they reach 50 (2).

This type of hair loss is referred to as androgenetic alopecia. 

No one really knows what causes this type of hair loss but it is most likely related to a combination of aging, nutrient deficiencies, and hormone sensitivity. 

It is speculated that estrogen likely plays a role because the incidence of this hair loss increases after menopause (and the incidence is increased in PCOS (3)). 

All women, including those with PCOS, can get this type of hair loss. 

Female pattern hair loss (FPHL) presents with thinning of the scalp which often creates a “Christmas tree” pattern. 

You can see an image below: 

female pattern hair loss in women

#2. Male pattern hair loss – 

Women with PCOS can also develop male-patterned hair loss (it’s not just for men!) (4).

This type of hair loss is felt to be caused by excess DHT conversion from testosterone (more on that below). 

Male patterned baldness tends to present with thinning of the hair at the hairline followed by a bald spot on the back of the head. 

This type of hair loss should be differentiated from FPHL which is discussed above. 

#3. Chronic telogen effluvium – 

This type of hair loss results in diffuse loss of hair all over the head (compared to the other types of hair loss which cause specific patterns of hair loss). 

This condition results in rapid hair loss with up to 50% of hair loss from the head in up to 3 months (5).

During this time period, you may notice dramatic “shedding” of your hair as you shower or brush your hair. 

This type of hair loss can be caused by many different conditions including stress, hormone imbalances, nutrient deficiencies, and so on. 

#4. Hormone-induced hair loss – 

Other hormones such as hypothyroidism, Hashimoto’s (6), and estrogen/progesterone imbalances (menopause) (7) can also contribute to premature hair loss. 

Women with PCOS have a higher risk of developing all of these hormone imbalances which can further cloud the picture. 

What makes treating hair loss in PCOS confusing is that no woman presents in the exact same way

For instance:

You may present with diffuse hair loss all over your head while other women with PCOS present with male-patterned baldness. 

It’s important to differentiate between these conditions because the treatment is different for both.  

When it comes to hair loss in PCOS it seems that while all hormones are important, androgens play a more critical role. 

Androgens and Hair Loss in PCOS

Androgen most likely plays an important role in regulating hair growth and the hair cycle but probably not in the way that we typically understand or think about it. 

Generally, we think that high DHT testosterone = hair loss (as occurs in men). 

But we really don’t see this pattern in women, especially those with PCOS. 

Many women with PCOS have so-called “normal” testosterone and DHEA levels and still suffer from hair loss (8).

How can this be?

Instead of focusing on the total amount of testosterone in the body, it’s probably more helpful to focus on the metabolism of androgens and how these hormones impact your hair follicles themselves. 

For instance:

Testosterone metabolism (which occurs in everyone) may create a byproduct known as DHT or dihydrotestosterone. 

It is well known that DHT is a potent androgen and one that negatively impacts hair growth and the hair cycle (9).

Androgen-responsive hair follicles respond to testosterone by shortening their growth phase which reduces the “growth” of your hair

Some women (and men), especially those with PCOS, preferentially metabolize testosterone into DHT. 

This can occur even with normal levels of testosterone in the body! 

And this disordered metabolism may explain why many women with PCOS, even with “normal” or “high-normal” testosterone, suffer from hair loss. 

Furthermore, it seems that women with PCOS have an increased cellular sensitivity to testosterone when compared to other women. 

What this means is that their hair follicles tend to react more robustly in the presence of testosterone compared to other women. 

In this way, it is possible that even slightly high or abnormal levels of testosterone and DHEA may cause hair loss when most people wouldn’t notice a difference

This information is important because there may be ways to reduce the sensitivity of your cells to androgens and to “push” the conversion of testosterone away from DHT. 

These therapies may then effectively treat hair loss. 

How to Grow your Hair Back if you have PCOS

Is there a way to grow your hair back if you have PCOS?

Is there a way to stop the hair loss that is already occurring?

The answer is maybe, but it depends on how you focus on treatment. 


PCOS is predominately a disease of your hormones and all of the symptoms of PCOS are manifestations of these imbalances. 

