When a woman is experiencing hair loss and has PCOS, spironolactone is often prescribed and it can be helpful but it’s important as well to address all these other issues when it comes to PCOS related hair loss. It’s also important to know that there is only a mild correlation of elevated testosterone on a blood test and hair loss. This is likely due to the hypersensitivity of the follicle to androgens in PCOS. Basically we get an exaggerated reaction from a smaller amount of testosterone.
That's why I've designed a system I call The Gottfried Protocol, a step-by-step, integrative approach to natural hormone healing that emphasizes lifestyle design first and foremost. It's based on decades of research, my education at Harvard Medical School, my own experiences with hormonal imbalances, my belief in peer-reviewed, well-performed randomized trials to support my recommendations, and what I've learned from patients over the past 20-plus years of practicing medicine. The Gottfried Protocol engages only the top hierarchy of scientific evidence and has been proven in scores of women in my practice.

During pregnancy, high concentration of estrogen levels in women result in the development of thicker, stronger, longer and healthier looking hair. Following pregnancy however, women tend to fret and think that they’re losing their hair when in fact they’re merely shedding the excess hair that the excess oestrogen created. The hair that was in a prolonged anagen stage are now all shifting into telogen (resting phase) to make way for new hair growth. This type of hair loss is comes under the condition known as telogen effluvium but the good news is that when oestrogen levels have returned to normal, your hair will too.


Telogen effluvium, a type of scalp hair loss characterized by hair shedding, may affect the eyebrows as well. It can be caused by any emotional or physiological stress, for example acute or chronic illnesses, hormonal changes, nutritional deficiencies, and medications that alter the normal hair cycle and cause the hair the enter the telogen phase prematurely.  

Thyroid hormone receptors were detected in both dermal and epithelial compartments of the human pilosebaceous unit.[48] T4 and T3 decrease the apoptosis of hair follicles and T4 prolongs the duration of anagen in vitro.[49] Thyroidectomy delays initiation of anagen. Administration of thyroxine advances anagen, initiation of which is however delayed once toxic doses are given. Therefore, ratio of telogen to anagen hairs is increased in hypothyroidism as well as hyperthyroidism.[50] Thus, the hair follicles are affected in thyroid disorders, and madarosis is caused due to disturbances in hair cell kinetics. Hypothyroidism is associated with generalized hair loss probably due to coarse, dull, and brittle hair with reduced diameter.[51] The eyebrows and eyelashes may also be lost. Loss of lateral one-third of eyebrows known as Hertoghe sign[38] is a characteristic sign of hypothyroidism.[52] Some people also refer to it as Queen Anne's sign,[53] after Anne of Denmark whose portrait with shortened eyebrows has been interpreted by some as indicative of the presence of goiter, even though such a fact has not been proved by any known sources of information. Madarosis may even be the presenting sign in hyperthyroidism.[21] In hyperthyroidism, there is thinning with breaking off and shortening of hair.[54] Madarosis can also occur in hypopituitarism, hypoparathyroidism,[21] and hyperparathyroidism.[55]
When the thyroid is under stress or poorly nourished—the thyroid is highly dependent on optimal levels of vitamins and nutrients to function optimally—it starts to focus its efforts on supporting the bodily processes (like breathing and regulating heart rate) that support and sustain life—and it stops paying as much attention to less vital functions, like hair growth.

Hormones are cyclical. Testosterone levels in some men drop by 10% each decade after age 30. Women's hormone levels decline as menopause approaches and drop sharply during menopause and beyond. The cyclic nature of both our hair and hormones is one reason hair loss can increase in the short term even when you are having a long-term slowdown of hair loss (and a long-term increase in hair growth) while on a treatment that controls hair loss.
If you’re experiencing hair loss, topical treatments like minoxidil (Rogaine) and others tend to only be partially effective, if they are effective at all; they don’t address the root causes of hair loss; they target androgenic alopecia (which only accounts for some cases of hair loss); and they come with a host of unpleasant side effects—side effects that can worsen the aesthetic problem you were hoping to fix. Rogaine can cause hair to grow in different colors and textures than the surrounding hair and can cause unwanted hair to grow on your cheeks and forehead.
Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.

