Demystifying the PCOS Hair Curse

Demystifying the PCOS Hair Curse

PCOSGuest Contributor: Olivia Carina


My scalp hair is disappearing, while my facial hairs are thicker than ever – it’s not right, and it’s not fair!

Sound like a familiar problem?

Of all the ways in which PCOS can make you feel unattractive and unfeminine, hair loss and hirsutism are among the worst.

If you’re like me, you have tried all kinds of supplements to increase your mineral levels. You may have used different forms of birth control to lower your androgen levels. You may have used topical treatments and dangerous medications to get your hair where it’s supposed to be, but chances are nothing has really helped.

With all the quick fix choices peddled as solutions out there, it can feel like you’re playing a game of “hormone tag” trying to make the shedding and thinning stop.

This post aims to help you put an end to that madness, and focus on correcting the biggest root problems causing hair loss in women. You may not be surprised that the same imbalances are behind both hair loss and hirsutism – what you may not know is that something other than androgens may be at the root of it all. To be most effective, we first need to toss out what isn’t working and take the most basic steps to help this problem correct itself.

To begin with, many problems with hair and health can be linked to a certain hormonal profile: low thyroid + high estrogen + low progesterone. If you are suffering hair loss, I recommend that you direct your focus toward these hormones.

Our goal is to turn our hormones into a healthier profile: that of high thyroid and minimal estrogen in relation to progesterone. I believe that doing this will give you the best results from your efforts.

Let’s get started.

Your thyroid’s hormones keep you looking and feeling young. They tell your ovaries to ovulate monthly, helping you create progesterone; they tell your adrenals to keep stress hormones low; they keep your body at an optimal temperature and improve circulation and digestion; and they keep your liver working well so that it can clear out toxins, allergens, and excess estrogen.

Now, your thyroid gland is powerful, but it is also easily influenced by factors in your internal and external environment. Stress, poor diet, excess estrogen, and pollutants all affect how your thyroid hormones work. Here’s how…

Too much stress can prevent the conversion of thyroid hormone T4 to its active form, T3. Instead, it will convert more into its inactive form, Reverse-T3. Reverse-T3 slows down cellular metabolism, which will mean less circulation to your hair follicles and signs of premature aging. Another thyroid problem emerges when stress hormones rise too high. These can disrupt the signals from your brain that tell your thyroid to produce hormones in the first place. Of course, this can lead to a vicious cycle, because when thyroid hormones are low, your stress hormones will rise even higher to compensate for them.

Certain dietary habits can also lead to low thyroid. A diet low in protein and carbohydrate will often cause your liver to grow weak and unable to convert T4 to active T3. Your liver requires plenty of protein and stored glucose (glycogen) to convert thyroid hormones, and perform its many other essential functions. Starvation diets, very low carbohydrate diets, low protein diets, and exercising to the bone, drain your liver of its thyroid-converting powers in a very short time.

Starvation isn’t the only problem. Diets that cause inflammation or insulin spikes will also lead to low thyroid. Huge insulin surges do direct damage to your thyroid. They also contribute to obesity, which causes inflammation, insulin resistance, and excess estrogen. Just as bad as a high GI diet is a diet that is high in allergens, polyunsaturated fats, grains, and nuts. These are essentially unstable and indigestible to your body, and inhibit cellular metabolism the way an air pollutant prevents healthy respiration.

Speaking of pollution, your thyroid faces daily attacks from environmental pollutants – radiation, dirty air, chemicals in food and water, and xenoestrogens. Common chemicals include halides (chloride, fluoride, bromide, iodide), plastic of all kinds (even BPA-free), birth control, and pesticides. These are pollutants that can prevent healthy thyroid function by taking up residence in the thyroid hormone receptors, among other effects. They also behave as estrogens in your body, which, as we’ll learn, is very bad for your hair.

There are a few factors in PCOS that cause estrogen to rise too high and progesterone to drop too low. First, you often have a low thyroid state, and/or a tendency to carry excess fat. To add to that, many women treat their PCOS with hormonal estrogen (birth control) in the hopes of bringing androgens down. Each of these factors leads to the compounding of estrogen in your body.

Consider this quote from Dr. Raymond Peat, PhD, who has studied female hormones extensively, “Experiments show it is estrogen that causes the hair follicle to become inactive, while an estrogen-blocker can stimulate the renewal of hair” (Dr. Ray Peat, PhD 1997). He goes on to cite a study from RC Smart, 1996, which demonstrated this effect. Despite the avid assurance and lobbying by the multi-billion dollar estrogen industry, evidence is slowly emerging that this hormone may have more to do with hair loss than androgens do – in both men and women. This would explain why estrogen “therapy,” birth control, and supposed androgen-blocking drugs do next to nothing for hair loss.