If hair loss is predominately a symptom of disordered hormone imbalances then the treatment for hair loss MUST focus on hormone balancing. 

Does this make sense?

This means that there is potentially a place for the use of hormones, supplements, and even medications in the treatment of hair loss in PCOS. 

Before you start thinking about using these therapies you need to stop and ask yourself a few questions:

#1. Are you managing your stress?

#2. Are you eating healthy & Is your diet in order? (Read more about the best diet for PCOS here)

#3. Are you reducing the amount of refined sugar that you eat?

#4. Are you exercising (not over-exercising) regularly?

#5. Are you sleeping 8 hours per night?

Before you jump into using supplements and medications these factors MUST be managed

In fact, in terms of importance, they are probably the most important things that you can do to manage hair loss. 

Once you get those in order, you are ready to jump into other therapies: 

#1. Managing Hormone Imbalances to Improve Hair Growth

Whenever possible it’s important to identify which hormone imbalances are present in your body. 

This will require some testing on your part (you can ask for these tests by your Doctor). 

If you know, for instance, that you suffer from high testosterone then you can target your treatment toward that goal. 

You can read more about how to identify if you have high testosterone in this post

Managing High Testosterone & Androgen

  • Focus on weight loss (losing weight will help drop insulin and reduce testosterone)
  • Reduce or reverse insulin resistance if present
  • Focus on using supplements such as Saw Palmetto and Zinc which can reduce DHT conversion from testosterone
  • Consider the use of GLP-1 agonists to help with weight loss (some women with PCOS respond very well)
  • Focus on weight training to increase muscle mass
  • Reduce the consumption of carbohydrates and refined sugars
  • Combine these therapies with the lifestyle recommendations listed above
  • Consider the use of adrenal adaptogens which may influence testosterone

These therapies may be able to help reduce your free and total testosterone, and DHEA and reduce the sensitivity of your hair follicles to androgens. 

Managing Thyroid Dysfunction: 

There is emerging information that shows a link between PCOS and thyroid disease, specifically Hashimoto’s thyroiditis (10).

The relationship between these two conditions appears to be bidirectional. 

This means that thyroid disease may lead to PCOS and PCOS may lead to thyroid disease. 

The exact mechanism isn’t well understood but what you should know is that thyroid disease is a major cause of hair loss. 

Because of this bidirectional connection, it is very important that all women with PCOS be tested (and treated if necessary) for thyroid disease and Hashimoto’s thyroiditis.

If you have PCOS you can improve thyroid function in the following ways: 

Balancing Estrogen and Progesterone: 

Estrogen and progesterone both play an important role in hair growth. 

The problem is that we really don’t understand what role they play…

But it still remains important to have estrogen: progesterone balance in your body. 

An increase in estrogen or a reduction in progesterone can tip the balance and result in symptoms such as hair loss. 

Focus on these therapies to balance out your estrogen: progesterone ratio

#2. Optimizing Hair Regrowth Nutrients

Balancing your hormones is the first, but not the only step, in growing back your hair. 

Another important step is the evaluation of certain nutrients which are involved in hair growth regulation. 

Perhaps the most important is that of ferritin (or iron). 

It is well known that low ferritin contributes to the inability to grow back new hair. 

ferritin levels in women with hair loss

Studies have shown a connection between low ferritin and female pattern hair loss (FPHL) which is one of the main causes of hair loss in women with PCOS. 

Women with FPHL have an average ferritin level of about 30 ug/L lower than healthy controls

What’s most important about this nutrient is that it can be optimized based on lab tests (it’s easy to order and evaluate your serum ferritin) and with the supplementation of iron. 

If you suffer from PCOS hair loss or FPHL then you’ll want to shoot for a ferritin level of or around 70 ug/L (13).

Anything less may make hair regrowth difficult. 

It’s also important to understand the difference between a “normal” ferritin and an “optimal” ferritin, especially in the setting of hair loss. 

You can learn more about evaluating iron and ferritin and how to supplement with iron in this post

While iron is perhaps one of the most important nutrients for hair growth it is certainly not the only one. 

