Checklist for Managing PCOS Hair Loss

PCOS-related hair loss affects many women due to elevated androgen levels, which shrink hair follicles and cause thinning, especially around the crown and part line. While frustrating, it’s possible to manage and even reverse this issue with the right combination of medical treatments, lifestyle changes, and hair care routines. Here’s a quick breakdown of how to tackle PCOS hair loss:

Step 1: Diagnosis and Testing
Confirm PCOS and elevated androgen levels with a healthcare provider. Blood tests like testosterone, DHEAS, and androstenedione help pinpoint the cause.
Step 2: Medical Treatments
Options like spironolactone, birth control pills, and minoxidil address hormonal imbalances and promote regrowth. Always consult a provider to find the right fit.
Step 3: Diet and Lifestyle Adjustments
Focus on a low-glycemic diet, regular exercise, and stress management to balance hormones and improve overall health.
Step 4: Hair Care Routine
Use gentle, sulfate-free products, avoid tight hairstyles, and incorporate scalp massages to support hair health.
Step 5: Track Progress
Monitor changes with photos and regular check-ins with your provider. Hair regrowth can take 6–12 months, so patience and consistency are key.

For added convenience, telehealth services like Oana Health offer affordable, prescription-based treatments tailored to PCOS hair loss. By combining these steps, you can address the root causes and work toward healthier hair over time.

How to Stop PCOS Hair Loss

Step 1: Get PCOS Diagnosis and Check Androgen Levels

Before starting any treatment, it’s important to confirm that elevated androgen levels are the cause of your hair thinning. Hair loss can have many triggers, so getting an accurate diagnosis is the first step toward effective treatment. Let’s break down how excess androgens affect your hair and the steps to identify the root cause.

How PCOS Causes Hair Loss

Hair loss linked to PCOS happens when high androgen levels - like testosterone - shrink hair follicles and disrupt the natural hair growth cycle. This process primarily affects the crown and top of the scalp, leading to a diffuse thinning pattern. Interestingly, the hairline usually stays intact despite these changes.

Getting Diagnosed

Finding a healthcare provider experienced in PCOS is key to getting a proper diagnosis. The process involves a combination of clinical evaluation and lab testing to confirm elevated androgen levels.

Before your appointment, take note of your symptoms. These might include hair thinning, irregular menstrual cycles, or changes in your skin, such as acne. During the evaluation, your provider will likely order blood tests to measure specific androgens, including:

Total and Free Testosterone: Indicates active hormones that may shrink hair follicles.
DHEAS (Dehydroepiandrosterone sulfate): Helps pinpoint whether the excess androgens are coming from the adrenal glands.
Androstenedione: A precursor to testosterone that reflects overall androgen activity.

Diagnostic Component	What It Measures	Impact on Hair Loss
Total/Free Testosterone	Levels of active hormones	Shows androgen excess, which can shrink follicles
DHEAS	Adrenal androgen production	Helps identify the source of androgen excess
Androstenedione	Precursor to testosterone	Indicates activity in the androgen pathway

For the most accurate results, request fasting morning blood tests. Additionally, your provider may test for thyroid disorders and iron deficiency, as these conditions can mimic PCOS symptoms.

PCOS is typically diagnosed using the Rotterdam criteria. This approach requires at least two of the following: irregular ovulation, signs of hyperandrogenism (clinical or biochemical), or polycystic ovaries visible on an ultrasound. Even if you don’t meet all the criteria, elevated androgen levels alone can still be a major factor in scalp thinning.

Once your diagnosis is confirmed and your androgen levels are measured, you’ll have a clear starting point for tracking progress as you begin treatment. Regular check-ins every 3–6 months will help monitor hormone levels and assess your hair regrowth journey. Establishing this baseline is essential as you move forward with the treatment steps outlined in the next sections.

Step 2: Consider Medical Treatments for Hair Loss

If you've confirmed elevated androgen levels through proper testing, medical treatments can address the hormonal causes of PCOS-related hair loss rather than just masking the symptoms. It's important to consult a provider who specializes in PCOS to find treatments tailored to your hormone profile. When paired with lifestyle adjustments and hair care strategies (discussed later), these treatments can form a well-rounded plan for managing hair loss caused by PCOS.

Anti-Androgen Medications

Spironolactone is a commonly used treatment for PCOS-related hair loss. It works by blocking androgen receptors, which reduces the effect of excess testosterone on hair follicles. This medication is often prescribed when minoxidil alone isn't enough to produce results. Most people start seeing improvements within 3–6 months. However, spironolactone can cause side effects like increased urination, menstrual irregularities, and, in rare cases, elevated potassium levels. Because of this, regular blood tests are usually recommended. It's also worth noting that spironolactone is not safe to use during pregnancy due to potential risks to the fetus.

