Polycystic ovary syndrome (PCOS) is a hormonal disorder, that often causes infrequent, irregular or prolonged menstrual periods, where the ovaries develop numerous small collections of fluid — called follicles — and may fail to regularly release eggs that can lead to challenges with conception and pregnancy. PCOS can have a range of symptoms, including hirsutism, which is excess facial and body hair, but also hair loss and thinning of hair on the scalp.
Role of hormones in PCOS and hair loss
Elevated levels of male hormones that tend to accompany PCOS leads to thicker hair on face and body, but hair thinning and hair loss on scalp, also known as female pattern hair loss (FPHL). PCOS related hair loss is closely related to androgenic alopecia (AGA). “Androgenic” is derived from the noun “androgen,” a word referring to any of the male hormones, including testosterone and androsterone.
This androgenic-related hair loss is linked specifically to testosterone, a male sex hormone, whose role, function and effect are complex and cannot be alleviated by simply taking medication as hormones needs to reach balance in order for body function, including hair growth, properly. A blood test can reveal if the levels of these androgens are elevated.
Testosterone converts into DHT – dihydrotestosterone – a by-product whose aim is to fight local inflammation to the body. As certain parts of our body remain inflamed, DHT are rushing to the rescue. A number of theories exist, two of the more prominent ones is gravity theory and inflammation theory. For both of them, blood flow plays a key role. It is through blood that nutrients get delivered to the follicle to enable it to grow healthy hair. The theory on “genetic predisposition” is less reliable, since the genes responsible for the enzyme behind DHT conversion are not associated with AGA. And frankly speaking… it is very “easy” to blame the genes for things that science struggles to find a sound explanation…
Inflammation theory of hair thinning
More recent studies show that the trouble of hair thinning comes from tension in our galea aponeurotica – the top muscle covering our skull. In simpler terms, scalp tension increases with time, as we age. This tension causes inflamation and excess DHT rushes already present in patients with PCOS rush to the rescue to fight it. The way it fights this, is by thickening the skin around the follicle dermal sheath, fibrosis (scarring) of the follicles and calcification – to ensure that the area is well protected from inflammation.
This process leads to hair follicle minituarision effectively “suffocating” the follicle, as the hair root receives less and less oxygen and nutrients due to decrased blood flow. This results in a rather vicious circle where the less nutrients hair follicle receives, the smaller it becomes, the less nutrients and blood supply it needs, and so on.
Gravity theory of hair loss
Gravity theory of hair loss uses inflammation as evidence: inflammation is the body “scavenging” for nutrients in the area they are most needed. In this case: in scalp. As per previous theory, scalp tension increases with age and is at its highest point at the top of the head making it harder for hair follicle to increase in size, as it needs to fight against the gravity and the tension of the muscle. It is important to mention another role of DHT – to actually grow hair. DHT receptors exist in sex hormone-sensitive areas of the body: armpits, pubic area, chest, face – that tends to get hair in puberty. So how come DHT destroys hair in scalp, but not in other parts of the body?
What also happens with age, is less subcutaneous fat being produced in the body, and the extra DHT that is “sent” to help the hair growth actually further erodes a cushioning layer of subcutaneous fat, which makes it harder the hair follicle to grow. Effectively DHT removes the soft cushioning beneath the hair follicle thus making it harder for hair root to reach for the blood vessels in order to maintain nourishment and growth of a healthy hair strand. Hair follicle never reaches maturation, and due to its smaller size it asks for less blood, and less nutrients, thus accelerating the hair follicle minituarisation process.
Polycystic Ovaries Hair thinning treatments
While ideally it is the root cause of polycystic ovaries that needs to be treated, whether by hormone therapy, nutrition, natural remedies or all three – the exact cause for the condition remains largely unknown. The good news is that the hair thinning aspect of PCOS can be addressed successfully by the measures of reducing inflammation in scalp, thus supporting scalp blood flow and hair follicles. For example:
- reducing scalp tension by scalp massages especially combined with inversion method
- reducing internal inflammation through nutritional choices (less refined sugars and higher amount of dark green leafy vegetables)
- improving blood supply to the hair follicles through mechanical stimulation (e.g. derma-rolling)
- topical solutions promoting blood flow to scalp (e.g. peppermint oil, or simply applying The Hair Fuel mask)
Have you struggled with hair thinning and androgenic alopecia relating to polycystic ovaries? Let us know in comments.