Dr. Ajayita | Gold Medal BAMS | 25+ Years Clinical Practice | Founder AClinic Chandigarh | TEDx Speaker
In my clinical practice, the combination of PCOS and hair fall is the most common pairing of symptoms that I see. And the most heartbreaking. Patients who come to AClinic with this combination have typically been told two different things by two different doctors. One doctor managed the PCOS with hormonal contraception. Another minoxidil prescribed for the hair fall. Neither one panned out in the long run. And there was no reason why both were happening at the same time.
Why they happen together is not complicated. They are caused by the same root cause It is that root cause understanding that changes the entire treatment approach.
Why PCOS and hair loss go together:
In classical Ayurveda and in allopathic medicine, the link between PCOS and hair fall is through the liver and the androgen pathway.
And this is the result. In Pitta dominant PCOS the liver is overloaded and doesn’t efficiently metabolize hormones. Androgens particularly testosterone and DHT build up in the blood instead of being broken down. These androgens build up and do two things at the same time. They disrupt the ovarian function leading to the irregular cycles, anovulation and polycystic appearance on ultrasound that is characteristic of PCOS. And they attack the hair follicle, gradually miniaturizing it until the follicle produces thinner, shorter, weaker hair until it stops producing hair altogether.
That’s why the results of treating PCOS and hair fall separately are incomplete. Application of minoxidil to the scalp will not correct an androgen excess caused by liver dysfunction. And hormonal contraceptives that regulate the cycle don’t treat the underlying buildup of androgens they cover it up. The hairfall comes back as soon as the contraceptive stops and the androgens come back.
Three types of PCOS-related hair fall:
Different hair root patterns in different PCOS and hair fall patients. The right pattern dictates the right treatment.
Most common pitta pattern. Spread over the parting and thinning. Scalp inflammation itching, sensitivity, sometimes dandruff with an inflammatory, not dry character. Premature graying Acne along with hair loss. This is an androgen excess from the liver. Hair fall and PCOS are both the downstream effects of the same Pitta imbalance.
Vata pattern dry brittle hair that breaks off before it falls out, rather than shedding from the root. Dry, flaky scalp. Hair fall with associated stress, irregular eating and sleep disruption not due to excess androgens. Cycles are volatile and unpredictable. This pattern is often accompanied by anxiety.
Kapha Type – Oily Heavy Scalpe. Flat and lifeless hair rather than actively thinning. Not dramatic shedding, just slow steady hair fall. PCOS and weight gain. Her labs were consistent with insulin resistance. Hair fall here is due to obstruction of the channel and not due to androgen attack on the follicle.
How Nadi Pariksha can tell which pattern you belong to:
At AClinic, all the consultation for PCOS and Hairfall begins with Nadi Pariksha. Even before the patient can tell me one symptom, the pulse tells me which dosha is most dominant. This is confirmed with blood work – checking androgens, LH/FSH ratio, AMH, ferritin, thyroid and vitamin D – and the clinical picture.
Two patients can present the same symptoms – irregular periods, diffuse hair thinning, scalp sensitivity – and need completely different treatment. One has excess of androgens Pitta. The other is the depletion of vata tissue. To do the same to them is a waste of months.
Ayurvedic treatment for PCOS and hair fall together;
The benefit of treating PCOS and hair fall together with Ayurveda is that the right treatment works on both at the same time through the same root cause.
For PCOS with Pitta dominance and hair fall – Virechana is the main Panchakarma therapy. Therapeutic purgation enhances liver function directly, and also removes accumulated androgens from the blood. The PCOS symptoms improve when the androgen levels normalize cycles normalize and the hair fall reduces simultaneously. Patients undergoing Virechana regularly report a decrease in hair fall and increase in cycle regularity during the same treatment period.
Nasya with cooling medicated oils Anu Taila and Ksheerabala Taila is directly nourishing the scalp through nasal-neural pathway. Shiro Abhyangam With Bhringraj oil to take care of scalp environment and follicular circulation. Both are used along with Virechana for hair fall component.
Internal herbal formulations for Pitta PCOS Hair Fall Shatavari, Amalaki, Guduchi, Triphala and Bhringraj. At the same time, they influence liver function, androgen metabolism and tissue nutrition. Post Nadi Pariksha, the exact formulation is decided – not from a standard PCOS formula.
In Vata predominant PCOS with hair loss Basti is the main therapy. It restores the nervous system regulation of the hormonal axis and rebuilds the tissue nutrition through Asthi Dhatu path which supports the hair growth. Shirodhara targets the stress component which is the root cause of both the Vata PCOS pattern and hair fall. Internal formulations contain Ashwagandha, Shatavari, Bala and Amalaki.
Virechana for Kapha PCOS with hair fall – addresses the metabolic correction needed. Kapha PCOS: non-negotiable diet modification- dairy reduction, no cold heavy foods, regular meal timing. Lighter stimulating oils and not heavy nourishing oils for scalp treatment.
Timeline for realistic results for PCOS and hair fall together:
Week 4 to 6 — inflammation of scalp subsides. Less shedding Cycle begins to indicate early signs of regularization.
Month 2 to 3 — Blood markers begin to change. Androgens begin to normalize. New hair growth is visible at the hairline and parting in most patients.
Month 3 to 4 – cycles begin to regularize. Hair fall has reduced substantially. Skin clearing as well as hair improvement.
Month 4 to 6 – Hormonal balance is retained. Noticeable increase in hair density. “The vast majority of patients don’t need the treatments they were symptomatically managing beforehand.
Q&A:
A: PCOS does not always cause hair fall.
A: Not always, but it’s very common. Hair loss due to PCOS is more consistent in the pattern of Pitta predominant with androgen excess as the primary driver. If you have a Kapha predominant PCOS, you may have less hair fall but more weight and metabolic symptoms.
Q: Will my hair grow back after PCOS treatment?
A: Hair lost due to androgen-driven miniaturization can grow back when the androgen excess is corrected – as long as the follicles are not permanently scarred. Early intervention is better for regrowth. Generally, the follicles that have been inactive for less than 3 to 4 years respond to treatment.
Q: Can I treat hair fall and PCOS simultaneously in Ayurveda?
A: Yes, this is one of the advantages of the Ayurvedic approach. The root cause of both of these conditions is the same in most patients, and treating the root takes care of both at the same time.
Q: How long before I see improvement in both PCOS and hair loss?
A: The majority of patients experience improvement in scalp inflammation and active shedding in 4 to 6 weeks. It normally takes 2 to 3 months to regularize the cycle. Most cases show visible new hair growth at 8 to 16 weeks.
Q: Do you provide online consultation for PCOS and hair fall?
A: Yes. Online consultation from all over India and abroad. Phone Rs.700. Video Rs.900. Call 0172-2650793 or book an appointment.