If you have PCOS — recently renamed PMOS — and your hair is thinning at the parting or crown, often while unwanted hair appears elsewhere, that frustrating combination has a clear mechanism. It is hormonal, it is not your fault, and in most women it responds to properly chosen treatment.
Hair GP is a doctor-led London clinic dedicated to women’s hair loss. Dr Amy Vowler is a GMC-registered doctor who treats the hormonal drivers of female hair loss every day — which matters here, because PMOS hair loss is treated with prescription medicine and blood-test-guided decisions, not shampoo. She also has PMOS herself so has the lived experience that that brings.
- – PCOS was renamed PMOS — polyendocrine metabolic ovarian syndrome — by global consensus in May 2026; same condition, more accurate name
- – Hair thinning in PMOS is driven by androgens acting on the follicle, often amplified by insulin resistance
- – The pattern is distinctive: thinning at the crown and parting, sometimes alongside excess facial or body hair
- – Anti-androgen treatment such as spironolactone is often effective — and needs a doctor to prescribe and monitor it
- – Diagnosis comes first: blood tests for androgens, insulin resistance, thyroid and iron shape the right plan
PCOS is now PMOS — what changed and why it matters
In May 2026, an international consensus published in The Lancet formally renamed polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome (PMOS). Nothing about your diagnosis changes — the new name simply describes the condition properly. PMOS was never really about ovarian “cysts”: it is a whole-body endocrine and metabolic condition, involving androgens, insulin and the ovaries together.
For your hair, the rename actually helps. It puts the two real drivers — androgen excess and insulin resistance — in the name, and those are exactly the two things effective hair treatment addresses. You will see both names used on this page while the world catches up.
Why PMOS thins your hair
Hair follicles on the scalp are sensitive to androgens, particularly dihydrotestosterone (DHT). In PMOS, androgen levels run higher — and insulin resistance amplifies this, because high insulin pushes the ovaries to make more androgens and lowers the protein (SHBG) that keeps them bound and inactive. At the follicle, the result is miniaturisation: each growth cycle produces a slightly finer, shorter hair, and the parting gradually widens.
The same androgens explain the paradox many women find so distressing: thinning hair on the scalp while coarser hair appears on the face or body. Follicles in different places respond to androgens in opposite ways. It is one mechanism with two visible effects — and treating the mechanism helps both.
What we test — and what each result tells us
| Blood test | What it tells us |
|---|---|
| Testosterone, SHBG & free androgen index | The androgen drive behind the thinning |
| DHEAS | Whether the adrenal glands are contributing |
| HbA1c or fasting insulin | The metabolic side — insulin resistance amplifies androgens |
| Thyroid function | Thyroid disease mimics and compounds PMOS hair loss |
| Ferritin & full blood count | Iron deficiency — common, and it multiplies any shedding |
| Prolactin | Rules out other hormonal causes of irregular cycles and shedding |
All bloods can be arranged through the clinic. A £300, 50-minute consultation with Dr Amy includes scalp examination under magnification and a written, results-guided plan. Bloods are an additional cost, please contact us for a quote.
Book a Consultation
If you're experiencing PMOS hair loss, a proper diagnosis is the first step toward the right treatment.
Our consultation includes a full clinical assessment, dermoscopy, and a personalised treatment plan — all in a single appointment.
Book your consultation today — £300Including assessment, and treatment plan. See full pricing
Treatment that addresses the mechanism
Spironolactone blocks androgens at the follicle and is one of the most effective options for PMOS-driven thinning — prescription-only, unsuitable in pregnancy, and exactly the kind of medicine that should be started and monitored by a doctor. Topical or low-dose oral minoxidil stimulates the follicles directly and pairs well with anti-androgen treatment.
Because PMOS is metabolic as well as hormonal, we also look at the insulin side: where insulin resistance is present, addressing it — through your GP or specialist where medication such as metformin is appropriate — reduces the androgen drive itself. And contraceptive choice matters more than most women are told: some pills are androgenic and quietly work against your hair, while others are anti-androgenic and work with it. We review yours as part of the plan.
What Patients Say
The whole picture, not just the hair
PMOS touches cycles, skin, fertility plans and long-term metabolic health, and your hair plan has to fit around all of it — including any facial hair treatment, where we can advise on what actually works. Dr Amy coordinates with your GP or endocrinologist rather than working in isolation, and nothing is prescribed without understanding the whole picture first. If your diagnosis is old, the appointment is also a chance to bring it up to date under the new PMOS framework.