Nutrients and trace minerals such as zinc, selenium, biotin, choline, and silicon play important roles in hair regulation

Deficiencies in these minerals are more common than you might think which is why hair, skin, and nail vitamins can be helpful for certain individuals. 

If you have PCOS you will likely need much more in terms of treatment than a single vitamin, but repleting these nutrients (if deficient) can go a long way to helping improve your hair. 

This is my preferred hair regrowth supplement which works quite well for many women (and men)

#3. Using Medications

The preferred method for managing hair loss in PCOS is to always go after the root cause and treat that issue. 

This approach will result in the best improvement and reversal of hair loss. 

Having said that, there is still a place for the use of certain medications. 

Medications like Minoxidil are FDA approved for the treatment of hair loss in both men and women (14).

The main drawback to using Minoxidil is that it only works insofar as you are using it. 

What this means is that it may definitely stop hair loss, or at least slow it down, but this benefit is reversed the second you stop using the medication. 

This makes it a less-than-ideal treatment, but it does have its place. 

Consider this example

If you are suffering from hair loss that is causing significant social anxiety or distress, then it may make sense to take a temporary measure such as using medication to quickly stop the hair loss while other therapies kick in. 

By using Minoxidil in this way you can obtain the benefit for a short period of time while you use other therapies (such as hormone balancing) listed above. 

You can learn more about using Minoxidil and how it works here


Hair loss among women with PCOS is a serious condition and one that should be evaluated and treated. 

Hair loss can cause considerable anxiety and social distress if left untreated and may be largely side-lined to other medical conditions and therapies.

If you have PCOS you should focus on treating underlying hormone imbalances, repleting nutrient deficiencies, and improving your lifestyle. 

These therapies will give you the biggest bang for your buck and will go a long way to reversing hair loss. 

Some people with PCOS may have a genetic component that will make their responsiveness to these therapies somewhat lackluster

At this time there isn’t a way to differentiate between those who respond to certain therapies and those who do not. 

Because of this, it’s best to attempt these therapies to see if they work for you. 

Now I want to hear from you:

Are you suffering from hair loss secondary to PCOS?

Do you have known thyroid disease or other hormone imbalances?

Do you also have high testosterone or high androgens?

What has worked to help grow your hair back? What hasn’t?

Leave your comments below! 















4 causes & 3 treatments for PCOS related hair loss

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

P.S. Here are 4 ways you can get more help right now:

#1. Get my free thyroid downloads, resources, and PDFs here.

#2. Need better symptom control? Check out my thyroid supplements.

#3. Sign up to receive 20% off your first order.

#4. Follow me on Youtube, Facebook, TikTok, and Instagram for up-to-date thyroid tips, tricks, videos, and more.

13 thoughts on “How to Stop & Prevent PCOS Hair Loss By Balancing Your Hormones”

  1. I was having a range of menopausal symptoms, including hair loss, and blood tests revealed that testosterone, estradiol, and progesterone was virtually non-existent. I began the lowest dose femhrt (ethinyl estradiol and norethindrone) and the hair loss normalized within weeks. It continued for this way for about 4 months, then hair loss suddenly increased even above pre-femhrt levels. Blood tests revealed that testosterone was high (at 49 from <3)); free test was up from 0.3 to 3.1 estradiol was the same (<5.0); progesterone was up from <0.1 to 0.3; and DHEA was up a little (at 61.9 from 56.5). The only change I am aware of is that my pharmacy changed generic supplier of the femhrt at my 4th RX fill. My questions: can femhrt raise testosterone and is it possible that the generic formulas are different from each other. (I am on no other meds. I take supplements and have a good diet. I do weights and/or cardio daily. I am 5'8"and weigh 127 lbs.) Thank you Dr. Westin. I have spent countless hours researching to get answers as this issue is most grievous.

    • Hi Lisa,

      Yes, generic formulations are slightly different and can cause changes in certain sensitive individuals. You may have more luck with the brand medication. It’s also possible that your need for hormone has changed over time.

