Hair Thinning & Loss in PCOS: A Compassionate, Holistic Approach

If you’re noticing more hair in your brush, a shrinking ponytail, or your part widening, please know you’re not alone. Up to 1 in 4 women with PCOS experience hair thinning or loss—often right where you want to keep it: on your scalp.

As a dietitian who has worked with so many women facing this, I know how much it can hurt your confidence and sense of self. But there is hope, and it starts with understanding, not blame.

Why Does Hair Loss Happen in PCOS?

PCOS is a hormonal condition where higher levels of “male” hormones (androgens, like testosterone) can shrink hair follicles and shorten the hair growth cycle. Over time, this means more hairs fall out and new ones grow back thinner. On top of this, many women with PCOS also have insulin resistance, which pushes up androgens even more.

But there’s one piece many people overlook: chronic stress. Stress hormones (like cortisol) can disrupt your cycle, increase androgen levels, and even push more hairs into the shedding phase. So if you feel like your hair gets worse during stressful periods, it’s not your imagination.

How Common Is It?

About 20–30% of women with PCOS experience some degree of scalp hair thinning or loss (sometimes called female-pattern hair loss or androgenic alopecia). Genetics and ethnicity play a role too—so this is not your fault, and you’re not alone.

Your Step-by-Step Approach to Healthier Hair

1. Start with Lifestyle Changes That Lower Androgens & Insulin

• Nourish your body: Focus on balanced meals with plenty of fibre (think: whole grains, beans, veg), healthy fats, and quality protein.

• Move your body: Gentle, regular exercise—like walking, strength training, or yoga—can improve insulin sensitivity and support hormone balance.

• Support your gut health: A healthy gut is linked to better hormone regulation—aim for a variety of plant foods and consider a probiotic if you struggle with bloating or gut issues.

• Add inositol: Evidence shows that inositol (a supplement) can improve insulin sensitivity and help lower testosterone levels in women with PCOS.

• Prioritise stress management: Chronic stress can both worsen PCOS and directly increase hair loss. Practices like deep breathing, mindfulness, regular sleep, and setting boundaries really do help. Even a few minutes a day can make a difference.

  
  

2. Gentle, Kind Hair Care

• Reduce hair washing: You don’t need to wash your hair daily—2–3 times a week is often plenty.

• Be gentle: Use a wide-tooth comb, avoid tight ponytails or braids, and skip harsh chemical treatments when possible.

• Limit heat styling: Reduce how often you use straighteners, curling wands, or hot dryers. Air-dry when you can, and always use heat protectant.

• Choose silk pillowcases: These create less friction and can help prevent breakage—plus, they feel a bit luxurious!

  
  

Why Patience Matters: The Lifecycle of the Hair Follicle

If you’re making positive changes, it’s natural to want to see results straight away. But your hair works on its own gentle schedule—one that can’t be rushed. Every strand grows through a cycle with three key stages:

• Anagen (growth): This is the “active” phase, which can last years! Most of your scalp hair is in this phase.

• Catagen (transition): A quick “rest stop” lasting just a couple of weeks.

• Telogen (resting/shedding): The hair stops growing and eventually falls out, making space for a new one.

  
  

Because of this natural turnover, it often takes at least 6–12 months before you notice real changes from any treatment or new habit—whether that’s diet, stress management, or topical solutions. Sometimes, you might notice extra shedding early on (even with things like minoxidil)—that can actually mean new, healthier hairs are beginning to grow.

💜 So, if you’re feeling discouraged, remember: your efforts are working, even if you can’t see it yet. Small, consistent changes truly add up over time.

3. Simple Topical Treatments

• If you’re ready to try a topical solution, minoxidil (the foam or lotion) is safe and available over the counter. It works best if you start early and use it consistently. Just remember: patience is key—it can take 6–12 months to see a difference, and some extra shedding at first is normal.

  
  

4. When to Seek Extra Support

• If hair loss is distressing or you’re not seeing progress with lifestyle changes and gentle care, talk to your GP or a dermatologist. Options like anti-androgen medication or hormonal therapies (e.g. spironolactone, the pill, or finasteride) can be explored with medical guidance. For some, PRP therapy or laser treatments might be an option, but these come later.

• Don’t forget: ask about checking your iron, vitamin D, and thyroid levels—deficiencies are common in PCOS and can make hair loss worse.

  
  

The Emotional Side—You’re Not Alone

Hair loss isn’t “just cosmetic.” I’ve listened to countless women who have felt embarrassed, anxious, or like they’re “losing” themselves. If that’s you—please be gentle with yourself. Reach out for support. You are still you, and your worth is not defined by your hair.

In Summary:

• Start with small, realistic lifestyle changes—they matter more than you think.

• Be kind to your scalp and gentle with your hair.

• Try minoxidil if you’re ready, but know that lifestyle is powerful too.

• Seek medical support if you need it—sometimes it takes a team.

  
  

And most of all: celebrate every small win (like less hair in the drain or a new baby hair peeking through). With time, consistency, and compassion, things can get better.