PMOS hair loss through your life stages
PMOS is lifelong, but its hair story changes costume by decade. In your teens and twenties it hides behind “it’s just your cycle settling” — often for years, which is why so many women reach us with a decade-old pattern nobody joined up. Through the fertility years, contraception choice becomes hair strategy (androgenic pills quietly aggravate what anti-androgenic ones calm), and conception plans sequence every treatment decision — spironolactone stops before trying, while the early-intervention logic argues for treating decisively in the windows between. From the forties onward, the metabolic side of the syndrome — the M in PMOS — moves to centre stage, insulin resistance often deepens, and perimenopause layers a second hormonal transition over the first. Same syndrome, three different treatment plans. This is why a PMOS hair plan has a shelf life and deserves review as your life moves.
Why PMOS hair loss gets dismissed — and what proper care looks like
Most women with PMOS thinning have heard some version of “your bloods are normal” or “try losing some weight and see”. Both deserve unpacking. Total testosterone frequently is normal in PMOS — the drive on your follicles comes from the free fraction, which is why we measure SHBG and calculate the free androgen index rather than stopping at the headline number. And while improving insulin sensitivity genuinely helps, prescribing weight loss instead of treatment is not a plan — it is a postponement, usually delivered without the anti-androgen therapy, follicle support and metabolic work-up that constitute one. Proper care runs the full panel, treats the mechanism from both ends, coordinates with your GP or endocrinologist, and reviews against photographs — which is precisely what the clinic appointment is built to do.
Your first appointment at the PMOS clinic
Bring whatever history you have — previous blood results, cycle notes, a list of contraceptives past and present — and expect to use all fifty minutes. Dr Amy takes the full endocrine history, examines your scalp under magnification to grade what the androgens have actually done, and arranges the panel from the table above where results would change the plan. You leave with a working diagnosis; once bloods return, a written plan follows: which treatment, at what dose, reviewed when, and what the insulin side of your syndrome needs alongside. The consultation is £300 with prescriptions issued directly where appropriate (at no extra cost). Still deciding whether your thinning is PMOS at all? That is a fifteen-minute conversation, and the free call exists for exactly that question.
Not sure where to start? Talk to Dr Amy first.
Dr Amy Vowler · GMC-registered GP · GMC 7451097
Book a free 15-minute phone call — a real conversation with the doctor, not a salesperson. Talk through what you're noticing and find out whether a full consultation is right for you. No obligation, nothing to prepare.
Prefer to ring? 020 8044 2081. Ready to go further? Book the full consultation — £300, 50 minutes with the doctor.
Yes. Polycystic ovary syndrome (PCOS) was formally renamed polyendocrine metabolic ovarian syndrome (PMOS) in May 2026 by international consensus. It is the same condition with a more accurate name — one that reflects the hormonal and metabolic drivers rather than ovarian “cysts”, which were never true cysts at all.
Often, substantially — if follicles are miniaturised rather than lost. Anti-androgen treatment and minoxidil can thicken existing hairs and restart shrunken follicles. Expect visible change over three to six months of consistent treatment, which is why starting early matters more than any individual product choice.
Typically testosterone with SHBG (free androgen index), DHEAS, HbA1c or fasting insulin for insulin resistance, thyroid function, ferritin and prolactin. This panel separates the androgen drive from compounding causes such as iron deficiency or thyroid disease, and all of it can be arranged through the clinic.
It is one of the better options we have, because it blocks the androgens driving the thinning. It is prescription-only, used off-label for hair, must not be taken in pregnancy, and works best combined with minoxidil. Whether it is right for you depends on your bloods, history and plans — which is what the consultation establishes.
It can, meaningfully. High insulin pushes androgen production up and SHBG down, so improving insulin sensitivity — through lifestyle change or medication where appropriate — reduces the hormonal drive on your follicles. It is rarely sufficient alone, but it makes every other treatment work better.
Yes — and this is partly why the name changed. The “cysts” of the old name were actually immature follicles, and they were never required for diagnosis. PMOS is diagnosed on the combination of androgen excess, ovulatory dysfunction and ovarian findings, not on cysts.
The assessment covers both, because they share a cause. Anti-androgen treatment helps both directions over time, and we can advise honestly on removal options such as electrolysis for established facial hair while the medical treatment takes effect.
Understand what's causing your hair loss
A 50-minute consultation with Dr Amy includes scalp microscopy, and a personalised treatment plan—giving you definitive answers rather than continued guessing.
Book Your Hair Loss Assessment£300 consultation | Parsons Green, London
Next-day appointments often available