An unhealthy gut is also a common source of inflammation and that alone can contribute to hair loss. But lack of robust digestion and a healthy gut bacterial environment will not only lead to nutrient deficiencies that impact hair health but an imbalanced impacting all other hormones related to hair loss such as low thyroid, poor estrogen metabolism and elevated cortisol.


Hair loss is something that everyone experiences sooner or later, but some get it earlier than others. Losing hair prematurely can be traumatic. Because of that, there is an infinite number of products that claim to cure and reverse the problem. But what if you could find out the likelihood that you will experience hair loss so that you could prevent it before the symptoms even showed? Researchers in the United Kingdom have reportedly found a way to predict who is at risk.

When you see more hair in the shower drain, in your hair brush or your ponytail holder goes around an extra time all of a sudden this is typically low thyroid, high stress or low estrogen. It can also be the increased inflammation or oxidative stress or as a result of nutrient deficiencies especially anemias (low iron, B12, etc.). Let’s dig into each of these.
The WHI was a very large, very prominent long-term study which looked at the health effects of HRT. While the study did find a few benefits (women who used HRT had fewer hip or bone fractures and were less likely to develop colorectal cancer), it found a number of risks, including an increased chance of heart attack, stroke, cancer, and blood clots.

Alopecia areata is a patchy hair loss associated with immune disturbances. In this condition the immune system attacks the hair follicles thereby impairing hair growth. It is more likely to occur in people with other immune-related disorders and has also been linked to psychological stress as well as with certain drugs like some types of ARVs used for HIV treatment. Alopecia areata does not only affect the scalp as commonly thought. The eyebrows and beard area, as well as hairy parts anywhere on the body may be affected.
Our professionally-trained people, products and services can help any person of any age or ethnicity, with any hair type or level of hair loss—whether it’s just beginning, it’s all gone or somewhere in between. We’re constantly innovating, using cutting-edge technologies and the latest proven hair restoration methods. We combine that innovation and technology with decades of first-hand experience in helping people deal with the issue of hair loss.
There is pilosebaceous inflammation[45] with both scarring and non-scarring alopecia depending on the degree of inflammation. Most commonly, there is involvement of the head and neck, though widespread involvement is also seen. Eyebrow loss is a prominent finding and may be the presenting symptom when the eyebrow region is involved in the acute benign form of follicular mucinosis.[46]
Hormones don’t just affect your mood, they are also common culprits of hair loss. A hormone imbalance caused by thyroid disease, pregnancy, menopause, or hormone medication (like birth control pills) can lead to eyebrow loss. Thankfully, once you identify the source of the hormone imbalance and address the problem, your hair will likely grow back naturally.

Last week, we schooled you on the foods and vitamins for long, healthy hair. Today, Kristin Dahl, a Los Angeles-based nutritionist and women’s wellness educator, is back again to talk about all things hormones and hair loss. Keep reading for Dahl's guide to maintaining optimum hormonal balance, how stress can mess with your mane, lock-block hair growth, and more. As the founder of The Women’s Wellness Collective and the holistic lifestyle hub, Dahl House Nutrition, Dahl knows what she's talking about so we'd take notes if we were you. 
FPHL or androgenetic alopecia is the most common cause of hair loss in women and one of the most common chronic problems seen by dermatologists worldwide (Varothai and Bergfeld, 2014). FPHL is a nonscarring form of alopecia in which the frontal hairline is maintained, but there is progressive hair thinning at the vertex of the scalp. Thinning of the hair is secondary to alteration of the hair cycle with shortening of the anagen phase and simultaneous lengthening of telogen. This increase in the resting phase and decrease in the growth phase of the hair cycle results in the miniaturization of hair because long terminal hairs are gradually replaced by short vellus hairs (Messenger and Sinclair, 2006, Sinclair et al., 2011).
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