Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentPrescriptionsDiagnosisWhen to See a Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Prescriptions
Diagnosis
When to See a Healthcare Provider
Frequently Asked Questions
Androgenic alopeciais common in people withpolycystic ovary syndrome (PCOS).In addition to hair loss, people with PCOS often experience weight gain, acne, andhirsutism(excessive facial or body hair) due to increases in male hormones.
This article discusses the symptoms and causes of androgenic alopecia, as well as some of the medications used to treat hair loss in people with PCOS.
Sol de Zuasnabar Brebbia / Getty Images
Symptoms of Androgenic Alopecia With PCOS
Androgenic alopecia, also known as androgenetic alopecia, is the patterned loss of hair that can affect males and females.In people with PCOS, the pattern is usually different from what is seen withmale pattern hair loss.
With male pattern hair loss, the hair loss will start in the front of the head and gradually recede to the back.
Withfemale pattern hair loss, the pattern will develop in one of two different ways:
Rather than complete baldness, female pattern baldness typically causes thinner and shorter hair. Even so, the thinning can be significant enough to expose large areas of the scalp.
In people with PCOS, androgenic alopecia rarely occurs in isolation. In addition to female pattern hair loss, people with PCOS may also experience:
Signs and Symptoms of PCOS
1:27Click Play to Learn About the Causes and Treatments for PCOS Hair Loss
1:27
Click Play to Learn About the Causes and Treatments for PCOS Hair Loss
Causes of Androgenic Alopecia With PCOS
The cause of PCOS is unknown. However, it is thought to involve a combination ofgeneticand environmental factors that trigger an imbalance in female hormones (calledestrogens) and male hormones (calledandrogens).
Under normal circumstances, females and males have specific proportions of estrogens and androgens in their bodies to function normally. When the balance is thrown off, any number ofhormonal problemscan occur.
This can trigger a condition known ashyperandrogenismin which the body produces excessive amounts of androgens. Chief among these is the androgentestosterone.
In males, testosterone is responsible for male sex characteristics like facial hair, increased stature and muscle growth, and a deeper voice. It also contributes to hair loss due to the conversion of testosterone into an androgen known asdihydrotestosterone(DHT).
DHT is also the cause of hair loss in females with PCOS.
In both males and females, around 10% of testosterone is converted into DHT. Once released into the bloodstream, DHT can link to receptors on hair follicles on the scalp, causing them to shrink. Even if the hair doesn’t fall out, it can become visibly thinner.
People with PCOS are vulnerable to androgenic alopecia because they have excessive amounts of testosterone in their bodies and, in turn, excessive amounts of DHT.
A Guide to PCOS and Menopause
How to Treat Androgenic Alopecia With PCOS
Though results can vary, people with androgenic alopecia may benefit from certain over-the-counter drugs, prescription medications, and specialist procedures.
Over-the-Counter Medications
Currently, there is only one product approved for the treatment of female pattern hair loss in the United States: an over-the-counter topical drug known as Rogaine (minoxidil).
Rogaine will not cure PCOS-related hair loss, but it may help manage it. Keep in mind that once you stop using Rogaine, the hair loss may re-occur.
Another over-the-counter option isiron supplements. Some studies have shown thatiron deficiencyplays a role in female patterned hair loss and that iron supplements may help prevent it.Even so, there is currently no clear evidence that taking iron supplements can reverse the hair loss once it occurs.
There are other medications that work directly on sex hormones. They may be prescribed if Rogaine falls short or blood tests reveal that you have excessively high androgen levels. With that said, there is only limited evidence supporting their use. Results can vary.
Some of the prescription medications used to treat female pattern hair loss include:
Surgery and Specialist-Driven Procedures
Some people may opt forhair transplantation surgeryif the hair loss is severe. This includesfollicular unit extraction(FUE) in which individual hair follicles are removed and transplanted. In another procedure,follicular unit transplantation(FUT), a strip of skin is removed from the scalp to harvest hair follicles for transplantation.
