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Can polycystic ovaries cause hair loss?

By October 15, 2020January 20th, 2021Biology, Hair loss, Scalp blood flow, Science of hair growth

Polycystic ovary syndrome (PCOS) is a hormonal disorder, that often causes infrequent, irregular or prolonged menstrual periods. The ovaries develop numerous small collections of fluid — called follicles — and may fail to regularly release eggs. This can lead to challenges with conception and pregnancy. PCOS has a range of symptoms, including hirsutism, which is excess facial and body hair – but also hair loss and thinning – on scalp. 

Hormones in PCOS hair loss

Elevated levels of male hormones in women can lead to 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. Its role, function and effect are complex and cannot be alleviated by simply taking medication. Hormones need to reach an overall balance in order for hair growth to start progressing properly, too. A blood test can reveal if the levels of these androgens are elevated. 

Such elevated levels of testosterone convert 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. Blood flow plays a key role in both of them. Since 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

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 in patients with PCOS rush to the rescue to fight it. It fights it by 1) thickening the skin around the follicle dermal sheath, 2) fibrosis (scarring) of the follicles and 3) calcification – to ensure that the area is well protected from further inflammation. 

This three-step process leads to hair follicle minituarisation, effectively “suffocating” the follicle, as the hair root receives less and less oxygen and nutrients due to decrased blood flow. This results in a vicious circle where the less nutrients hair follicle receives, the smaller it becomes, thus the less nutrients and blood supply a reduced follicle 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 most deprived of – nutrients. 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. It needs to fight against the gravity – and the tension of the muscle. 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?  

Our body already produces less subcutaneous fat with age, but 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. This process removes the soft cushioning beneath the hair follicle, making it harder for hair root to reach the blood vessels and receive nourishment for healthy growth. 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.

PCOS hair thinning treatments

While ideally, the root cause of polycystic ovaries 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. 

Sources:

Baldness may be caused by the weight of the scalp: Gravity as a proposed mechanism for hair loss (1)
Polycystic Ovary Syndrome: Diagnosis and Treatment (2)

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