Hair loss conditions Mostly affects women
PCOS hair loss: scalp thinning, hormones and treatment
Polycystic ovary syndrome (PCOS), which the NHS now calls polyendocrine metabolic ovarian syndrome (PMOS), can cause hair loss on the scalp as well as extra hair on the face and body. The thinning usually follows the female pattern: a wider parting and less volume on top. Diagnosis comes through your GP, and treatment usually combines managing the PCOS with hair-specific options.
What is pcos hair loss?
The NHS describes PCOS (PMOS) as a hormone condition that can affect hair growth, periods, fertility and mood. Symptoms usually start around puberty and can continue until the menopause. The main ones include irregular periods, excess hair growth on the face or body (hirsutism) or hair loss, weight gain, difficulty getting pregnant, oily skin and acne.
The cause is not fully known. The NHS says it may be to do with hormones such as insulin and testosterone not working properly, and that you are more likely to have it if a close relative does or you are from an Asian background. NICE CKS notes it is common, affecting around 10 to 13% of women worldwide under the most widely used criteria, and that many women are undiagnosed.
The British Association of Dermatologists (BAD) explains that female pattern hair loss may accompany conditions with raised androgens (a group of hormones that includes testosterone), such as PCOS. So scalp thinning in PCOS usually looks like pattern hair loss. The reverse is not always true: NICE CKS says pattern hair loss on its own, without excess facial or body hair, is a weak sign of raised androgens, so thinning alone does not mean you have PCOS.
Signs to look for
- Thinning over the top of the scalp and a wider parting
- Irregular periods, or long gaps between periods
- Excess hair on the face, chest or body (hirsutism)
- Oily skin and acne
- Weight gain, or difficulty losing weight
- Thick, dark patches of skin on the neck or armpits (acanthosis nigricans)
What causes it
Androgens
Raised levels of, or sensitivity to, hormones such as testosterone can shrink scalp follicles while increasing hair growth on the face and body.
Insulin resistance
The NHS says insulin not working properly may be involved, and GPs may test for insulin resistance as part of the work-up.
Family history
PCOS is more likely if a close relative has it, and pattern hair loss itself also runs in families.
Other causes to rule out
NICE CKS says other causes of irregular periods and raised androgens should be excluded before PCOS is diagnosed. Iron and thyroid problems can also cause shedding.
How it is diagnosed
PCOS is diagnosed by a doctor, not by a single test. NICE CKS says that in adults it is diagnosed when two of these three are present, once other causes have been excluded: infrequent or absent ovulation (usually shown by irregular or absent periods), signs of raised androgens (such as excess hair growth, acne or raised testosterone on a blood test), and polycystic ovaries on an ultrasound scan. In teenagers, both raised androgens and irregular periods are needed, and ultrasound is not used.
The NHS says your GP may arrange blood tests to check hormone levels and insulin resistance, and an ultrasound scan if you are over 18, sometimes through a gynaecologist or endocrinologist.
The hair loss itself is assessed in the same way as any female pattern hair loss: by its pattern and history, with blood tests to rule out iron deficiency and thyroid problems. WMG Health's PCOS symptoms page explains the tests in more detail.
Treatment options
Every option below has trade-offs, and choosing not to treat is a reasonable decision too. Medicines are only prescribed after a doctor has reviewed your history and confirmed they are suitable for you.
What to expect
PCOS is a long-term condition. The NHS says there is no cure, but treatments and lifestyle changes can help the symptoms. Hair responds slowly: any hair loss treatment needs at least 6 months before you can judge it, and benefits last only while you continue.
Your plans for pregnancy shape the options. Spironolactone and minoxidil are not used during pregnancy, and oral minoxidil needs reliable contraception, so tell your doctor if you are planning a family and review your medicines before you start trying.
The NHS also notes that PCOS can increase the risk of type 2 diabetes, high blood pressure and heart disease over time, so regular check-ups with your GP are worthwhile alongside any hair treatment.
When to see a doctor promptly
See your GP soon, rather than waiting or self-treating, if you notice any of these:
- Excess hair or scalp thinning that comes on quickly or worsens fast, especially after the menopause
- Fewer than one period every three months, or abnormal vaginal bleeding
- Bald patches, or a red, scaly or painful scalp
- Feeling very low or anxious; the NHS says talking therapy can help
How WMG Meds can help
WMG Meds does not diagnose or manage PCOS. That belongs with your GP, who can arrange the right tests and treat periods, fertility and metabolic health.
Where we can sometimes help is the scalp thinning itself. Through our free online assessment, a GMC-registered doctor reviews your history, including your periods, contraception and any pregnancy plans, and decides whether a minoxidil-based treatment is clinically appropriate. Options include compounded topical minoxidil and low-dose oral minoxidil, both off-label. We do not prescribe spironolactone, the contraceptive pill or metformin, and finasteride and dutasteride are not suitable for women who are or could become pregnant.
If you have not yet been assessed for PCOS, we will suggest you see your GP or consider a hormone blood test, rather than treating the hair in isolation.
Frequently asked questions
Does PCOS cause hair loss?
It can. The NHS lists hair loss, as well as excess hair growth, among the main symptoms of PCOS (PMOS). The BAD explains that female pattern hair loss may accompany conditions with raised androgens such as PCOS. Many women with thinning hair do not have PCOS, though, so it needs a proper diagnosis.
Will treating my PCOS stop the hair loss?
It may help, but there are no guarantees. Managing weight and hormones can reduce androgen-related symptoms, yet hair follicles respond slowly and some thinning may persist. Hair-specific treatments such as minoxidil act on the scalp directly and can be used alongside PCOS care if a doctor agrees.
Can I use minoxidil if I am trying to get pregnant?
No. The BAD advises avoiding minoxidil if you are planning a pregnancy or breastfeeding. Oral minoxidil is not suitable in pregnancy, and women who could become pregnant need reliable contraception while taking it. Talk to your GP about which treatments can wait and which can continue. See can women use minoxidil.
Can I get spironolactone for PCOS hair loss?
Possibly, through your GP or a dermatologist. The BAD says spironolactone is used off-licence for female pattern hair loss and excess hair growth, is usually available on the NHS, and takes up to six months to show a benefit for hair. It needs potassium checks and must be stopped in pregnancy. WMG Meds does not prescribe it.
Can a blood test tell me if I have PCOS?
Not on its own. Blood tests can show raised testosterone and help rule out other causes, but NICE CKS says diagnosis in adults needs two of three features: irregular ovulation, signs of raised androgens and, sometimes, polycystic ovaries on ultrasound. Your GP puts all of this together.
What is PMOS?
Polyendocrine metabolic ovarian syndrome (PMOS) is the new name the NHS uses for polycystic ovary syndrome (PCOS). It is the same condition. The new name reflects that it affects hormones and metabolism, not just the ovaries.
Sources
- NHS: Polyendocrine metabolic ovarian syndrome (PMOS), previously PCOS
- NICE CKS: Polycystic ovary syndrome, diagnosis
- NICE CKS: Polycystic ovary syndrome, management in adults
- British Association of Dermatologists: Hair loss, female pattern (androgenetic alopecia), patient leaflet
- British Association of Dermatologists: Spironolactone, patient leaflet
Facts checked against these sources on 4 October 2026. This page is general information, not a diagnosis. Read our editorial policy.