The Dilemma: PCOS Hair Loss

PCOS and hair loss often go hand-in-hand. PCOS hair loss is a real struggle.

Polycystic ovary syndrome (PCOS) is a common hormone disorder affecting at least 1 in 10 women of reproductive age. PCOS is characterized by high androgens (testosterone), high estrogens (estrogen dominance), high insulin and/or irregular menstrual cycles. In fact, contrary to popular belief, PCOS is not defined by cysts on the ovaries at all—at least is does not have to be.

PCOS hair loss - woman worried about her pimples

Common signs and symptoms of PCOS include:

  • Skin breakouts, rosacea and acne
  • Infertility (Fact: PCOS is actually the #1 cause of infertility in women)
  • Irregular cycles, missing periods or “bad” PMS
  • Anxiety and/or low level depression
  • Not feeling like yourself
  • Brain fog
  • Thyroid disorders and Hashimoto’s
  • SIBO—small intestinal bacterial overgrowth
  • Gut problems—constipation and bloating
  • Weight loss or weight gain resistance
  • Gaining muscle or “bulking” easily
  • Low libido
  • Dysglycemia (blood sugar imbalances)
  • Sugar, caffeine or carb cravings
  • Binge eating
  • High testosterone and/or high DHA on bloodwork
  • Facial hair growth
  • Hair thinning and loss

Yup, PCOS is a leading cause of hair loss in young women—often overlooked or misdiagnosed as just a “thyroid issue” or shrugged off to be something that happens when we get older. If you’re losing your hair and you’re of menstruating age, PCOS symptomology may be at play.

Why PCOS Hair Loss Happens 

PCOS hair loss does not happen overnight. Nor are you born with PCOS.

PCOS is a slow-building accumulation of hormone imbalance in the body that is greatly attributed to shifts in insulin, blood sugar imbalances and endocrine disruptors (toxins). In PCOS, spikes of insulin—the blood sugar hormone—stimulate theca cells (hormone cells in the ovaries) to produce androgens (testosterone), as well as the development of more follicles or “cysts” in some (but not all) women.

Some examples of triggers that set the stage for  insulin spikes and PCOS include:

PCOS (Insulin Imbalance) Triggers

  • Birth control pills
  • Inflammatory foods and unaddressed food intolerances
  • Disordered eating
  • High intakes of caffeine or alcohol
  • Low water intake
  • Low protein diets
  • Low essential fatty acids
  • High grain and carb intake
  • Mold toxins and heavy metals
  • Circadian rhythm disruption (shift work, poor sleep habits, blue screens)
  • Frequent plastic use (water bottles, tupperware)
  • Sleep deprivation
  • High amounts of sugar, industrial seed oils and/or processed, refined or takeout foods
  • Overtraining or sedentary lifestyles

Going a step further, the reason why these stressors result in PCOS for some women, but not others, may come down to one’s immune balance—or lack thereof. As the precursors for hormone activation, our immune cells (Th1 and Th2) play a HUGE role in estrogen and testosterone balance.

Emerging research actually suggests that PCOS may be likened to an autoimmune disorder that some women are genetically more susceptible to—their body attacking itself when exposed to stressors mentioned above, igniting free radicals and oxidative stress, and resulting in a host of inflammatory side effects like skin breakouts, bloating, constipation and hair loss. This is perhaps why Hashimoto’s Thyroiditis (an autoimmune disorder against the thyroid) is often seen in PCOS—autoimmune disease rarely occurs I isolation.  High levels of estrogen (estrogen dominance), common in PCOS, also triggers high levels of histamine and inflammatory cytokines—along with symptoms of hair loss.

When you understand the root causes behind PCOS, it can better help you and your clinician to address the real reasons why your hair is falling out—beyond just Google searching the best vitamins, collagen supplements or hair growth creams to use. 

5 Steps to Grow Your Hair Back Naturally

PCOS hair loss - woman checking on her hair loss

You don’t just have to “deal” with hair loss. When you address the root causes behind PCOS, starting with these 5 hacks, operation PCOS hair loss regrowth is yours for the taking.

#1. Balance Blood Sugar

One of the main drivers of hair loss in PCSO is dysglycemia—blood sugar imbalances. Specifically, hypoglycemia (low blood sugar episodes). Balanced blood sugar is a sign that your body is both absorbing nutrients appropriately as well as getting the “just right” amount of energy it needs to keep all bodily processes functioning. If blood sugar is not able to keep up with your body’s energy demands, or your diet is completely out of whack, blood sugar may fall, causing  cortisol to rise and side effects like hair loss.

