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pila99 04-09-2010 07:25 AM

Does PCOS cause rapid hair loss?

November 2009 I started experiencing heavy hair shedding (200+ hairs lost just in the shower). I went to the doctor and had my thyroid, hormones and iron/ferritin checked. Everything came back fine except my iron and ferritin. I was severely anemic and had a ferritin of <5. The doctor thought that [I]maybe[/I] the anemia and low ferritin were causing the rapid hair loss.

Back in July 2009, during an abdomen ultrasound (for my kidney) they found one 4 cm cyst on my right ovary. I went to my GYN and had another ultrasound done. They confirmed that I had a 4.2 cm on my right ovary. She suggested that I get on BCP to help shrink the cyst and prevent any more from forming. I really didn't want to be on BCP since I had been off of them for 2 years (I was previously on Ortho TriCyclen Lo for 9 years) and I felt great not being on the pill. I decided I would try going on the pill again and she prescribed YAZ. After 1.5 months of taking it, my heart started beating really fast and it freaked me out. I decided to go off of them immediately. I took my last pill at the end of September 2009. By the end of November is when the hair loss started and by December I was breaking out like never before. In December I had a follow up ultrasound and the 4 cm cyst had dissappeared, but now they found a bunch of smaller cysts on my left ovary (typical in PCOS).

I have recently gone to an Endocrinologist to get a better answer as to what is happening with my body. She said it's most likely PCOS. But here are some questions I have and I'm hoping you ladies might be able to shed some light on this.

1. My periods have always been on a perfect 28 day cycle. Before the pill and even after going off the Ortho and the YAZ. And my periods usually last about 4 and heavy on the first and second day. Isn't one of the major symptoms of PCOS irregular or absent periods?

2. I've also read that high androgens cause the acne and hair loss. But my DHEA's, Total and Free Testosterone are all towards the low end of the range.

3. Does PCOS cause rapid hair loss? Or is it more of a gradual hair thinning? Mine started out of nowhere and it's shedding a lot. My primary care and hematologist think it's Telogen Effluvium.

4. My endo also thinks that going off of YAZ in the September might have caused the hair loss and acne due to the changes in hormone levels. Can going off the pill cause PCOS?

I was off the pill for 2 years and during that time I was perfectly fine. My skin was actually a lot better. During that time I only had 1 larger cyst that eventually dissappeared on its own and I've read is very common. But after going off of YAZ is when I started breaking out bad and losing hair (still don't know if this is because the low ferritin or a combination of the 2).

My endo also tested me for insulin resistance which I have. But she said it's not bad where she thinks just changing my diet and exercising could possibly turn that around.

It's been a little over 4 months and I'm still shedding a lot of hair. The doctors keep telling me the Telogen Effluvium can last up to 6-8 months. I'm just wondering if this hair loss can be caused by PCOS? Or is it most likely the cessation of the pill and low ferritin?

Thank you in advance!


pila99 04-09-2010 10:05 AM

Re: Does PCOS cause rapid hair loss?
Sorry to make to this longer than it already is...but would I benefit from taking Saw Palmetto even though my androgens are low? I have some acne and some peach fuzz above my lip, chin and sideburns (light, blonde, thin hairs).

Pcosgirl 08-05-2012 01:37 PM

Re: Does PCOS cause rapid hair loss?
Hi Pilar,

Short answer - yes, it did for me.

PCOS is one of the most difficult syndromes because it is only diagnosed by a constellation of symptoms and not all need to be present. However, (absent an ultrasound to catch the cysts on the ovaries), it is difficult to diagnose because not all may be present and not all the time.

For at least the past 10 years about 5 different doctors suggested I had PCOS, but they always referred me to an endocrinologist - and it just happened that I couldn't ever get a good one who participated to see me, so I ignored the symptoms that led doctors to make that preliminary diagnosis.

Those were very painful periods, bad acne (from puberty to now, almost 20 years into adulthood), hirsutism (excessive hair) and significant weight gain from puberty until now, that has become increasingly difficult to lose over the years despite the fact I generally maintain a relatively healthy quasi-vegetarian diet (I eat egg whites, fish and dairy products) - particularly when compared with my age-appropriate peers ... and I have had lap-band surgery.

