I have PCOS and have taken Metformin & BCP (Beyaz) for years. I stopped the BCP 7 months ago & have had severe hair loss.Advice?

Question

I came off of the BCP due to low libido & concern of artificial hormones. The hair loss started very suddenly about 2-3 months later & has not gotten any better. It has been traumatic & frightening! I saw an endocrinologist who prescribed Spironolactine. I've read some scary things about taking this & don't want to do anything to make my situation worse! I battle PCOS symptoms constantly & can't take this hair loss on top of it all. Will the Spiro help me? Will it help regrow the hair I've lost?

Jae Pak, MD · Answer

You need to have an examination and a diagnosis before considering treatment options.  Traditionally if you have a medical problem, you see a doctor in person. A doctor takes a detailed medical history, conducts an examination, and orders pertinent tests.  After all this, the doctor can give you a diagnosis.  When the diagnosis is made, the doctor and the patient can explore a treatment plan.  You have many issues (Diabetes, PCOS, Medications, BCP, etc)  You also have doctors who follow you.  Hair loss may be a symptom of one or more of your medical issues.  Seeking treatment options or reassurance on the Internet may lead to confusion and conflicting information.  It is best to speak to a doctor in person.

Nikki D. Hill, MD, FAAD · Answer

Hi Boymom2,I understand your concern.  Typically we lose between 100-150 strands of hair a day.  This alone can be quite alarming if we actually capture each strand lost. Your hair strands are in three phases at all time, a growth phase, rest phase, and a fall out phase. Typically, a certain percent of hairs are in each phase at a time. A dynamic shift can occur resulting in the majority of the hairs moving to the fall out phase, called a telogen effluvium (TE), or stress shed. This can be the result of a few things, including starting and stopping medications (birth control pills are infamous for this), surgeries, illnesses, stress, nutrition, medical conditions, and more.  The reassuring thing is that TE typically stops in a 3 month cycle and people usually go back to their natural hair state before the shedding occurred.  Rarely, it can be longer such as 6 months and additional interventions are necessary.  Spironolactone will help with the PCOS influence of excessive hair growth and may help correct the hormonal changes that were a result of discontinuing the birth control. Reading your story you have 3 reasons that are likely causing shedding.  An endocrinologist should make sure your hormonal levels are within normal range.  Asking your endocrinologist to collaborate with your dermatologist is key to helping to stop the shedding and reverse the process.

Jeff Donovan, MD, PhD · Answer

It's important for women with PCOS to seek consultation for a specialist knowledgable about PCOS. Usually this is an endocrinologist, gynecologist and dermatologist   Issues such as weight control, diabetes, blood pressure issues and cholesterol issues and managed by an endocrinologist.  Fertility issues, irregular periods, and the differences in oral contraceptives are manages by a gynecologist or endocrinologistThe dermatologist manages hair loss, acne and increased hair growth on the face that sometimes is present. Other specialities may become involved to as PCOS is a multisystem issueNow back to hair loss. Yes, improvements in hair are possible and I can say that after treating many patients. Concerns about birth control pills are valid. Absolutely. But not all affect libido equally. Use of birth control as a means to regulate periods is important in PCOS and may reduce the risk of cancer. Shedding is possible with starting and stopping OCPs and can last 12 months. There are many reasons for ongoing shedding so please see a specialist for further evaluation. Without seeing your scalp and knowing your history, it's not possible to comment further. Spironolactone, laser, minoxidil, oral contraceptives and platelet rich plasma are options. 90 % of my patients are on at least two of these sometimes 3. All in all PCOS requires expert care that really can only be received by sitting down face to face with a knowledgable expert. Decisions on oral contraceptives and similar types of medicines to regulate periods are among the most important health decisions in women with PCOS, followed by blood pressure control, weight management and blood sugar regulation.

William Rassman, MD (retired) · Answer

This is a difficult problem and usually treatments fail to regrow hair. One thing that you might consider is a cosmetic treatment for hair thinning and this treatment is terrific in treating thinning hair in women, but it does not grow hair, just makes you look like you have lots of it. see the web reference below for more information on the cosmetic procedure I am discussing.

I have PCOS and have taken Metformin & BCP (Beyaz) for years. I stopped the BCP 7 months ago & have had severe hair loss.Advice?

Answers (4)

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