PMOS Hair Loss: Why It Happens and What Can Help

Hair loss can be an unexpected and difficult part of living with polyendocrine metabolic ovarian syndrome (PMOS*), especially when it is unclear whether the condition is responsible.

PMOS can contribute to scalp hair loss, but it does not affect everyone in the same way. Understanding the pattern and cause of your hair loss is the first step towards finding a suitable treatment.

*PMOS, formerly PCOS Polyendocrine metabolic ovarian syndrome, or PMOS, is a hormone condition that can affect periods, fertility, weight, skin and hair. It was previously called polycystic ovary syndrome, or PCOS, so you may still see both terms used online.

Does PMOS Cause Hair Loss?

PMOS can contribute to hair loss in some women. One type linked to PMOS is female pattern hair loss, also called androgenetic alopecia.

Each hair grows from a small structure in the skin called a follicle. With female pattern hair loss, some follicles gradually become smaller and produce finer, shorter hairs. This usually causes thinning around the parting and across the top of the scalp.

Hair loss is only one possible symptom of PMOS. Thinning hair does not necessarily mean you have PMOS, and having PMOS does not mean you will develop hair loss.*

*British Association of Dermatologists. (2024). Hair loss female pattern.

What does PMOS hair loss look like?

PMOS-related female pattern hair loss usually develops gradually rather than suddenly.

Common signs include:

• A parting that appears wider than it used to

• Thinning across the top of the scalp

• More scalp becoming visible around the crown, which is the area towards the top and back of your head

• Hairs becoming finer, shorter or less dense

• A gradual reduction in the volume of your ponytail

The front hairline is often preserved, although some women notice thinning around the temples. Complete baldness is uncommon in female pattern hair loss.*

Female pattern hair loss usually does not cause round bald patches, redness, scaling or soreness. These changes may point to a different cause and should be assessed by a clinician.

*British Association of Dermatologists. (2024). Hair loss female pattern.

Why Can PMOS Affect Your Hair?

PMOS can affect scalp hair through a combination of hormones, insulin resistance and genetics. These factors can influence both your androgen levels and how sensitive your hair follicles are to them.

Androgens can make hair follicles smaller

Androgens are hormones found in everyone, including testosterone. Some women with PMOS have higher androgen levels.

Each hair grows from a follicle in your scalp. When a follicle is sensitive to androgens, it can gradually become smaller. Each new hair may then grow back finer, shorter and lighter than the one before it. Over time, this can reduce the amount of hair covering your scalp and make your parting look wider.*

However, higher androgen levels do not always cause hair loss. Some women with PMOS have raised levels without developing thinning.

*British Association of Dermatologists. (2024). Hair loss female pattern.

Your follicles may be more sensitive to hormones

Some women develop female pattern hair loss even when their androgen blood test results are within the normal range. This may happen because their hair follicles are particularly sensitive to these hormones.

A normal testosterone result therefore does not rule out hormone-influenced hair loss. Hair loss on its own also does not mean that you have high androgen levels.*

*Carmina E, et al. (2019). Female pattern hair loss and androgen excess: a report from the multidisciplinary Androgen Excess and PCOS Committee.

Insulin resistance may increase androgen activity

Many women with PMOS have insulin resistance. This means the body does not respond to insulin as effectively as it should, so it may produce more of it.

Higher insulin levels can encourage the ovaries to produce more androgens. This may increase the effect these hormones have on sensitive hair follicles.

However, insulin resistance is not the only cause of PMOS hair loss. Improving it may support your wider health and other PMOS symptoms, but it does not guarantee that lost hair will grow back.

Genetics can affect your risk

Female pattern hair loss often runs in families. You may inherit hair follicles that are more sensitive to androgens from either side of your family.

The combination of PMOS-related androgen activity and an inherited sensitivity may explain why some women with PMOS develop hair loss while others do not.

Hormones affect scalp and body hair differently

Androgens can have different effects depending on where a hair follicle is located. They may cause hair on the face or body to grow thicker while making sensitive follicles on the scalp produce finer hair.

This explains why PMOS can cause increased facial or body hair and thinning scalp hair at the same time.

Could Something Else Be Causing Your Hair Loss?

PMOS is not the only possible cause of hair thinning or shedding. Even if you have already been diagnosed with PMOS, another condition or recent change may be affecting your hair. Possible causes include:

Medical conditions

• Iron deficiency or anaemia

• Thyroid conditions

• Alopecia areata, which causes smooth, round patches of hair loss

Nutritional and weight-related factors

• Not getting enough energy, protein or certain nutrients

• Marked weight loss or extreme dieting

Other triggers

• A recent illness, infection or operation

• Ongoing stress

• Childbirth

• Starting or stopping some medications

• Tight hairstyles or repeated pulling on the hair

A temporary type of shedding called telogen effluvium can develop after illness, childbirth, stress or weight loss. It happens when more hairs than usual enter the resting and shedding stage at the same time.

