Co-Occurrence of Trichotillomania and Polycystic Ovarian Syndrome: A Case Report

Trichotillomania(TTM) and Polycystic Ovarian Syndromes(PCOS) are common among young females. TTM, also known as Hair Pulling Disorder, is characterized by repetitive pulling of one’s hair commonly the scalp, eyebrows, and eyelashes but could also involve other parts of the body [1]. Majority of patients started hair pulling in between ages of 11 and 15 years [1]. Polycystic ovarian syndrome (PCOS) is a common metabolic-endocrine disorder characterized by menstrual irregularity, clinical hyperandrogenism, and ultrasound appearance of polycystic ovaries according to Rotterdam criteria [2]. It presents in 12-21% of women of reproductive age. Clinical symptoms of PCOS such as acne, hirsutism, obesity, and alopecia may cause psychological problems and body image issues, whereas psychiatric problems such as depression and anxiety, are common comorbidities seen in people with TTM [2]. Scientific evidence linking TTM and PCOS is insufficient. Our current understanding suggests the important roles of stress in both TTM & PCOS [3, 4]. There is also growing evidence of the effectiveness of N-acetylcysteine(NAC) in the treatment of both TTM & PCOS [5, 6]. How common is the co-occurrence between TTM and PCOS and what is the possible explanation?