A year ago, I started getting light-headed and dizzy whenever I would eat complex carbohydrates, but I did not test positive for diabetes. Further, my cholesterol was going up though I don't eat things like fast-food and potato chips, etc. Then, I became so lethargic and started getting migraines that coincided with my menstrual cycle and had to take actual pain killers to have any effect on either the cramps or the migranes.

Last fall, my hair starting falling out in the shower in significant amounts (at least 200 hairs at a time - like handfuls of it), and though I always had a lot of thick hair, there was much less and the strands were getting increasingly finer. I was alarmed and a doctor tested my thyroid, but we were all shocked when it came back negative since that much hair loss and those symptoms were not normal. But, that doctor didn't have any other ideas and I hadn't mentioned the prior doctors' suggestions that I get checked for PCOS because I didn't make the connection between PCOS and hairloss/lethargy.

Also, I'd lost a lot of hair years ago and attributed it to stress then, so I assumed it was that until I went to my long-time dermatologist for facial laser hair removal and asked offhand if she addressed hair and scalp issues. She looked at my scalp and asked if I'd ever been diagnosed with PCOS, given the hirsutism, history of severe acne and obesity. She told me the hair loss and thinning follicles was almost like male pattern baldness because of the hormonal imbalance likely caused by my suspected PCOS, and prescribed OTC Rogaine for women.

My pharmacist told me the Saw Palmetto would not be the right thing to take, though I haven't asked my primary care physician yet. I did speak with my primary care physician after the dermatologist visit in January this year, who was so confident that my symptoms (including the vague blood sugar issues and cramps and migraines) were related to PCOS and she put me on Metformin. Good thing, because it is the only thing that stopped the weight gain and helped me either stabilize, or with exercise lose, weight. The hair loss, which fortunately was still only noticeable to me and my close family and doctor by that point, seems to have stopped since I now more vigilently maintain a healthy low-carb, high protein and high anti-oxidant diet (though the lost hair likely won't grow back without using minoxidil, which I've been too upset to try yet)... So, I suggest you modify your diet and see how it impacts your hair loss.

I don't always have irregular periods, but that isn't the only indicator - and being over 35 I'm afraid of the side-effects of birth control pills (I took them for a few years, started getting stiff and cramped legs and then stopped). I was prescribed Spironolactone but only took it for a short while and don't think I was patient enough for results. I think, however, birth control pills may also help with hair loss, but I'm not positive.

I deeply regret not following up on PCOS more seriously years ago (I mentioned it to doctors in the past and got birth control pills covered by insurance because of it, but rather than treat me, they they only referred me to an endocrinologist, which was so frustrating just to book an appointment that I gave up!) and especially not agreeing to the metformin long ago and watching those carbs/exercise. Having lived it the hard way, I recommend you speak with your doctor and, if safe and appropriate, take the birth control pills, Metformin, spironolactone, vaniqa and incorporate regular cardio exercise and get a dietician to work out a low-glycemic index (low complex carb, high protein) diet for the very best results. Diet and exercise actually play a bigger role than you'd think, and not just for weight - I think I read some study online that there is a hormonal connection between body fat storage and the estrogen levels, which impacts your hair growth cycles (I've since made myself my own advocate and expert). I can say that it has, for now (fingers crossed) stopped the hair loss and diminished my symptoms ... If I hadn't started losing my hair, I might never have taken the PCOS seriously and who knows where it would've led me! I still don't have an endocrinologist and my gyno told me to find one and won't treat me for PCOS (I get the sense he isn't comfortable/familiar enough with it, even though it was another doctor in his own office 8 years ago who told me I had PCOS and who first prescribed the birth control and Spironolactone for it!).

Some other less traditional tips to help with the hair loss: 1) biotin supplements, 2) wash your hair daily with a shampoo that cleanses the scalp well (I use Nizoral), and massage to stimulate circulation, 3) incorporate walnuts and high antioxidant foods, like blueberries, green gea, amaranth, quinoa, etc., into your diet 4) reduce stress levels, which can also cause or add to hair loss - try yoga, meditation, 5) get enough sleep! I had trouble sleeping and found the Melatonin dissolvable supplement helpful for me, and 6) don't wear your hair back in pony tails or use hair ties that pull the strands.

For excess, I've had electrolysis and laser hair removal for about 23 years now (I'm only 37!), and while much better, thanks to my hormones it is likely the results will never be permanent. A combination of laser hair removal and vaniqa works best for me.
Hope my story is helpful ... Best of luck!

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