PCOS, hair loss and low androgen levels.

Dear Ask The Doctor: Hi, I am a 24 year old female, in generally good health, who was diagnosed at 17 with PCOS, due to extremely irregular periods. I was prescribed Dianette, which regulated my cycle, but since then I have experienced ongoing hair loss, which by now is quite noticeable and distressing me quite badly. I went to my local hospital, and they tested my androgen levels, including testosterone, but the results showed that not only are my levels not particularly high but they are in fact unusually low. I am now really confused as to the nature of my condition - do I then have PCOS, or is it possible I have been misdiagnosed? And since the hair loss continues, in spite of Dianette and now Spironolactone, should I take any other action? Thanks.

Dear Zoe: PCOS is diagnosed when a patient has irregular periods along with cysts in the ovaries and a LH to FSH ratio of greater than 2:1. Typically PCOS patients have increased androgens and free testosterone in the blood which leads to the male pattern baldness on the head along with increased hair growth on the body and torso.The Dianette that you are taking is an antiandrogen and thus decreases the effect and the levels of the androgens in your body and thus should have stopped the hair loss to some extent. However since that is not seeming to work I would advice you to see your gynecologist for a physical examination and a repeat blood test to see what is actually going on. You may also need to get your thyroid hormones checked as hypothyroidism which is characterised by cold intolerance, faigue,increased weight, decreased appetite, along with irregular periods may also lead to similar symptoms.You would also need to repeat your ultrasound to see whether there are cysts still present in your ovaries.