  2. Hi Westin,

    I’m a 24 Yr old woman suffering from heavy hairloss since the age of 21 prior to which I had severe cystic acne that went away with accutane.
    I do have hashmitos thyroiditis with high TPO but normal t3, t4 and tsh levels.
    Testosterone, dheas and estradiol are all very normal although it is possible that I have pcos. I’ve tried different dht blockers and none have made a difference.
    Other than the heavy hair loss, I suffer from occasional insomnia. I’ve read through your articles and I have incorporated these activities since a few months:
    -Gluten free, Dairy free low GI diet
    -3 to 4 times medium impact exercise
    – yoga and meditation
    -taking dim/calcium D glucarate supplements
    -I have no known nutritional deficiencies

    Seek your help! Thank you!!

  3. Hi Dr. Westin,

    I have been experiencing abnormal hair shedding on and off for about a year. I have seen a gynecologist and two GPs. The original hypothesis was that my low-androgen combination birth control pill caused the hormonal imbalance. But it has been 10 months since I discontinued usage and I am still shedding abnormally and am not seeing return to full density. I believe I have lost at least 1/3 of my hair diffusely.

    My new GP prescribed me with a natural thyroid medication despite normal blood results on a full thyroid panel. She alluded to the testing gap with thyroid diagnosis and believes my cold sensitivity, low energy and family history of hypothyroidism justify the diagnosis.

    My bloodwork shows high total and bioavailable testosterone, with DHEA on the higher albeit normal range. My half sister has PCOS. Word is that my grandma wore a hair piece when she was older, so I may have a genetic predisposition to hair loss.

    I have long believed I have PCOS, but medical professionals say I do not present as a classic PCOS patient because I am thin; although, I very irregular periods and cysts on my ovaries.

    I want to find the root cause of my hair loss so I can treat it effectively. What do you advise as my medical next steps?

  4. Hi Dr. Westin,

    I was diagnosed with PCOS in September last year after having come off the pill in June last year and my periods not returning. In August last year my severe hair loss started – I went through 9 sessions of mesotherapy, 3 PRP sessions and one Regenera Activa therapy and nothing is helping at all.
    I have cleaned uo my diet (no sugar, low carb / low GI, no processed food, low dairy) and have been taking Metformin for 2 months now as well as Saw Palmetto, B12, NAC, Zinc, Magnesium….My testosterone levels have gone down slightly but my DHEA-S is still very high – I have absolutely no idea what I can do – I have almost no hair left on my scalp with many areas showing completely especially at the front middle. It is making me not want to leave the house. On top of that I have Hashimoto’s but currently no anti-bodies, I was recently switched to a combined T3 + T4 medication (Novothyral) from a pure levothyroxine medication. But nothing is helping me – I would like to just know whether there is any hope of me somehow balancing hormones and then my hair returning or whether what is lost is now gone forever?

    Thank you for taking the time to read and maybe reply to me,

    Kind regards,

  5. Hello Dr. Childs. Ive been recently diagnosed with PCOS. After doing a blood test in November my testosterone and DHEA Sulfate were too high. I’ve been taking Saw Palmetto and drinking Spearmint tea to help reduce these androgens. I just repeated my blood work and my testosterone lowered, however my DHEAS seemed to be higher. How can this happen? What can I do to reduce DHEAS? Please advise if you can. Thank you!!

  6. I know my hormone are out of balance and have been since my 20’s. I take thyroid medication. I am now overweight. I recently have developed hair shedding, brittle nails and a change in the texture of y hair also. I also have struggled with facial hair. Now its out of control. I am also taking many of the vitamins suggested and more. I also suffer though Covid and have the long haul covid. So If you could give some idea of what is should do at this point it would fall on fertile ground. There is quite a lock down on good medical help these days.

  7. Hi
    I have an underactive thyroid on Leventhyroxin for 25 years I think I have severe female pattern baldness can I grow my hair back and if so what supplements would you recommend
    I’m at a low g place at the moment would really appreciate if you got back to me.
    I live in the UK


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