Another option isplatelet-rich plasma (PRP) injections. This is a process in which blood is spun to separate blood cells from the main liquid component called plasma. Scalp PRP injections have shown some promise in reversing alopecia in people with patchy hair loss.
Are There Tests to Diagnose Androgenic Alopecia?
PCOS is one of the main causes of androgenic alopecia in females—but not the only one. There are other conditions that can alter hormones and trigger female pattern hair loss, including:
Because there are many causes of androgenic alopecia, your healthcare provider will order different tests to help narrow the possibilities.
How PCOS Is Diagnosed
There are no tests that can definitively diagnose PCOS. PCOS ultimately involves a diagnosis of exclusion, meaning that all other causes must be excluded before a diagnosis can be reached.
The investigation typically starts with the following tests and procedures:
Based on the initial findings, additional tests and procedures may be ordered to rule out possible causes. This may take time and patience.
Androgenic alopecia is neither dangerous nor necessarily a cause for alarm. While distressing, the condition can often be treated once the underlying cause is identified.
With that said, early treatment is more likely to render positive results than waiting until the hair loss is severe.
There are certain types of alopecia that warrant immediate attention. This includescicatricial alopecia, a poorly understood inflammatory condition that destroys the stem cells and oil glands of hair follicles, leading to scarring and permanent hair loss.
See a healthcare provider immediately if any or all of the following occurs:
Summary
Androgenic alopecia may be treated with topical Rogaine (minoxidil) or oral drugs like spironolactone, finasteride, or flutamide that bring down testosterone levels. Platelet-rich plasma (PRP) injections or hair transplant surgery may be pursued if topical or oral medications fail to provide relief.
A Word From Verywell
If female pattern hair loss is seriously bothering you, ask your primary care healthcare provider for a referral to a specialist known as anendocrinologist. These are physicians specially trained in diseases and disorders of theendocrine (hormonal) system.
Endocrinologists have expertise in many hard-to-diagnose hormonal conditions, like PCOS. They can also recommend the latest, most effective treatments for conditions like androgenic alopecia.
Frequently Asked QuestionsRogaine (minoxidil), a topical drug used to treat androgenic alopecia in people with PCOS, has been shown to significantly increase hair thickness after one year. Even so, results can vary. Oral minoxidil has proven less effective, although it may reduce hair shedding.Rogaine is considered safe but can cause side effects in some, including:Skin irritationDifferences in hair color or texture from surrounding hairHypertrichosis(excessive hair growth in places like the cheeks or forehead)Some studies suggest that 67% of males experience some degree of androgenic alopecia compared to 24% of females. Polycystic ovary syndrome (PCOS) is one of the most common causes in females of reproductive age.
Rogaine (minoxidil), a topical drug used to treat androgenic alopecia in people with PCOS, has been shown to significantly increase hair thickness after one year. Even so, results can vary. Oral minoxidil has proven less effective, although it may reduce hair shedding.
