Endometriosis and hair loss


Endometriosis does not directly affect the hair follicle but in the long-term the disease can indirectly lead to thinner hair.  Stress, hormonal fluctuations and inactivity brought about by fatigue can contribute to all hair loss conditions.  There is also an autoimmune and thyroid element to the disease that can all negatively affect hair growth.  It is also possible to receive a ‘dual diagnosis’ of endometriosis and PCOS that may further impact hair growth.


Endometriosis is defined as a condition where cells like endometrial cells to grow in places other than the uterus such as the ovaries and fallopian tubes.  Endometrial cells usually only line the uterus and prevent adhesion between the muscles of the uterine cavity. Growth in other areas can lead to painful bowel movements, pelvic pain, heavy periods and infertility in some women.

The endometrium is made up of two layers, the basal layer and the functional layer.  The functional layer is shed during menstruation.  The functional layer is on top of basal layer and is built up after the end of the menstrual cycle.

Estrogen induces the growth of the functional layer during the follicular phase of the menstrual cycle and progesterone engineers later changes during the luteal phase to provide the right environment for the growth of the embryo.  The absence of progesterone leads to the restriction of blood flow to the functional layer leading to that layer being shed; this leads to the start of the menstrual cycle.  The areas of endometriotic lesions bleed each month and results in inflammation and scarring of the affected tissue.



Endometriosis often goes undiagnosed in women.  The average delay in diagnosis after the onset of symptoms is around 7 years.  To combat this diagnostic inefficiency, NICE guidelines for endometriosis diagnosis and management have been published for doctors and medical professionals.  Diagnosis is normally based on the patients’ symptoms, medical imaging (such as ultrasounds or MRI scans) and a pelvic exam by a doctor.

The symptoms of endometriosis can be similar to irritable bowel syndrome, pelvic inflammatory disease and interstitial cystitis.  The only absolute way to determine the diagnosis of endometriosis is by a laparoscopy, where a small camera is used to image the pelvic organs and a surgeon can look for any signs of endometrial cells outside if the uterus.


There are several reasons why hair loss can occur in patents with endometriosis:

Unmanaged thyroid disease – A 3 year retrospective study into endometriosis discovered a link between Graves’ disease and the condition.  Graves’ disease and endometriosis are potentially linked by the fact they are both autoimmune conditions that lead to inflammatory tissue damage.  They are also linked by the fact they are both estrogen-dependent diseases [1].  Graves’ disease can result in hair loss until thyroid hormone levels are normalised.

High levels of cortisol and prolactin– Increased levels of cortisol and prolactin are common in patients with endometriosis disease [2].   Whilst cortisol is a powerful moderator of the inflammation it is a catabolic hormone.  When cortisol levels are consistently high normal metabolism and growth will be suppressed.  Cortisol leads to the breakdown of the collagenous stricture that supports the hair follicle.  When collagen is broken down, the hair fibre will be less firmly anchored and the keratin cells within the hair fibre will go through a shorter hair growth phase leading to shorter hair that sheds prematurely.  Prolactin regulates growth, metabolism and blood pressure, high levels of prolactin can cause the hair follicles to shrink over time.  A study found that moderately high levels of prolactin did not affect hair growth, but consistently high levels inhibited hair growth [3].

Medication side effects – Some medication used to treat the condition can cause temporary hair loss such as telogen effluvium.  Prescription medication such as Danazol (an androgen) or Dydrogesterone (synthetic progesterone) can lead to an increase in masculine traits and induce thinning hair.  Lupron is another prescribed drug for the treatment of endometriosis that can slow down the normal hair growth cycle.


Endometriosis can be managed with surgery or medication but there is no definitive cure. To help with hair growth there are a few options you can consider:

Get a blood test – Check for abnormal DHEA levels, high prolactin and take a 24-hour saliva test to assess your cortisol levels.  Also consider testing thyroid function and prolactin.  The quicker you can assess your individual biomedical parameters, the earlier you can begin working out how to manage your condition most effectively.

Balance your estrogen levels naturally – Epidemiological studies looking at endometriosis establish a clear link between high levels of estrogen and the severity of the symptoms.  Specifically, errant metabolism of estrogens contribute to the condition [4].   To help balance your estrogen levels, ensure you eat enough protein with every meal, engage in regular exercise and reduce your intake of alcohol, sugar and refined carbohydrates.  Eating regularly also helps manage estrogens, have a good breakfast and eat a reasonable meal every few hours.

Eat a high zinc diet or take a supplement Zinc balances immune response to inflammation and increases the specific targets and strength of the adaptive and innate immune response.  This response is often defective in autoimmune conditions or where there is constant inflammation.  A study in 2014 found that women with endometriosis had a lower level of serum zinc than controls and deduced the mineral affected the multifactorial pathogenesis of the disease [5].  Multiple studies have shown that zinc lowers cortisol levels; this is likely due to the alteration of immune function and the lessening inflammation [6].


Hair loss is a potential side effect of endometriosis but there are a number of other factors that can effect the health of your hair.  Hair loss can potentially be managed by a change of lifestyle and by closely managing endometriosis with the help of a doctor.


  1. Graves disease is associated with endometriosis: a 3-year population-based cross-sectional study. Medicine, 95(10).
  2. Prolactin and cortisol levels in women with endometriosis. Brazilian journal of medical and biological research, 39(8), pp.1121-1127.Lutz, G., 2012. Hair loss and hyperprolactinemia in women. Dermato-endocrinology, 4(1), pp.65-71.
  3. Estrogen production and metabolism in endometriosis. Annals of the New York Academy of Sciences, 955(1), pp.75-85.
  4. The possible role of zinc in the etiopathogenesis of endometriosis. Clin. Exp. Obstet. Gynecol, 41, pp.541-546.
  5. Zinc acutely and temporarily inhibits adrenal cortisol secretion in humans. A preliminary report. Biol Trace Elem Res. 1990 Jan;24(1):83-9. doi: 10.1007/BF02789143. PMID: 1702662.