PCOS and Hair Loss – Natural Therapies Can Restore Scalp Hair

Excessive scalp hair loss is a severe challenge to a woman’s self image and her standing in business and society. Although we usually think of balding as a man’s problem, women actually make up forty percent of the people in North America experiencing the distress of excessive hair loss. Many women losing significant scalp hair have Polycystic Ovarian Syndrome. Safe, effective, natural therapies that treat the hormone imbalances related to PCOS will also restore your hair to optimal health. I am delighted to offer you these indispensable tools to help you restore your hair and your health.

Women experiencing hair loss lose ground fast in today’s world. At work and in her personal life a woman’s appearance has much to do with her financial and social success. Men may also prefer not to go bald. But since balding is known to be caused by high levels of testosterone, a bald man may be credited with extra virility. There is no such happy story for balding women. The appearance of thinning scalp hair translates to a significant loss of personal power for women.

The medical community in general treats women’s hair loss as a minor health issue. Most physicians have little inclination to address the emotional distress you feel. In many cases physicians treat balding as if it were “only” a vanity issue; they may not recognize hair loss as a red flag pointing to serious metabolic conditions, including PCOS.

The psychological pain of hair loss and its effect on our sense of empowerment is as devastating as any disfiguring disease. If you are a balding woman, your hair loss is a life altering condition with profound consequences for your health. Getting your hands on the wheel and driving yourself toward a solution for hair loss is the first step toward reviving your sense of personal strength and power. If hair loss is part of PCOS, the effort you make to restore your physical health will also renew scalp hair growth.

You need expert help to properly diagnose the cause of your hair loss. Hair loss that could have been merely temporary may become permanent if you have a delayed or incorrect diagnosis. Misdiagnoses is perhaps the most frustrating aspect of hair loss for women. The information I present here will help you identify the cause of your hair loss and ideally lead you and your doctors to proper treatments for your kind of hair loss, sooner rather than later.

Alopecia is the medical term for excessive or abnormal hair loss. There are different kinds of alopecia. What all hair loss has in common, whether it’s in men or women, is that it is always a symptom of something else that’s gone wrong. Your hair will remain on your head where it belongs if hormone imbalance, disease, or some other condition is not occurring. That condition may be as simple as having a gene that makes you susceptible to male or female pattern baldness. Or it may be as complex as a whole host of diseases. Hair loss may be a symptom of a short-term event such as stress, pregnancy, or a side effect of certain medications. In these situations, hair grows back when the event has passed. Substances including hormones and medication can cause a change in the hair growth patterns. When this happens, growth and shedding occur at the same time. Once the cause is dealt with, hairs go back to their random pattern of growth and shedding, and balding stops.

Alopecia: A Common Problem

Today more women than ever are experiencing hair loss — and the causes are typically quite different that what causes balding in men. According to the American Academy of Dermatology, some 30 million women in the United States are experiencing some degree of distressing scalp hair loss. The most common causes of scalp hair loss in women can include:

Mineral or vitamin deficiency – zinc, manganese, iron, vitamin B6, biotin

Essential fatty acid deficiency from a low calorie diet or eating disorders

Protein deficiency, as is common with vegetarian diets

Anemia from a low iron diet, poor digestion or any excess blood loss

Eating disorders, like anorexia, bulimia, even ‘yo-yo’ dieting; also compulsive or excessive physical exercise

Drug toxicity, for instance anesthesia with surgery or chemotherapy for cancer

Many prescription medications have hair loss as a potential ‘side’ effect, including bromocriptine, beta blockers, ACE inhibitors, amphetamines, anti-cholesterol agents

Severe infections, either viral or bacterial

Severe stress, either a sudden extreme event or persistent, long term challenges

Any hypothalamic or pituitary disorder

Any liver, thyroid gland, adrenal gland or ovarian disorder, including PCOS

Any sex steroid imbalance such as low progesterone, estrogen dominance, excess testosterone or insulin

Starting or stopping any hormone therapy, including birth control pills, menopausal hormone replacement treatment or thyroid hormone replacement

Any natural event that causes big hormone changes, like child birth, breastfeeding and weaning or menopause

Perms, hair color, bleach, improper brushing/combing, pulling on the hair

Autoimmune disease such as lupus or multiple sclerosis

Allergies to foods, medicines, environmental chemicals or topical drugs

Recent hepatitis B shot. If you had a Hep B vaccine since this hair loss started, there may be a connection. An article in the Journal of the American Medical Association (278:117-8, 1997) links the Hep B vaccine to increased incidence of alopecia in women.

How does an individual woman figure out why she is losing too much of her hair? To understand that, it’s important to understand how hair grows.

