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Q&A

pcos · hair-loss

Why does PCOS cause hair loss?

Written byEditorial Team, HormonalHealth PortalReviewed byEditorial Medical Review, MD, NAMS-CMP· Updated May 15, 2026

Elevated androgens (testosterone, DHEAS) in PCOS bind to hair follicles on scalp, causing androgenetic alopecia. Same mechanism causes hirsutism elsewhere on the body.

The detail

Free testosterone and dihydrotestosterone (DHT) miniaturize scalp hair follicles. Pattern: thinning at crown and part line, sparing the hairline. Treatment combines anti-androgens (spironolactone), 5-alpha reductase inhibitors (finasteride off-label), and topical minoxidil. Addressing insulin resistance often improves androgen levels.

Sources

SC
Reviewed by Editorial Medical ReviewBoard-certified OB/GYN · NAMS-certified · Updated 2026-05-15

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Can I take spironolactone long-term for PCOS?

Yes, spironolactone is commonly used long-term (years) for PCOS-related hirsutism, acne, and hair loss. Monitor potassium and blood pressure annually.

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