Telogen effluvium usually causes increased shedding from across the scalp rather than gradual thinning around the parting. It can occur at the same time as female pattern hair loss, which can make the cause harder to identify.*

*British Association of Dermatologists. (2025). Telogen effluvium.

How Is Hair Loss Due to PMOS Diagnosed?

There is no single test for hair loss caused by PMOS. A clinician will usually look at your scalp and ask about:

• Where the thinning started

• Whether the change was sudden or gradual

• How much hair you are shedding

• Whether hair loss runs in your family

• Your periods and whether they are regular

• Acne or increased facial and body hair

• Recent illness, stress, pregnancy or weight changes

• Your diet, medications and supplements

• Any itching, pain, scaling or redness on your scalp

Depending on your symptoms, blood tests may be recommended to check for other causes, such as iron deficiency, anaemia or a thyroid condition. Tests may also check androgen levels if you have other signs of increased androgen activity.

Hair loss alone cannot confirm PMOS. Current guidance considers female pattern hair loss on its own to be a weak sign of raised androgen levels. The wider pattern of your symptoms needs to be considered.*

A clinician may refer you to a dermatologist if the cause remains unclear. A dermatologist is a doctor who specialises in conditions affecting the skin, hair and nails.

*Teede HJ, et al. (2023). Recommendations from the international evidence based guideline for the assessment and management of polycystic ovary syndrome.

Is Hair Loss Caused By PMOS Reversible?

Female pattern hair loss can be frustrating to deal with, and it’s understandable to want a clear answer about whether it can be fixed for good. Although there currently isn’t a permanent cure, treatment may slow further thinning and help some hair grow back.

Results from treatment vary between individuals, as follicles that are still producing fine hairs may respond better than follicles that have stopped producing hair altogether. Starting treatment earlier may therefore help preserve more of your existing hair.

Minoxidil is a medication used to treat female pattern hair loss. With consistent use, you may start to see results within 3 to 6 months. Continued use is usually needed to maintain them.*

It's also worth knowing that not all hair loss is the same. Hair loss caused by a temporary trigger may be more likely to recover. For example, shedding related to illness, childbirth, marked weight loss or a nutritional deficiency may improve after the trigger has resolved. This type of shedding is different from female pattern hair loss, although the two can occur together.

*British Association of Dermatologists. (2024). Hair loss female pattern.

What Treatments Can Help With PMOS Hair Loss?

The most suitable treatment depends on the cause and pattern of your hair loss, your health, your other medications and whether you are pregnant or planning a pregnancy.

Minoxidil

Minoxidil is the main established treatment for female pattern hair loss. It helps keep hair follicles in their active growth stage for longer and may increase the size of follicles that have become smaller.

Topical minoxidil: The treatment is applied directly to the scalp as a liquid or foam. It is available in different strengths. Some forms can be bought from a pharmacy, while others may be prescribed.

Some people experience increased shedding when they first start using minoxidil. This is usually temporary and can happen as hairs move into a new growth cycle. Scalp irritation and unwanted facial hair can also occur, particularly if the product runs onto the face.

Oral minoxidil: Low dose oral minoxidil is taken as a tablet. It may be prescribed off label when a clinician considers it suitable. Off label means that a licensed medication is being prescribed for a use that is not included in its marketing authorisation.

How long does it take to see results? With consistent use, you may start to see results from topical or oral minoxidil within 3 to 6 months. Continued use is usually needed to maintain them.*

Minoxidil should not be used during pregnancy or breastfeeding. Speak to a clinician before using it if you are trying to become pregnant.

*British Association of Dermatologists. (2024). Hair loss female pattern.

Spironolactone

Spironolactone is a medication that reduces the effects of androgens on susceptible hair follicles. It may help slow female pattern hair loss in some women, particularly when there are other signs of higher androgen activity.

Spironolactone is prescribed off label for female pattern hair loss in the UK. Evidence specifically involving women with PMOS is limited, so it will not be suitable or effective for everyone.*

Possible side effects include needing to urinate more often, dizziness, breast tenderness, tiredness and changes to your periods. Spironolactone can also affect potassium levels and kidney function, so blood tests may be needed.

Spironolactone must not be taken during pregnancy because it could affect the development of a baby. If pregnancy is possible, discuss contraception and future pregnancy plans with your clinician.

*British Association of Dermatologists. (2025). Spironolactone.

Other PMOS medication

Medication used to manage other PMOS symptoms does not necessarily treat scalp hair loss.

• The combined contraceptive pill can reduce androgen activity and may help with irregular periods, acne and increased facial or body hair. However, it is not an established hair regrowth treatment on its own.

• Metformin may be prescribed to improve how the body responds to insulin and reduce the risk of type 2 diabetes. Some people also find that it helps make their periods more regular. It is not a direct treatment for female pattern hair loss.

• Weight loss medication may support weight management and improve some health risks associated with PMOS when it is clinically suitable. However, it is not a direct hair loss treatment. Marked or rapid weight loss can sometimes trigger temporary shedding, particularly if you are not getting enough energy, protein or nutrients.