Hair Grows in Cycles

Scalp hair grows about one-half inch per month. An individual strand of hair will grow for two to six years. Eventually each hair “rests” for a while, and then falls out. Soon after, that follicle will start growing a new strand. A healthy scalp will let about 100 of these cycling hairs fall out every day.

In folks with a genetic predisposition to hair loss, and for women with PCOS, hormones called androgens drive this process. Androgen hormones include testosterone, androsteinedione, and dihydrotestosterone (DHT). Men make and use relatively large amounts of androgens. Appropriate, smaller amounts of androgens are essential to women’s health as well.

In those who are genetically susceptible, testosterone activates enzymes produced in the hair cell, which then cause it to be converted into the more potent androgen DHT. DHT then binds with receptors deep within the hair follicle. Eventually, so much DHT builds up that the follicle begins shrinking. It can’t produce new hair reliably. Some of the follicles permanently stop producing new hairs. The end result is significant hair loss. The medical term for this condition is androgenic alopecia. Testosterone converts to DHT with the aid of the enzyme Type II 5-alpha reductase, which is held in a hair follicle’s oil glands. Actually, it’s not the amount of circulating testosterone that is the problem but the amount of DHT clogging up and shrinking scalp follicles, making it impossible for healthy hair to survive.

The process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Usually women have a tiny fraction of the amount of testosterone that men make. It seems that for women with hair loss, the actual level of testosterone is not as crucial as are changes in the amount of testosterone she has. A shift in hormone levels triggered by lifestyle or other factors, will cause DHT- triggered hair loss in women. Even when hormone blood levels remain within what doctors consider “normal”, they can become high enough to cause a problem for an individual woman. The levels may not rise at all and still be a problem if you are very sensitive to even normal levels of chemicals, including hormones.

Because our hormones operate through a delicately balanced feedback system, with signals sent via the blood between the brain and body tissue, androgens do not need to be raised to trigger a problem. If the so-called female hormones, (which also are essential to men’s health) are for any reason shifting in relation to androgens, the resulting imbalance can also cause problems, including hair loss.

Hormones are always changing. Testosterone levels in men drop by as much as 10 percent each decade after age thirty. Women’s hormone levels shift with each menstrual cycle, or due to a lack of regular menses, in pregnancies and menopause. Eating disorders, excessive exercise, drugs and environmental toxins can also impact hormone levels.

Keys To Successful Treatment

Treatment of thinning scalp hair must be grounded in changing the habits you may have that support elevated androgens. Diet and exercise are key to maintaining optimal hormone balance. In fact, for women with PCOS, research is clear- there is no drug therapy more effective than proper diet and regular exercise. First, you get your foundational health habits in order; then, specific targeted therapies have the best chance of being effective for you.

Women with PCOS may also have excess coarse dark hair on their face and body. The only way to address the dark, coarse hair that grows out of follicles that have already been altered by excess androgens, is to destroy the follicle with laser or similar therapy. Once a follicle has changed the type of hair it produces, it will not change back. It is crucial to tame the excess androgens and prevent conversion of additional follicles, before investing in a therapy to permanently destroy facial or body hair follicles.

What Causes Women to Lose Too Much Scalp Hair?

For a long time doctors believed that androgenic alopecia was the main cause of balding in both men and women. Now we know that the process that leads to excessive hair loss in women is different. It is called female pattern hair loss.

An important difference between male and female balding is the pattern in which the hair loss occurs. Female pattern hair loss tends to happen as an overall thinning across all areas of the scalp, including the sides and back. Men lose hair from specific spots, like the temple, the crown, that bald spot in the back of the head. Male and female hormone and enzyme receptor sites are also in different areas of the scalp, causing the different gender related loss patterns of hair loss.

A second major difference is that balding in men is usually caused by a man’s genetics and his age, but for women, balding can happen at any age.

Lifestyle Choices, Illness and Medical Treatments Cause Hair Loss

Most women with hair loss have multiple features of their lifestyle, diet and health-related events that contribute. Sex hormone fluctuations are responsible for most female hair loss, including those who have PCOS, a recent pregnancy, menopause, hormone replacement therapy or birth control drug side effects. Chemotherapy for cancer, anti-coagulant drugs, iron- deficiency anemia, autoimmune disease can cause hair loss. Any disease involving hormone producing glands, including the thyroid, the adrenal and pituitary glands can trigger balding in women. It is essential for all women to learn the true cause of their hair loss before engaging any particular treatment.

The complex hormonal changes that accompany polycystic ovary syndrome (PCOS) often result in scalp hair loss. Sometimes hair loss is the first sign that a woman is suffering the metabolic disorder that also causes problems with acne, facial and body hair growth, irregular menstrual cycles and infertility. PCOS is associated with increased risk of heart disease, type 2 diabetes and some cancers.