Rogaine is considered safe but can cause side effects in some, including:Skin irritationDifferences in hair color or texture from surrounding hairHypertrichosis(excessive hair growth in places like the cheeks or forehead)
Rogaine is considered safe but can cause side effects in some, including:
Some studies suggest that 67% of males experience some degree of androgenic alopecia compared to 24% of females. Polycystic ovary syndrome (PCOS) is one of the most common causes in females of reproductive age.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Carmina E, Azziz R, Bergfeld W, et al.Female pattern hair loss and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Clin Endocrinol Metab. 2019 Jul 1;104(7):2875-91. doi:10.1210/jc.2018-02548MedlinePlus.Androgenetic alopecia.Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clin Epidemiol.2013;6:1-13. doi:10.2147/CLEP.S37559Eunice Kennedy Shriver National Institute of Child Health and Human Development.What causes PCOS?Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001Park SY, Na SY, Kim JH, Cho S, Lee JH.Iron plays a certain role in patterned hair loss.J Korean Med Sci.2013 Jun;28(6):934–8. doi:10.3346/jkms.2013.28.6.934Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A.The role of vitamins and minerals in hair loss: a review.Dermatol Ther (Heidelb).2019 Mar;9(1):51–70. doi:10.1007/s13555-018-0278-6Brough KR, Torgerson RR.Hormonal therapy in female pattern hair loss.Int J Womens Dermatol. 2017;3(1):53–57. Published 2017 Feb 24. doi:10.1016/j.ijwd.2017.01.001American Society of Plastic Surgeons.Hair transplantation and restoration.Hegde P, Relhan V, Sahoo B, Garg VK.A randomized, placebo and active controlled, split scalp study to evaluate the efficacy of platelet-rich plasma in patchy alopecia areata of the scalp.Dermatol Ther.2020 Oct 9:e14388. doi:10.1111/dth.14388Bhat YJ, Saqib NU, Latif I, Hassan I.Female pattern hair loss—an update.Indian Dermatol Online J.2020 Jul-Aug;11(4):493–501. doi:10.4103/idoj.IDOJ_334_19National Organization of Rare Disorders.Cicatricial alopecia.Suchonwanit P, Thammarucha S, Leeunyakul K.Minoxidil and its use in hair disorders: a review.Drug Des Devel Ther. 2019;13:2777–86. doi:10.2147/DDDT.S214907Salman KE, Altunay IK, Kucukunai NA, Cerman AA.Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey.An Bras Dermatol.2017 Jan-Feb;92(1):35–40. doi:10.1590/abd1806-4841.20175241
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Carmina E, Azziz R, Bergfeld W, et al.Female pattern hair loss and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Clin Endocrinol Metab. 2019 Jul 1;104(7):2875-91. doi:10.1210/jc.2018-02548MedlinePlus.Androgenetic alopecia.Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clin Epidemiol.2013;6:1-13. doi:10.2147/CLEP.S37559Eunice Kennedy Shriver National Institute of Child Health and Human Development.What causes PCOS?Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001Park SY, Na SY, Kim JH, Cho S, Lee JH.Iron plays a certain role in patterned hair loss.J Korean Med Sci.2013 Jun;28(6):934–8. doi:10.3346/jkms.2013.28.6.934Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A.The role of vitamins and minerals in hair loss: a review.Dermatol Ther (Heidelb).2019 Mar;9(1):51–70. doi:10.1007/s13555-018-0278-6Brough KR, Torgerson RR.Hormonal therapy in female pattern hair loss.Int J Womens Dermatol. 2017;3(1):53–57. Published 2017 Feb 24. doi:10.1016/j.ijwd.2017.01.001American Society of Plastic Surgeons.Hair transplantation and restoration.Hegde P, Relhan V, Sahoo B, Garg VK.A randomized, placebo and active controlled, split scalp study to evaluate the efficacy of platelet-rich plasma in patchy alopecia areata of the scalp.Dermatol Ther.2020 Oct 9:e14388. doi:10.1111/dth.14388Bhat YJ, Saqib NU, Latif I, Hassan I.Female pattern hair loss—an update.Indian Dermatol Online J.2020 Jul-Aug;11(4):493–501. doi:10.4103/idoj.IDOJ_334_19National Organization of Rare Disorders.Cicatricial alopecia.Suchonwanit P, Thammarucha S, Leeunyakul K.Minoxidil and its use in hair disorders: a review.Drug Des Devel Ther. 2019;13:2777–86. doi:10.2147/DDDT.S214907Salman KE, Altunay IK, Kucukunai NA, Cerman AA.Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey.An Bras Dermatol.2017 Jan-Feb;92(1):35–40. doi:10.1590/abd1806-4841.20175241
