Hair Loss in Women: Polycystic Ovarian Syndrome and Oral Contraceptives.
Hair loss or hair thinning is an issue many people encounter. In both men and women, hair loss can be attributed to stress, improper diet, illness and prescription medications to name a few. However, here we will be dealing specifically with two causes of hair loss unique to women: Polycystic Ovarian Syndrome and Oral Contraceptives or ‘The Pill’.
Polycystic Ovarian Syndrome (PCOS):
One catalyst of female hair loss can be Polycystic Ovarian Syndrome (PCOS). Apart from symptoms such as weight gain, fatigue and increased facial hair, PCOS can cause excessive hair shedding and hair thinning. PCOS is an endocrine disorder and can cause the body to produce more androgens (male hormones). This is called hyperandrogenism. Androgens affect the degree and frequency of bleeding during a menstrual cycle, can cause oily skin, acne, excessive body hair and decrease the growth of hair on your scalp. However, in terms of hair loss, genetics always factor into this equation. Androgens have a greater impact on those with hair follicles more sensitive to their presence. This follicle sensitivity is not simply ‘caught’ or randomly acquired, however. It is genetically inherited and has been there since birth. For example, the hair of a woman with little or no hair follicle sensitivity will not be very affected by extra androgens. However, normal or even subnormal amounts of androgens could make the hair of a woman with a genetic pre-disposition to hair loss, and thus high follicle sensitivity, fall out.
Treatment for PCOS can be complicated, depending on symptoms other than thinning hair. But if hair loss is the only or predominant symptom, it is relatively straightforward. This hair thinning is treated by orally and/or topically taking anti-androgens. Topically applied solutions for hair loss usually contain an anti-androgen as well as a stimulant. The most common oral anti-androgens used for hair loss are Spironolactone or Dianette, an oral contraceptive.
The Pill (Oral Contraceptives):
As mentioned above, one of the medications for PCOS is Dianette – an oral contraceptive. For some types of hair shedding and hair thinning, this pill can be very helpful – and so can many other oral contraceptives. However, there are also contraceptive pills which can have a negative impact on your hair and cause hair thinning. This again, however, depends on the sensitivity of your hair follicles and your genetic predisposition.
Most birth control pills contain two hormones: oestrogen and progestin, and only some progestin. Both of these hormones can be beneficial to the hair as they are ‘less androgenic’. Examples of contraceptive pills that are hair friendly are Yasmin, Dianette and Cileste. However, some pills contain hormones such as Levonorgestrel, Norethisterone and Gestidone, all of which are androgens. If you have follicular sensitivity, these androgens within The Pill can result in hair loss and hair thinning. However, if you do not have the genetic pre-disposition to sensitivity, the hair loss will not occur.
That being said, coming off of the pill can cause temporary hair shedding for any woman, regardless of her genes. The reason for this is that stopping a contraceptive pill can result, although not always, in a type of post-partum shedding. This is caused by a sudden drop in oestrogen. However, this is only short-term shedding and all the hair lost will grow back.
One also must remember that hair loss may coincide with an event that it is unrelated to. For example, your hair may start to fall out after stopping the pill or being diagnosed with PCOS. The hair loss may be a direct result of these, but can often be attributed to different factors such as diet or stress or a combination of underlying issues.
Please note: Always consult your doctor or gynaecologist before changing or starting any contraceptive pill.