Birth Control Pills

For women who aren't planning to get pregnant, birth control pills with anti-androgen properties offer both contraception and hormonal regulation. Pills containing higher estrogen levels and low-androgen progestins (such as drospirenone or desogestrel) can help reduce hair loss by suppressing androgen production and balancing hormone levels. These pills also address other PCOS symptoms like irregular periods and acne. Typically, noticeable improvements occur after 3–4 months of consistent use. However, choosing the right formulation is crucial, as pills with higher androgenic activity may worsen hair loss.

Topical and Oral Minoxidil

Minoxidil is the only FDA-approved topical treatment for female pattern hair loss. Available in 2% and 5% solutions, it works by increasing blood flow to hair follicles, often leading to noticeable regrowth within 3–6 months. For those who prefer a systemic option, oral minoxidil is available off-label, though it requires blood pressure monitoring to ensure safety.

Treatment Type	Mechanism	Typical Timeline	Key Considerations
Spironolactone	Blocks androgen receptors	3–6 months for results	Monitor potassium levels; avoid in pregnancy
Birth Control Pills	Regulates hormone production	3–4 months for changes	Use low-androgen formulations
Topical Minoxidil	Stimulates follicle blood flow	3–6 months for regrowth	FDA-approved; requires twice-daily use
Oral Minoxidil	Systemic follicle stimulation	Varies	Monitor blood pressure; off-label use

Oana Health Treatments

Oana Health

Oana Health offers prescription treatments for PCOS, including the medications mentioned above. Through their telehealth platform, you can connect with licensed medical professionals who specialize in PCOS-related hair loss.

Oana Health provides options like spironolactone starting at $14 per month, topical spironolactone at $43 per month, and oral minoxidil for $25 per month. These treatments are compounded in FDA-regulated pharmacies and come with free shipping. Oana Health also ensures consistency with ongoing support and automatic refills.

For more severe cases, combining therapies such as spironolactone and minoxidil may improve results. However, combination treatments should always be managed by a healthcare professional to monitor for side effects or interactions. The 2023 International Evidence-based Guideline for PCOS emphasizes regular monitoring of hyperandrogenism symptoms, including hair loss, and recommends adjusting treatment plans based on your progress.

Selecting the right medical treatment is a crucial first step in addressing PCOS-related hair loss, setting the stage for further improvements through diet, lifestyle, and hair care strategies.

Step 3: Make Diet and Lifestyle Changes

In addition to medical treatments, adjusting your diet and lifestyle can play a big role in managing androgen triggers and encouraging hair regrowth. These changes work alongside treatments to create a better environment for your hair to recover. They help balance insulin levels, lower androgen production, and provide essential nutrients for healthier hair follicles.

Follow a PCOS-Friendly Diet

With PCOS, elevated insulin levels can increase testosterone, making hair loss worse. A diet tailored to PCOS focuses on steadying blood sugar levels and supplying vital nutrients through wholesome, nutrient-dense foods.

Start by choosing low glycemic index (GI) foods. These include complex carbohydrates like whole grains, legumes, and vegetables, which help prevent insulin spikes that could worsen androgen levels. Avoid refined grains and sugary snacks whenever possible.

Incorporating omega-3 fatty acids is another great step. Foods like salmon, mackerel, and flaxseed are rich in omega-3s, which have anti-inflammatory benefits that may alleviate some PCOS symptoms and support hair health. Aim for two servings of fatty fish per week or add ground flaxseed and chia seeds to your meals.

Don't forget iron-rich foods like lean red meat or spinach, especially when paired with vitamin C to improve absorption. Additionally, nutrients like zinc, biotin, and vitamin D are essential for maintaining strong, healthy hair.

And of course, hydration matters. Drinking at least 2 liters of water daily helps keep your body functioning well and supports hair growth.

Add Regular Exercise

Exercise is another powerful tool for managing PCOS. It improves insulin sensitivity and helps balance hormones, which can reduce androgen production and aid in hair regrowth. The key is consistency rather than intensity. Experts suggest aiming for at least 150 minutes of moderate aerobic activity per week, along with strength training two to three times weekly.

This could look like 30 minutes of activity five days a week - whether it’s brisk walking, swimming, cycling, or even dancing. Yoga and Pilates are also excellent options, as they not only improve physical fitness but also help reduce stress and promote hormonal balance.

If you’re just starting out, go easy on yourself. Begin with short walks after meals and gradually increase your activity level over time. Even small steps can make a big difference in the long run.