Thyroid disorders, anemia, chronic illness or the use of certain medications, particularly any form of hormone replacement therapy or contraceptive prescriptions- should be considered a possible cause of hair loss in women. Autoimmune disorders will result in somewhat different, often less dramatic hair loss known as alopecia areata — an inflammatory condition in which hair comes out in clumps or patches.

Any drop in estrogen levels, as happens after pregnancy, with menopause, or when changing your hormone therapy including birth control pill use, will cause what is called estrogenic alopecia. In contrast to testosterone, estrogen helps scalp hair grow faster and stay on the head longer, resulting in thicker hair. This is the reason women’s hair gets fuller during pregnancy when estrogen levels are quite high, then sheds several weeks after the baby is born.

For women who do not have fertility-related hormone changes, estrogen-deficiency scalp hair loss generally starts around menopause. This form of female hair loss can be the first sign of approaching menopause. Sometimes the alopecia won’t begin until a few months or even years after menstruation has ended. Not all women get noticeable alopecia after menopause but most have a little thinning.

It’s not uncommon to have multiple factors involved in female hair loss. Many women with PCOS have thyroid problems, usually hypothyroidism (low thyroid function). Not only does hypothyroidism contribute to weight problems, it can also contribute to hair thinning. Some women with PCOS have both an excessively high level of testosterone and an under active thyroid.

If your hair is thinning, you may have heavy metals like lead, mercury or cadmium in your tissues. These poisonous residues saturate our environment. If you have lived near what is, or ever was an industrial or mining site, or lived with someone who works in a polluting industry, you may be contaminated. If you have ever smoked tobacco, you have a lot of cadmium in your body.

The majority of women with androgenic alopecia have diffuse thinning on all areas of the scalp. Some women may have a combination of two pattern types. Androgenic alopecia is caused by a variety of factors tied to the actions of hormones including PCOS, using contraceptives, pregnancy, and menopause. Any blood sugar and insulin hormone imbalance will lead to excess androgens. Women with insulin resistance, from chronic over-eating of refined carbohydrate food, will see more impact from androgens. Insulin resistance is associated with PCOS as well as Type 2 diabetes. Chronic stress that depletes adrenal glands can change the levels of androgens a woman produces as well. This is often the source of problems like infertility, acne and hair thinning in lean, athletic women with PCOS. Heredity may play a role in androgenic alopecia.

Any big event like childbirth or breastfeeding, malnutrition from an alteration in your diet, a severe infection, major surgery, or any extreme stress, can suddenly shift much of the 90 percent or so of your hairs that are in the growing phase or resting phase into the shedding phase. You will see this shift in the rate of hair loss 6 weeks to three month after the stressful event. This is called telogen effluvium. It is possible to lose great bunches of hair daily with full-blown telogen effluvium. Usually this type of hair loss is reversible, if major stressors are avoided. For some women however, telogen effluvium is a mysterious chronic disorder and can persist for months or years, without ever completely identifying all of the triggering factors.

Anagen effluvium happens when the hair follicle cells are so damaged they can not recover or reproduce. This is usually due to toxicity of chemotherapy for cancer. Chemotherapy is meant to destroy rapidly dividing cancer cells. Hair follicles in the growing (anagen) phase, are therefore vulnerable. Anagen effluvium means the hair shaft narrows as a result of damage to the follicle. The shaft breaks off at the narrowing and causes the loss of hair.

Traction alopecia is damage from hairstyles that pull at hair over time (braiding, cornrows, ponytails, extensions). If the condition is detected early enough, you can change your styling practice to be gentler on the follicles, and your hair will regrow.

Hormone contraceptives are a leading cause of distressing hair loss and other symptoms in women. Since the birth control pill first began being used in 1960, oral contraceptives, injections, implants, skin patches and vaginal rings have become the most commonly prescribed forms of birth control.

Unfortunately, many young women are given contraceptive hormones even when they are not sexually active, as a ‘treatment’ for irregular menses or acne. This is a mistake. This is not a treatment that addresses the underlying cause of problem periods or pimples. Contraceptive hormones will severely complicate a woman’s hormone balance and can lead to many health problems, including significant hair loss and worsening acne.

All contraceptive drugs use synthetic hormones to suppress ovulation. These drugs cause your ovaries to stop working; they are in a kind of ‘sleep’ state. Instead of having your natural cycles result from a dance of signals between your body and your brain, your tissues are subject to synthetic hormones in amounts much larger than your body normally makes. There are many long and short -term consequences to ovarian suppression. Most women experience side effects using contraceptive drugs, including hair loss either during or several weeks or months after stopping the drug.