If you live with polycystic ovary syndrome PCOS, (now PMOS), you already know it's about more than irregular periods. For many people, PCOS shows up first on the skin and scalp, as stubborn acne, new hair growth in unexpected places, or thinning hair on top of the head. These changes can feel confusing, especially when they happen at the same time. Understanding the shared root cause can help make sense of it all.
That root cause is often a group of hormones called androgens. In this article, we'll break down what androgens are, how PCOS affects them, and what current research says about a surprising kitchen herb, spearmint, that scientists have studied in this space.
What Is PCOS/PMOS, and Why Does It Affect Skin and Hair?
PCOS/PMOS is a hormonal condition that affects how the ovaries work. According to the Androgen Excess and PCOS Society, one of the defining features of PCOS is hyperandrogenism, meaning the body produces higher-than-typical levels of androgens. This single hormonal shift can explain why PCOS symptoms often show up in seemingly unrelated places: the ovaries, the skin, and the hair follicles.
Because hair follicles and oil glands are especially sensitive to androgens, they tend to respond first, and most visibly, when androgen levels rise.
Androgens 101: The Hormones Behind the Symptoms
Androgens, including testosterone, are sometimes called "male hormones," but everyone's body makes them, regardless of sex. In typical amounts, androgens support normal growth and development. In PCOS, the ovaries and sometimes the adrenal glands produce more androgens than usual.
Every hair follicle and oil gland on the body has androgen receptors, which act like tiny docking stations. When more androgens are circulating, they interact with these receptors more often, and the follicle or gland responds by changing how it behaves. This is the mechanism connecting PCOS to three separate skin and hair symptoms: acne, hirsutism, and hair thinning.
PCOS Acne: Why Breakouts Happen
Oil glands, known as sebaceous glands, also have androgen receptors. Higher androgen levels can prompt these glands to produce more sebum, the natural oil that lubricates skin. Extra sebum can mix with dead skin cells and clog pores, creating the kind of deeper, often jaw-and-chin-focused breakouts that many people with PCOS notice.
This is different from acne caused by other factors, like humidity or certain skincare products, because the underlying driver is hormonal rather than purely topical.
Hirsutism: When Hair Growth Changes
Hirsutism is the medical term for coarse, dark hair growth in areas where hair is typically fine or absent in women, such as the chin, upper lip, chest, or lower abdomen. The Endocrine Society explains that elevated androgens can convert fine "vellus" hairs into thicker, darker "terminal" hairs, and that when this happens, PCOS is the most common underlying cause.
Hirsutism affects an estimated 5 to 10 percent of women overall, and it's one of the most visible signs clinicians look for when evaluating hyperandrogenism.
Hair Thinning: The Other Side of Androgen Sensitivity
While hirsutism describes new hair growth on the body, some people with PCOS experience the opposite pattern on the scalp: gradual thinning, sometimes called female pattern hair loss. Scalp hair follicles can respond to androgens differently than body hair follicles do. In androgen-sensitive scalp follicles, higher androgen exposure, particularly from a potent form called dihydrotestosterone (DHT), is associated with a shortened hair growth cycle and progressively finer strands over time.
It can feel counterintuitive that the same hormone family is linked to both more hair in some places and less hair in others, but this comes down to how differently various follicles are wired to respond to androgen signals.
Supporting Your Body Through PCOS
Because PCOS involves interconnected hormonal systems, many healthcare providers encourage a broad, whole-body approach to daily wellness, which may include regular movement, balanced meals, consistent sleep, and stress management. These habits don't target PCOS symptoms directly, but they support the body's overall hormonal and metabolic environment, which is worth understanding as part of the bigger picture.
The Bottom Line
Acne, hirsutism, and hair thinning can all trace back to the same hormonal thread in PCOS: elevated androgens interacting with sensitive hair follicles and oil glands throughout the body.
References
- Akdoğan, M., Tamer, M. N., Cüre, E., Cüre, M. C., Köroğlu, B. K., & Delibaş, N. (2007). Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism. Phytotherapy Research, 21(5), 444–447.
- Grant, P. (2010). Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome: A randomized controlled trial. Phytotherapy Research, 24(2), 186–188.
- Endocrine Society. (2022). Hirsutism. Endocrine Library, Patient Engagement Resources.
- Azziz, R., et al. (2009). The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report. Fertility and Sterility.
- American Society for Reproductive Medicine / ReproductiveFacts.org. Hirsutism and Polycystic Ovary Syndrome (PCOS), patient education booklet.
