What To Know About Hirsutism? | Endocrinology

Hirsutism

Overview of hirsutism

Hirsutism refers to the thick or coloured hair that grows on the face and body of some women. Sometimes it can be the result of a medical condition. Most women have thin, pale hair that is barely visible on the face and body, but this hair can sometimes be thicker and more visible.

About half of all people with hirsutism have an excess of androgens. These hormones usually trigger male physical and sexual development. Women normally have low androgen levels, but these levels might vary for a range of reasons.

Hirsutism can occur between 5 and 10 per cent of women, depending on local and cultural definitions of a “normal” quantity of hair.

Symptoms of hirsutism

A woman with the mildest form of hirsutism may notice significant growth of hair on the upper lip, chin, sideburn area, and around the nipples or lower abdomen.

This hair will be mature hair or hair that is the same colour as that growing on the scalp.

More advanced hirsutism will cause mature hair to grow on the upper back, shoulders, chest, and upper abdomen and usually begins during puberty.

Besides excessive hair growth, a woman with hirsutism may also experience other symptoms, including:

  • Oily skin
  • Acne
  • Hair loss, known as alopecia
  • A receding hairline
  • An enlarged clitoris
  • A deeper voice

Risk factors of hirsutism

Many times the condition is related to high levels of male hormones (called androgens). It is normal for women’s bodies to produce them, and low levels do not cause excessive hair growth. But when these amounts are too high, they can cause hirsutism and other belongings, like acne, a deep voice, and small breasts.

  • Polycystic ovarian syndrome, which causes small cysts or fluid-filled sacs to form on the ovaries.
  • Cushing syndrome, which is contracted when you have high levels of cortisol, the stress hormone, for long periods of time.
  • Tumours in the adrenal glands (which make hormones such as cortisol) or in the ovaries.
  • Medicine. Some medications can change the hormone levels in your system, causing unwanted hair to grow on your face or body.
  • Medications that stimulate hair growth, such as minoxidil (Rogaine)

Causes of hirsutism

In many cases, the exact cause of hirsutism is unknown. However, several conditions are known to cause hirsutism. These conditions include:

Polycystic ovary syndrome (PCOS) is a common hormonal condition that causes a woman to produce too many androgens. Women with PCOS may also have acne, irregular or absent menstrual periods, diabetes, weight gain, and/or fertility problems. The hormonal changes of menopause can cause an increase in facial hair (moustache and whiskers).

Other more serious conditions

Hirsutism that happens suddenly along with other male characteristics, such as an excavated voice, acne, or increased muscle mass, can be caused by a more serious condition, such as disorders of the adrenal glands or ovaries.

Medications

The following medications can cause hirsutism:

  • Anabolic steroids
  • Testosterone
  • Glucocorticoids
  • Cyclosporine (Sandimmune)
  • Minoxidil (Loniten, Rogaine)
  • Danazol (Danocrine)
  • Phenytoin (Dilantin)
  • Hirsutism diagnosed

Contact your doctor if you have abnormal hair growth or other related symptoms. Your doctor can run tests to checkered your hormone levels. If they are high in androgens, you may have an ultrasound to examine your ovaries or a CT scan to check your adrenal gland. These tests can show if you have a tumour.

Treatment of hirsutism

Medicines can help treat most cases. They can balance your hormone levels to reduce the number of androgens. Here are the types of medications your doctor may prescribe:

  • Antiandrogens: the most common spironolactone and finasteride. These can stop your body from making male hormones. They can also decrease the amount of new hair. However, they cannot get rid of the hair you already have. Anti-androgens take at smallest 3 to 6 months to work. They can cause birth defects. Do not take them if you are pregnant or trying to get pregnant.
  • Birth Control Pills: Decrease androgens in your body. Birth control pills are a good option for women who do not want to get pregnant shortly. They can be used in combination with antiandrogen medications.

Some women choose to remove their hair permanently. Two types of procedures do this. Talk to your doctor to see if these procedures would be right for you.

  • Electrolysis – The doctor inserts fine needles into your unwanted hair follicles. The needles release electrical charges that abolish the follicles. This procedure can be painful and expensive. It may be necessary more than once.
  • Laser therapy: The physician uses targeted lasers to damage the follicles. This causes your unwanted hair to fall out. You may need several treatment sessions to fully treat the follicles. Treatments can make your skin red, swollen, or irritated. There is a risk of burns, scars, and skin discolouration. For some women, hair growth can return.

Risk factors

  • Family history. Numerous conditions cause hirsutism, including congenital adrenal hyperplasia and polycystic ovary syndrome.
  • Ancestry. Women of Mediterranean, Middle Eastern, and South Asian ancestry are more likely to have more body hair with unidentifiable cause than are other women.
  • Obesity. Being obese causes augmented androgen production, which can worsen hirsutism.

Complications

It can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some develop depression. Also, although it doesn’t cause physical complications.

If you have hirsutism and uneven periods, you might have polycystic ovary syndrome, which can inhibit fertility. Women who take certain medicines to treat hirsutism should avoid pregnancy because of the risk of birth defects.

Prevention

Control hirsutism is not always possible. However, a nutritious, balanced diet and regular exercise can help to control weight and reduce the risk of high cholesterol and diabetes.

Avoiding unnecessary medicines known to cause hirsutism can also reduce the risk.

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