Some simple ways to balance your blood sugar include:

  • Consume 20-30 grams of protein in the first 1-2 hours of waking each morning
  • If you tend towards insomnia and nighttime waking, sip some bone broth, protein powder or collagen in tea before bed
  • Include 4 to 6 oz of protein with each meal (ideally organic, pasture raised wild caught or grassfed)
  • If you need a snack, reach for a protein or healthy fat based snack (versus carbs like fruit alone, crackers, granola bars, etc.)
  • Eat your starchy carbs on your plate last—after eating protein and veggies
  • Stick to 15 to 30 grams of starchy carbs with meals if you include added starch (like potatoes, winter squashes, rice, quinoa, oats, etc.)
  • Eat the majority of your starchy carbs and fruits after workouts, or add your starch the evening meal with protein, healthy fat and veggies to prevent fatigue earlier on in the day
  • Consume no more than 15 to 20 grams of added sugars daily; and minimize artificial sweetener consumption
  • Supplement with B vitamins—specifically B1, essential for carb absorption
  • If you tend towards high blood sugar, try supplementing with berberine at meal times to keep blood sugar stable ( Check out “Glycoberine” by Apex Entergentics on Full Script). 

#2. Support Your Immune System

Immune balance, controlled by Th1 and Th2 cells, is critical for hormone balance and vice versa. It’s a two way stress. Hence, if your hormones and insulin are out of balance in PCOS, there’s a good chance that your immune system is out of balance. Immune supports like mast cell stabilizers and natural antihistamines may aid in calming down inflammation and “calming” the insulin surge storm.

Balance the immune system with a combination of the following:

#3. Heal Your Gut

We can be eating but starving at a cellular or bacterial level—especially if your gut bacteria aren’t absorbing your nutrients or you have low stomach acid and enzyme production. “Healing your gut” is a broad term for:

(a.) work with a practitioner to figure out if you have SIBO, leaky gut, food intolerances, parasites, etc.;

(b.) address your specific gut issues;

(c.) optimize the foundations or good gut health (check em out here). 

#4. Boost Your Mitochondria

Mitochondria are the essential energy sources (batteries) of all cells, tissues, hormones and organs. In PCOS and oxidative stressful conditions in general, mitochondrial function is challenged.

Give your hormones and all bodily processes a lift off with a broad-spectrum mitochondrial vitamin, along with lifestyle boosters including:

  • Daily movement
  • Quality sleep
  • Eating enough—proteins, healthy fats, carbs (primarily veggies) 

#5. Reset the HPAT Axis

PCOS hair loss - women doing exercise

Last but not least, the mack daddy of them all—stress, mentally and physically.

Your HPAT axis is a code word for “stress management system”—consisting of your hypothyroid, pituitary, adrenal and thyroid glands, and responsible for regulating cortisol (stress hormone).

When blood sugar (insulin) surges, cortisol surges and when blood sugar plummets, cortisol plummets, followed by a high speed kick of adrenaline to pull you out. Stress exacerbates blood sugar swings, just like blood sugar swings exacerbate stress physically and mentally.

Ever felt hangry when there’s no food insight? Hello stress! You’re hungry. All you can think about is food. You feel lightheaded. Shaky. Lethargic. Blood sugar sends your body into stress. Likewise, ever felt so stressed (like you completed a hard workout or you feel lonely, overwhelmed or life feels out of control) that all you could think about is food or nourishment—your body needing fuel (or chocolate) to make it better? Stress sends your body (and blood sugar) into “feed me” mode.

If insulin and hormones are out of whack in PCOS, you can further correct and mitigate those symptoms by addressing the HPAT axis. Many of the tactics we’ve already mentioned are natural anti-stressors including:

  • Daily movement
  • Optimizing sleep
  • Daily breath work, meditation or yoga
  • Circadian rhythm regulation (eating at the same times most days, going to sleep at a decent time, using natural light as much as possible)
  • Human connection and doing things you love (life is short)
  • Adrenal adaptogenic herbs (like Boswellia, Ashwagandha, Rhodiola, Reishi or Cordyceps) 

Work with a functional medicine practitioner to uniquely address your PCOS hair loss with tactics, nutrients and supplements built for you.