A common and distressing side effect of PCOS is hair loss. In most patients with PCOS. This hair loss is caused by Androgenic Alopecia.
PCOS leads to elevated levels of testosterone and other androgens, such as DHT. Similar to male pattern hair loss, DHT attacks hair follicles and can led to a progressive process called miniaturization. Hairs can slowly become more fine and sparse, particularly on the top and crown of the head and ultimately fall out or stop growing.
The good news is that there are many treatments to stop progression of hair loss.
1) Minoxidil: 5%
Minoxidil has been approved for regrowth of hair for decades, and while some patients do not see immediate results, it has been proven to maintain hair in many patients. Consistent use daily is necessary, as this medication works to dilate blood vessels to increase the number and thickness of new hairs.
2) Androgen blockers: Spironolactone and Cyproterone Acetate
Spironolactone and Cyproterone Acetate are two medications that act as anti-androgens. These prescription medications can help to decrease further miniaturization and block the effects of high testosterone and DHT on the scalp. Spironolactone is also a diuretic, and some patients notice less water-weight retention.
3) Anti-androgen progesterone containing Oral Contraceptives
In combination-pill birth control, there are two components: Estrogen and Progesterone. There are many different types of progesterone components in these medications, including some which have anti-androgen properties! Drospirenone in particular is an anti-androgenic progestin that can help to alleviate symptoms of hirsutism and hair loss in PCOS patients.