A clinician may recommend treating PMOS and hair loss separately because improving one symptom does not always improve the other.*

*Teede HJ, et al. (2023). Recommendations from the international evidence based guideline for the assessment and management of polycystic ovary syndrome.

Can Natural Treatments Help With PMOS Hair Loss?

There is no diet, supplement or natural treatment that has been shown to reverse female pattern hair loss.

A varied diet containing enough energy and protein supports normal hair growth. Iron, zinc and other nutrients also play a role, but supplements are most likely to help when you have a confirmed deficiency.

Biotin is often marketed for hair growth, but there is little evidence that taking extra biotin improves hair growth when you already get enough.*

Before taking a hair supplement, check whether the same ingredients are already included in another vitamin or treatment. Taking more than you need does not mean your hair will grow faster.

If you are losing weight, aim for a gradual approach and make sure you are eating enough protein and essential nutrients. Very restrictive diets and marked weight loss can trigger temporary shedding.

*National Institutes of Health Office of Dietary Supplements. (n.d.). Biotin: fact sheet for health professionals.

7 Tips for Managing Thinning Hair

These steps will not treat the underlying cause, but they may help protect fragile hair and make thinning less noticeable.

1. Treat your hair gently. Avoid pulling when brushing and use a wide toothed comb on wet hair.

2. Limit tight hairstyles. Repeated tension from tight braids, ponytails or extensions can damage hair follicles.

3. Reduce heat and chemical damage. Frequent bleaching, straightening and high heat can make fine hair more likely to break.

4. Try a different parting. Moving your parting or choosing a shorter, layered style may make thinning less noticeable.

5. Consider cosmetic fibres or scalp products. These can temporarily reduce the contrast between your hair and scalp.

6. Protect your scalp from the sun. Use a hat or a suitable scalp sunscreen where thinning leaves more skin exposed.

7. Take progress photos. Use the same lighting, angle and hairstyle every few months. This can make gradual changes easier to see.

When Should You Speak to a Clinician?

Speak to a GP or dermatologist if:

1. Your hair loss is sudden, severe or getting worse quickly

2. You develop smooth or round bald patches

3. Your scalp is painful, inflamed, itchy or scaly

4. You are losing hair from your eyebrows or eyelashes

5. Your hair loss began after starting a new medication

6. You have very heavy periods, tiredness or other possible signs of iron deficiency

7. You have irregular periods, acne or increased facial and body hair but have not been assessed for PMOS

8. Hair loss is affecting your confidence or mental health

Seek medical advice promptly if hair loss develops quickly alongside other noticeable hormone-related changes, such as a deeper voice or a rapid increase in facial or body hair.

PMOS Hair Loss: The Bottom Line

PMOS can contribute to female pattern hair loss, but it is not the only possible cause of thinning. The usual pattern is gradual thinning around the parting, crown and top of the scalp.

A clinician can help identify whether PMOS, another health problem or a temporary trigger is affecting your hair. Treatments such as minoxidil and spironolactone can help some women slow further thinning and encourage regrowth.

With consistent use, you may start to see results from hair loss treatment, such as minoxidil, within 3 to 6 months. Starting treatment earlier may help protect more of your existing hair, so it is worth seeking advice if your parting is becoming wider or your hair is becoming gradually finer.

FAQs

Can PMOS hair loss grow back?

Some regrowth may be possible, especially when treatment starts while the affected follicles are still producing fine hairs. Treatment may also help slow further thinning.

Hair lost through temporary shedding may recover after the trigger has resolved. Female pattern hair loss is a long-term condition, so ongoing treatment is usually needed to maintain results.

How long does minoxidil take to work for PMOS hair loss?

With consistent use, you may start to see results from minoxidil within 3 to 6 months. Changes in thickness and coverage happen gradually because hair grows slowly.

Using more minoxidil than recommended will not make it work faster and may increase the risk of side effects.

Can losing weight stop PMOS hair loss?

Losing weight can improve some PMOS symptoms and health risks if you are overweight, but it does not guarantee that scalp hair will grow back.

Female pattern hair loss can continue even when periods, insulin resistance or other PMOS symptoms improve. Marked or rapid weight loss can also cause temporary shedding.

Can the contraceptive pill help with PMOS hair loss?

It can help with related symptoms, but it is not an established treatment for scalp hair regrowth on its own. The combined contraceptive pill can reduce androgen activity and may improve some PMOS symptoms, including acne, irregular periods and increased facial or body hair.

A clinician may consider it alongside other treatments depending on your symptoms, health and pregnancy plans.

Does high testosterone always cause PMOS-related hair loss?

No. Some women with female pattern hair loss have testosterone levels within the normal range. Their hair follicles may be more sensitive to androgens even when blood test results are normal.

This is why a clinician will consider your hair loss pattern and wider symptoms rather than relying on one blood test.

Can you have PMOS hair loss without other symptoms?

Yes, it is possible to have hair thinning alongside mild or less noticeable PMOS symptoms. However, hair loss alone is not enough to diagnose PMOS.

A clinician may ask about your periods, acne, facial or body hair, weight changes and family history before deciding whether further tests are needed.