What is Hirsutism?
Hirsutism is a condition of male pattern hair growth which is seen in females. Hair sprouts and grows in parts of the body where only men show obvious hair growth. This includes the upper lip area, chin and side locks of the face, the back, the stomach and the chest region.
Symptoms of Hirsutism
- Appearance of thick and coarse hair on the above mentioned body parts.
- The woman may experience other accompanying symptoms such as weight gain, deepening of voice, acne and alopecia.
Causes of Hirsutism
The causes for Hirsutism are as follows:
The main cause for hirsutism is high androgen levels in women. All women have a small amount of androgen in their body and this does not cause any excessive hair growth. Certain lifestyle disorders cause the levels of androgen to increase in the body. The higher levels over stimulate the hair follicles. As a result of this, the woman suddenly is faced with increased hair growth all over.
Some major health conditions which cause the hormonal increase are:
- Poly Cystic Ovarian Syndrome or PCOS – In this condition, cysts develop in the ovaries and this causes an increase in testosterone levels, irregular menstrual cycles, weight gain, mood swings and a possible risk for infertility. The increased testosterone levels cause hirsutism to occur.
- Cushing’s syndrome – In this condition, the adrenal glands produce too much of cortisol which is a stress hormone. The high cortisol levels are also linked to increased hair growth in women.
- Congenital Adrenal Hyperplasia – Here, steroid hormones, mainly cortisol and androgen are produced in excess in the body and can also cause excessive hair growth.
Hirsutism has a genetic component where it is found among the biologically related women of the family. It the mother in the family has it, chances are that the daughters will also have it. The genetic component determines the thickness, color and distribution of hair as well.
Certain medications taken for various health reasons can interfere with hormone levels, thereby increasing androgen levels. Some medications like anabolic steroids contain hormones by themselves. Certain drugs like Minoxidil cause increased hair growth. Damazol, a drug used by women to treat endometriosis and Prozac, which is used to treat depression, is also linked to hirsutism.
Some tumors are found in ovaries or adrenal glands and they can cause the secretion of excess androgens, thereby indirectly causing hirsutism.
Diabetes, obesity and high cholesterol are also seen to be linked with excess hair growth.
This occurs in women who have no increased androgen levels and no symptoms of PCOS or Cushing’s syndrome. There is no underlying cause for the excess hair growth which can be identified. This is found more in certain ethnic groups such as women from the South Asian, Middle Eastern and Mediterranean backgrounds.
Complications of Hirsutism
On its own, hirsutism does not pose any serious physical complications. However, if it is a symptom of an underlying medical condition like PCOS, there could be effects of those conditions to deal with such as increased weight gain and a possible risk for infertility. In case, the hirsutism is caused by a tumor, then that warrants serious medical treatment.
However, the presence of unwanted hair can make women feel very self conscious about their appearance and this can cause emotional issues such as depression and low self esteem.
Diagnosis of Hirsutism
The doctor will first analyze the medical history of the woman, especially the regularity of the menstrual cycle. If the woman has a history of regular menses, then the hirsutism is mostly genetic. If the menses are irregular, a probable diagnosis of PCOS may be made. Tests can also be suggested to check for serious conditions like tumors in the ovaries or adrenal glands. These could include ultrasounds and CT scans.
Blood tests will also be administered to check whether the androgen levels have increased for the woman. Other hormones that will also be checked are the adrenal hormones, prolactin, insulin and progesterone. Sugar levels may also be tested.
Treatment for Hirsutism
Treatment for hirsutism involves medications and various hair removal treatments.
- Weight loss – As increased weight gain is linked to excess hair growth, losing weight causes the body to produce less androgen.
- Hair removal methods – Shaving, waxing, tweezing, threading and using hair removal creams takes care of removing hair, especially in visible areas. These are not permanent methods and can be painful and tedious.
- Electrolysis – This removes excess hair by passing electric current through a tiny needle to the hair follicle. The follicle is destroyed from the root, thereby making this a permanent method. It is painful but effective and multiple sessions may be needed.
- Laser treatment – Highly concentrated light is focused on the hair follicles to destroy them and prevent future growth. This may also have certain side effects like swelling, redness, skin discoloration and sometimes, a burning sensation. It is also very expensive, especially because it requires multiple sessions.
- Medications– Oral contraceptive pills or OCPs are taken as they contain estrogen and are used by women who don’t want to get pregnant. Headache, nausea and dizziness are probable side effects. Anti androgen blockers like Aldactone block androgens from getting attached to receptor sites. They are often prescribed six months after OCPs if they prove ineffective. Topical creams like Elfornithine are prescribed to inhibit new facial hair from growing in women.
Hirsutism is a condition where women face excess hair growth in areas where usually only men have hair. This is largely due to increased androgen levels and can be corrected by taking medications and using various hair removal methods.
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