Manage Stress

Stress can wreak havoc on your hormones, so finding ways to manage it is critical for reducing hair loss. Practices like yoga, meditation, and mindfulness can help regulate your hormones and improve your overall well-being. Even a few minutes of daily meditation can have a positive impact.

Taking care of your mental health is equally important. Coping with the emotional effects of PCOS-related hair loss can be challenging, so consider joining a support group. Whether online or in person, connecting with others who understand what you’re going through can provide encouragement and a sense of community.

Step 4: Create a Hair Care and Scalp Health Routine

To complement your medical and lifestyle changes, establishing a thoughtful hair care routine can help protect your existing hair and create a supportive environment for regrowth. By treating your hair and scalp with care, you can reduce additional stress and promote healthier growth over time.

Choose Gentle Hair Products

Hormonal shifts linked to PCOS can leave your hair more delicate, so it’s essential to opt for products that are nourishing yet gentle. Look for sulfate-free shampoos and conditioners, as they help maintain your hair’s natural oils and prevent irritation. Stick to washing your hair 2–3 times a week with diluted sulfate-free shampoo. After workouts, rinsing your hair with water can help clear sweat without stripping moisture. It’s also best to steer clear of styling products like gels or mousses that can build up on your scalp.

Avoid Stressful Hairstyles and Treatments

Tight hairstyles, harsh chemical treatments, and excessive heat can weaken your hair further. Instead, go for loose, relaxed styles that don’t pull on your strands, especially while sleeping. If you use heat styling tools, limit their use and always apply a heat protectant. For coloring, consider gentle, temporary options to minimize damage.

Incorporate Scalp Massages and Treatments

Scalp massages can help promote blood flow to your hair follicles, potentially aiding regrowth. Try massaging your scalp 2–3 times a week with natural oils like castor or rosemary oil. However, during periods of active hair loss, avoid heavy oiling, as it can weigh down fragile strands. You can also use natural hair masks - ingredients like aloe vera, onion juice, or amla are great options - once or twice a week to improve scalp health and reduce shedding.

Consistency is key here. By sticking to this routine, alongside your other treatments, you’ll be supporting your scalp’s health and giving your hair the best chance to recover and grow stronger over time.

Step 5: Track Progress and Stay Consistent

Keeping tabs on your progress is key to staying motivated and ensuring your treatment is effective. By regularly monitoring changes and sticking to your plan, you'll be in a better position to notice improvements and make any necessary tweaks along the way.

Track Your Hair Regrowth

Documenting your hair's changes can give you a clearer picture of how well your treatment is working. Start a weekly hair journal where you jot down observations about density, shedding, new growth, and texture. Over time, this record can reveal patterns you might not catch otherwise.

Take monthly photos of your scalp and hairline from the same angles, in similar lighting, and at a consistent time of day. Use the same camera distance and focus on the areas most affected by hair loss. This will make it easier to compare changes over time. You might also consider using a standardized hair density scale to measure progress more objectively.

Some key things to track include:

Hairs per square inch in problem areas
Daily shedding (count hairs on your pillow or shower drain)
Scalp health, such as reduced irritation or flakiness
New growth in previously bald spots and changes in hair thickness

There are also apps designed to help you track hair health. These tools let you log photos, symptoms, and treatment details digitally, making it easier to visualize your progress and share updates with your healthcare provider.

Schedule Regular Follow-Ups

Routine follow-ups with your healthcare provider are essential for managing PCOS-related hair loss effectively. These check-ins allow your doctor to monitor how well your treatment is working, address any side effects, and adjust your medications or therapies as needed. According to the 2023 International Evidence-based Guideline for PCOS, it's important to regularly monitor hair loss symptoms during treatment to determine if adjustments are necessary.

Bring your hair journal and photos to these appointments - they provide concrete evidence of your progress. Your doctor may also review lab results to assess hormone levels and ensure underlying imbalances are being addressed. If progress is slower than expected, they can reevaluate your diagnosis and explore alternative treatments or combinations.

If you're starting a new medication or experiencing side effects, you may need more frequent visits. And if you notice any concerning changes or have questions, don't hesitate to schedule an earlier appointment.

Be Patient with Results

Hair regrowth isn’t instant - it often takes 6–12 months to see visible changes. Early improvements, like less shedding or better texture, may seem small, but they’re important milestones. Understanding this timeline can help you stay committed to your treatment plan.

At first, you might notice subtle changes - like fewer hairs in your brush or softer, healthier-feeling strands - before seeing significant regrowth. Celebrate these small wins as signs that your efforts are paying off. Set short-term goals, like reducing daily hair loss or improving scalp health, instead of focusing solely on dramatic transformations.

