About the deep relationship between polycystic ovary syndrome (PCOS) and female hair loss

When looking for the cause of hair loss in women, we often encounter a disease called ‘polycystic ovary syndrome (PCOS).’ [cite: 281] In fact, one of the main symptoms of polycystic ovary syndrome is hair loss, so the two are very closely related. If you are suffering from hair thinning and falling out along with an irregular menstrual cycle or acne, understanding the condition accurately can be the first step in treating hair loss.

1. What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome is one of the most common endocrine (hormonal) diseases in women of childbearing age. [cite: 285] Because of the name, it is easy to misunderstand that it is a disease that causes cysts in the ovaries, but in essence, it means a condition in which ovulation does not occur smoothly due to hormonal imbalance.

The main symptoms and causes are as follows:

core symptoms

• Chronic anovulation:Irregular menstrual cycles (oligomenorrhea) or, in severe cases, absence of menstruation for several months (amenorrhea).
• Hyperandrogenemia:If the level of male hormones (androgens) in the blood is high, or clinical symptoms (hirsutism, severe acne, male pattern hair loss, etc.) appear even if the level is normal.
• Polycystic ovaries on ultrasound:During an ultrasound examination, small, immature follicles appear like a necklace along the edge of the ovary.

cause

The exact cause is not yet known, but 'insulin resistance' along with genetic factors are considered important causes. Insulin resistance is a condition in which our body does not respond properly to the function of insulin to regulate blood sugar, and to compensate, the body secretes more insulin. This increased insulin stimulates the ovaries to make more male hormones, ultimately leading to hormonal imbalance.

2. Increased PCOS and increased hair loss in women

The problem is that the number of PCOS patients is steadily increasing due to changes in modern people's lifestyles. [cite: 296] According to a study by the National Health Insurance Service Ilsan Hospital (2018), the new incidence of PCOS among women of childbearing age in Korea showed a clear increasing trend from 76.2 per 100,000 in 2007 to 123.0 in 2015. This is believed to be because modern lifestyle patterns, such as westernized eating habits, increased obesity rates due to lack of exercise, and stress, increase insulin resistance and worsen hormonal imbalance.

The process by which PCOS causes hair loss is clear. Increased male hormones (testosterone) are converted to DHT (dihydrotestosterone), which causes male pattern baldness. When this DHT binds to the androgen receptor in the hair follicle, it shortens the hair growth phase and causes 'miniaturization', which causes the hair follicle itself to atrophy. As a result, hair gradually becomes thinner and weaker and eventually falls out, with hair loss occurring mainly in the crown and frontal areas.

3. Hair loss due to PCOS, how should I manage it?

PCOS is more of a chronic disease that requires ongoing management rather than a cure. Therefore, the key to treatment is to correct your overall lifestyle.

Oriental medicine approach & natural therapy

In Oriental medicine, PCOS is approached through the concepts of ‘wet dan (濕痰)’, which refers to unnecessary waste in the body, and ‘sin deficiency’ (腎虛), which refers to a decrease in hormonal function, and treatment is performed to correct the body’s balance according to the constitution.

medication

Hospitals may prescribe the diabetes drug metformin to improve insulin resistance, or use oral contraceptives to control irregular menstrual cycles and androgen levels. This is an effective method, but if there is no fundamental improvement in life, symptoms are likely to recur when the drug is stopped.

Improving lifestyle habits (the most important treatment)

• Diet Control:This is the most important part. You should avoid refined carbohydrates (white rice, flour, sugar) and processed foods that rapidly raise blood sugar levels, and focus your diet on low glycemic index (Low GI) foods (whole grains, beans, vegetables) that raise blood sugar levels slowly. Consuming healthy fats (olive oil, avocado, nuts), high-quality protein, and sufficient dietary fiber is essential.
• Weight Management:Obesity is a major factor in worsening insulin resistance. Studies have shown that losing as little as 5 to 10 percent of body weight can improve hormone levels and restore ovulatory function. At this time, losing weight rapidly or excessively in a short period of time may actually worsen hair loss. It is important to control your weight gradually over a year or two through a healthy diet and regular exercise.
• Regular exercise:Moderate-intensity aerobic exercise, such as brisk walking or cycling, is very effective in increasing insulin sensitivity. Increasing muscle mass through strength training helps with long-term weight management by increasing basal metabolic rate.
• Stress management and getting enough sleep:Chronic stress and lack of sleep worsen hormonal imbalances. It is important to manage stress through meditation, yoga, and hobby activities, and to get at least 7 hours of quality sleep every day.

In conclusion, hair loss due to PCOS cannot be solved by simply applying something to the scalp. Only when we face the fundamental problem of our body, hormonal imbalance, and make consistent efforts to maintain a healthy life, can we finally regain our precious hair.