PCOS treatment reset - hair loss mainly

[Peonyyyy]

Hi there, I’ve had a long journey with pcos which I won’t go into now but now I’m done having babies I’m ready to get back into it. I’m hairy but my acne is not too bad these days, my main concern is hair loss. over the years I’ve been on diabette, Yasmin, spironalactone and metformin which I’m currently on now. I have also tried minoxidil and been to an expensive trichologist and saw no improvement. My hair is very thin and showing scalp around my parting and at the front. I am slim build so a lot of doctors not even believe I have pcos.

im looking to get back into treatment as my hear loss gets me down the most and I know when it’s gone it won’t come back. I want to stop taking metformin (mainly took whilst TTC) because a private consultant gynaecologist told me it can lead to liver damage long term and I don’t think it helps my symptoms much.

I just wondered if anyone can advise me what worked for them, mainly for hair loss?

I need contraception so was considering going back on Yasmin, but have seen that it increases the risk of blood clots, strokes and some cancers. A have a close family member that died of a stroke (but they were elderly). my periods can be quite long and heavy so Yasmin could help with that too.

should I start by asking my GP to do some blood tests? Maybe testosterone, iron, thyroid? I have have high cholesterol in the past so maybe that too?

I know a lot of people might say ‘just talk to your GP’ but trust me I’ve talked to LOADS and they have limited if any knowledge of PCOS.

Would love to hear your advice and thoughts and what’s worked for you. Thanks

Yes I'd ask your GP to do a whole set of bloods, and also some other hormones, again cholesterol and insulin tests, as well. Then you do need to start some form of contraception because you need uterine protections especially as with PCOS it can be a 2-5 x higher risk of uterine cancer, so you I'd also look into that. Try and see if your GP surgery has anyone with a special interest in women's health or endocrinology.

PCOS & Metformin can affect your Vit D and Iron levels. I'd add a supplement of both plus zinc to your daily diet and look into Inosital & Myosital as well.

Thank you this is really helpful! I didn’t know about the increased cancer risk. Going on the pill is pretty much definite for me also because of not wanting to get pregnant again so it’s good to be clear on at least one thing.

what would you recommend I ask for blood test wise?

have you done at treatment that has helped you?

@FartSock5000 ah ok great thank you. I take iron and vitamin d, and I should’ve mentioned actually that I take myoinositol (this was mostly due to ttc)

Blood test wise I'd probably ask for:
• Total testosterone
• Sex Hormone Binding Globulin
• Free Androgen index
• Fasting glucose + insulin
• Lipid panel (cholesterol, triglycerides)
• Vitamin D
• Thyroid panel (TSH, free T4)
Hirtuism blood panel as well

I would go for the pill or the mirena (it is localised so helps with side effects), but either is good, you can go through pros/cons with your GP.
Definitely bring up the acne, hair loss/excessive hair - and the locations of that. There are creams and meds you can try for that so ask them about different things for that.

I'd also use vitamin B6 and D supplements as they can be helpful with energy, also for periods. Also try tranexamic acid if you have heavy periods as it can massively reduce bleeding.

Have you seen your GP yet? Or booked an appointment yet?

Thanks all. All my bloods came back ‘normal’ apparently apart from Iron and Cholesterol (6.6)

I am currently taking:

ferrous fumerate for the low iron
yasmin pill (used to be on this before kids)
metformin (they said it’s fine to continue taking it)
myo inositol powder
vitamin d
vitamin c and zinc
b complex
MSM (sulphur)

at the moment I’ve got some persistent acne, hard lumps under the skin which I haven’t had since I was a teenager before I went on the pill. Also finding my hair is getting greasy quickly and I’m very emotional. Hoping the pill kicks in soon, I’ve only been taking it for 3 weeks so far.

A higher protein diet and not being anemic has really helped my hair.

Can I ask if you are overweight OP? If you are, losing weight can make a huge difference to symptoms. Excess weight causes even more hormone havoc in women with pcos. I noticed a difference just with a small drop in weight. At BMI 25 I had some symptoms, but got down to around BMI 23 and they've gone.
(I know BMI 25 is borderline rather than properly overweight, but just demonstrating that even a smaller weight loss can be helpful).

If you already have a lower BMI then my only suggestion is committing for a long period to the pcos diet and seeing if that improves things.

Strangely I’m not overweight, my bmi is 18.

i do need to get back on the wagon with the pcos diet. Overall I have a pretty good diet and only eat wholewheat pasta etc but I do have a tendency to want to eat chocolate and biscuits when I feel down! It’s really hard. Thank you for your advice 🙂

@Candlesandmatches that's good to know - I think I have been low on iron for years and years and never realised.