If estrogen’s direct effects on hair weren’t harmful enough, it can also stimulate tumor growth in your pituitary gland. These pituitary tumors secrete the hormone, prolactin, which is considered a stress hormone outside the context of pregnancy. Prolactin’s normal function is to release calcium from your bones and teeth into your blood to make breast milk for new mothers. But with chronically high prolactin, the calcium that is released in your blood can find its way back into arteries and hair follicles, causing “calcification.” Elevated prolactin levels are often found in people with hair loss, causing shedding. It is also associated with molting in birds.

Another function of prolactin is to suppress ovulation, which again, serves a purpose for new mothers, but can contribute to PCOS in other women. This adds to the feedback loop wherein high estrogen stimulates the production of prolactin, which inhibits the production of progesterone, which causes estrogen to rise even higher. When prolactin is chronically elevated along with high estrogen, it can cause hair loss that just won’t stop.

Working to reduce estrogen dominance will help support a better balance of prolactin and other stress hormones such as cortisol, which your adrenals will produce in response to estrogen’s stimulation. Ironically, estrogen dampens your ability to cope with stress, causing symptoms like anxiety, suicidal depression, and a tendency to cry easily, according to Dr. Raymond Peat. If any of those symptoms sound familiar, that should be a sign you’ve got some work to do…

So, what now? Do you need to take some estrogen-blocking drug? Is there some herbal concoction that will snap your hormones back into balance?

Definitely not…and if there was a miracle that did this, it would probably wipe out most of our savings.

But there is better news. By following the 80/20 rule, where most of our results come from a few crucial actions, we can support our hormones easily and affordably by following 3 simple suggestions. No more taking this herb and that medication, emptying your wallet for ineffective treatments.

  1. You will need to first get a baseline for where your hormones are. Achieve this with lab work and talk to your doctor. Get a full thyroid lab panel with antibodies, and get a blood test to measure estrogen and progesterone at the same time. A healthy ratio of progesterone to estrogen will be between 5 – 10 (P):1(E) (Dr. Raymond Peat, PhD, 1997). (for more about hormone testing, download PCOS Diva’s PCOS 101 Guide
  2. Focus on supporting your thyroid health.

Eliminate the consumption of allergens and polyunsaturated fats in all of their forms. All prevent efficient metabolism and cause inflammation. Eat a high amount of quality protein and carbohydrates from nutrient-dense foods. Your liver absolutely needs protein and carbohydrates in order to take out the trash from excess estrogens, polyunsaturated fats, and autoimmunity-triggering allergens. Aim for around 100 grams of protein per day, and always pair protein with a carbohydrate like fruit. Get the diet aspect right first, since a supplement cannot correct an anti-thyroid diet. Lastly, consider the use of a thyroid supplement. Ask your doctor about a natural thyroid supplement, or a T3 supplement.

  1. Focus on lowering your exposure to estrogen.

Stop taking it in in the form of birth control, estrogenic herbs and foods, and chemicals. Carefully lose excess weight (supporting your thyroid should aid in this effort). Additionally, you may want to use a quality progesterone supplement to help your body re-establish its own hormonal rhythm.

Supplemental progesterone, while very safe, only needs to be used temporarily before it stimulates your body to create more of its own natural progesterone.

Remember that for hair loss, you don’t need a million different supplements, you shouldn’t need to be dependent on a pharmaceutical, and you don’t need to do anything un-natural. Simple changes in diet and lifestyle (the things that are most in your control) can assist your body’s most powerful hormones in getting back to a balance that grows your hair.


Peat, Raymond. From PMS to Menopause: Female Hormones in Context. Raymond Peat, 1997.
Smart, RC, and second author HS Oh. “An Estrogen Receptor Pathway Regulates the Telogen-Anagen Hair Follicle Transition and Influences Epidermal Cell Proliferation.” Proceedings of the National Academy of Sciences USA. 1996 Oct 29;93(22):12525-30
Olivia Carina is a layperson researcher, focusing primarily on female hair loss. By following the work of some of the most forward-thinkers of our time, she has learned that hair growth can only be achieved by cultivating a healthy internal state. As we grow older, this requires more attention, as stress and imbalance leave deeper imprints that we must erase. But it is possible to grow well again naturally. Master the basic aspects of your life – diet, rest, and movement as the main foundation for your health and hair growth.
It is her goal to help other women who struggle with hair problems, from hair loss to hirsutism. She is the host of the Women’s Hair Growth Sessions summit  where 11 wonderful experts share what has helped their female clients get their hair back.

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  1. I am confused about the recommendation to reduce polyunsaturated fats and the notion that these cause inflammation. Any research I have seen indicates that PUFA, found in fish and other healthy sources of oils, reduce inflammation and improve myriad health issues. Am I missing something?