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Carmina E, Azziz R, Bergfeld W, et al.Female pattern hair loss and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Clin Endocrinol Metab. 2019 Jul 1;104(7):2875-91. doi:10.1210/jc.2018-02548MedlinePlus.Androgenetic alopecia.Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clin Epidemiol.2013;6:1-13. doi:10.2147/CLEP.S37559Eunice Kennedy Shriver National Institute of Child Health and Human Development.What causes PCOS?Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001Park SY, Na SY, Kim JH, Cho S, Lee JH.Iron plays a certain role in patterned hair loss.J Korean Med Sci.2013 Jun;28(6):934–8. doi:10.3346/jkms.2013.28.6.934Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A.The role of vitamins and minerals in hair loss: a review.Dermatol Ther (Heidelb).2019 Mar;9(1):51–70. doi:10.1007/s13555-018-0278-6Brough KR, Torgerson RR.Hormonal therapy in female pattern hair loss.Int J Womens Dermatol. 2017;3(1):53–57. Published 2017 Feb 24. doi:10.1016/j.ijwd.2017.01.001American Society of Plastic Surgeons.Hair transplantation and restoration.Hegde P, Relhan V, Sahoo B, Garg VK.A randomized, placebo and active controlled, split scalp study to evaluate the efficacy of platelet-rich plasma in patchy alopecia areata of the scalp.Dermatol Ther.2020 Oct 9:e14388. doi:10.1111/dth.14388Bhat YJ, Saqib NU, Latif I, Hassan I.Female pattern hair loss—an update.Indian Dermatol Online J.2020 Jul-Aug;11(4):493–501. doi:10.4103/idoj.IDOJ_334_19National Organization of Rare Disorders.Cicatricial alopecia.Suchonwanit P, Thammarucha S, Leeunyakul K.Minoxidil and its use in hair disorders: a review.Drug Des Devel Ther. 2019;13:2777–86. doi:10.2147/DDDT.S214907Salman KE, Altunay IK, Kucukunai NA, Cerman AA.Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey.An Bras Dermatol.2017 Jan-Feb;92(1):35–40. doi:10.1590/abd1806-4841.20175241
Carmina E, Azziz R, Bergfeld W, et al.Female pattern hair loss and androgen excess: a report from the Multidisciplinary Androgen Excess and PCOS Committee.J Clin Endocrinol Metab. 2019 Jul 1;104(7):2875-91. doi:10.1210/jc.2018-02548
MedlinePlus.Androgenetic alopecia.
Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clin Epidemiol.2013;6:1-13. doi:10.2147/CLEP.S37559
Eunice Kennedy Shriver National Institute of Child Health and Human Development.What causes PCOS?
Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S.Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review.Int J Womens Dermatol. 2018;4(4):203–211. doi:10.1016/j.ijwd.2018.05.001
Park SY, Na SY, Kim JH, Cho S, Lee JH.Iron plays a certain role in patterned hair loss.J Korean Med Sci.2013 Jun;28(6):934–8. doi:10.3346/jkms.2013.28.6.934
Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A.The role of vitamins and minerals in hair loss: a review.Dermatol Ther (Heidelb).2019 Mar;9(1):51–70. doi:10.1007/s13555-018-0278-6
Brough KR, Torgerson RR.Hormonal therapy in female pattern hair loss.Int J Womens Dermatol. 2017;3(1):53–57. Published 2017 Feb 24. doi:10.1016/j.ijwd.2017.01.001
American Society of Plastic Surgeons.Hair transplantation and restoration.
Hegde P, Relhan V, Sahoo B, Garg VK.A randomized, placebo and active controlled, split scalp study to evaluate the efficacy of platelet-rich plasma in patchy alopecia areata of the scalp.Dermatol Ther.2020 Oct 9:e14388. doi:10.1111/dth.14388
Bhat YJ, Saqib NU, Latif I, Hassan I.Female pattern hair loss—an update.Indian Dermatol Online J.2020 Jul-Aug;11(4):493–501. doi:10.4103/idoj.IDOJ_334_19
National Organization of Rare Disorders.Cicatricial alopecia.
Suchonwanit P, Thammarucha S, Leeunyakul K.Minoxidil and its use in hair disorders: a review.Drug Des Devel Ther. 2019;13:2777–86. doi:10.2147/DDDT.S214907
Salman KE, Altunay IK, Kucukunai NA, Cerman AA.Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey.An Bras Dermatol.2017 Jan-Feb;92(1):35–40. doi:10.1590/abd1806-4841.20175241
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