"I get the same benefits but no more upset stomach and nausea, and this helps me stick with it a lot more consistently." - Carrie S., Topical Metformin User

If you’re using Oana Health treatments, consistency is crucial. Just 5 minutes a day can lead to results over time. For example, their Hairless Hype treatment has shown that 81% of women experience noticeable improvement within a year, with some seeing changes in as little as 8 weeks.

Finally, don’t underestimate the power of self-care and support. Joining groups with others facing similar challenges can provide encouragement and practical tips for staying on track. Managing PCOS is a long-term effort, but the work you put in now can lead to healthier hair and overall well-being.

If you don’t see improvement after 6–12 months of consistent treatment, consult your healthcare provider. They can reassess your approach and explore other options, such as adjusting medications, supplements, or lifestyle changes, to help you achieve better results.

Conclusion: Managing Hair Loss with PCOS

To effectively address PCOS-related hair loss, it’s essential to take a well-rounded approach that includes targeted medications, lifestyle adjustments, and thoughtful hair care. This five-step plan highlights how combining medical treatments with healthy habits can tackle both the underlying causes and visible symptoms of hair loss.

Medical options such as anti-androgen medications, birth control pills, and minoxidil work to address hormonal imbalances that contribute to hair loss. At the same time, dietary improvements and regular exercise can boost insulin sensitivity and support better metabolic health. Complementing these efforts, gentle hair care practices help protect your existing hair while creating the ideal conditions for regrowth.

Keep in mind that hair regrowth is a slow process. It typically takes 3–6 months to see noticeable changes, so patience and consistency are key. The progress you make today might not be immediately visible, but steady effort will yield results over time.

For added convenience, telehealth services like Oana Health offer personalized, FDA-regulated treatments for PCOS hair loss delivered straight to your door. Options such as Oral Minoxidil starting at $25/month and Topical Spironolactone at $43/month provide accessible and affordable solutions for long-term care.

"All of our treatments are doctor trusted, evidence based, and custom made for you in FDA regulated pharmacies." - Oana Health

The journey begins with a proper diagnosis and a tailored treatment plan. By combining medical care, lifestyle changes, and consistent hair care, you can manage PCOS hair loss effectively. While it’s not an overnight fix, this comprehensive approach can lead to healthier hair and boosted confidence over time.

FAQs

How can I tell if my hair loss is caused by PCOS?

Hair loss associated with PCOS is typically tied to hormonal imbalances, particularly increased levels of androgens. If you suspect PCOS might be the reason behind your hair loss, consulting a healthcare provider is a crucial first step. They can assess your symptoms, go through your medical history, and, if needed, conduct tests to pinpoint the exact cause.

For a more tailored approach, you might explore telehealth options like Oana Health. They specialize in addressing PCOS-related issues, including hair loss, through personalized care plans and science-based treatments designed to meet your unique needs.

Spironolactone and minoxidil are often prescribed to address hair loss linked to PCOS, but like all medications, they come with possible side effects.

Spironolactone, which works by blocking androgen hormones, may lead to side effects such as dizziness, fatigue, headaches, or menstrual cycle changes. In some cases, it can raise potassium levels, so regular blood tests might be necessary to keep an eye on this.

Minoxidil, a topical solution, can sometimes cause scalp irritation, dryness, or even unwanted hair growth in areas where it accidentally spreads. Occasionally, users might experience temporary hair shedding as new growth begins to take root.

If you're thinking about trying these treatments, it's important to talk to a healthcare provider to make sure they're a good fit for your situation. Providers like Oana Health specialize in creating personalized, evidence-based plans for managing PCOS symptoms, including hair loss.

What lifestyle changes can support hair regrowth alongside medical treatments for PCOS?

Managing hair loss caused by PCOS often involves a mix of medical treatments and lifestyle changes. While prescribed therapies are essential, adjusting daily habits can also have a noticeable impact.

Here are some practical tips to get started:

Eat Smart: Build your meals around lean proteins, healthy fats, and a variety of fruits and vegetables. Cutting back on refined carbs and sugars can help manage insulin resistance, a common issue tied to PCOS.
Stay Active: Regular physical activity, like walking, yoga, or strength training, can promote hormonal balance and boost overall well-being.
Reduce Stress: Stress can make hair loss worse. Try relaxation techniques such as meditation, deep breathing, or mindfulness exercises to keep stress in check.
Be Kind to Your Hair: Steer clear of harsh treatments or tight hairstyles that can strain your hair. Opt for gentle shampoos and conditioners that are easy on sensitive scalps.

For a tailored solution, professional guidance can make all the difference. Oana Health offers customized, science-based treatments delivered straight to your home by licensed medical professionals.