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Hirsutism
What Is Hirsutism?
Hirsutism - Pronounced - HER-suh-tiz-um. Also called Hypertrichosis.
Hirsutism is excessive or unwanted body hair growth in women. The normal amount of body hair varies widely among women. In hirsutism, coarse, dark hairs grow where women typically do not grow dark hair, such as the face, lip, chin, chest, abdomen (stomach area), back, thumbs, or toes.
What Causes Hirsutism?
Excessive hair growth in women is usually due to elevated male hormone (androgen) levels. Females with hirsutism are often overweight and have metabolism disturbances as insulin resistance and impaired glucose tolerance. A common cause is Polycystic Ovary Syndrome (PCOS). In most cases, however, the specific cause is never identified. It tends to run in families. In general, hirsutism is a harmless condition. But many women find it bothersome, even embarrassing.
If hirsutism develops suddenly and is accompanied by other typical male features, such as deepening voice, acne, or increased muscle mass, it may be caused by a more serious disorder. These causes, such as hormone-secreting tumors or cancer, are rare. Rare causes include:
- Tumor or cancer of the adrenal gland - pronounced - uh-DREE-nul, a pair of small glands, each of which sits on top of each kidney. These glands produce hormones that help to control the body's heart rate, blood pressure, the way food gets used, and other functions. They make the hormone adrenaline, which the body releases in response to stress. Also called suprarenal gland.
- Tumor or cancer of the ovary - pronounced - o-var-ee, two reproductive organs - about the size of an almond or grape - one on each side of the uterus, in the pelvis of a female. The ovaries contain eggs (ova) and make female hormones. When one of the ovaries releases an egg about once each month as part of the menstrual cycle, it is called ovulation.
- Cushing's syndrome - a disease that occurs when your body produces too much of the hormone cortisol. It may also occur if you use take too much cortisol or other steroid hormones.
- Congenital adrenal hyperplasia - refers to a group of inherited disorders of the adrenal gland, it can affect both boys and girls. People with congenital adrenal hyperplasia lack an enzyme needed by the adrenal gland to make the hormones cortisol and aldosterone. Without these hormones, the body produces more androgen, a type of male sex hormone. This causes male characteristics to appear early (or inappropriately). About 1 in 10,000 to 18,000 children are born with congenital adrenal hyperplasia.
- Hyperthecosis.
- Medications - testosterone, danazol, anabolic steroids, glucocorticoids, cyclosporine, minoxidil, phenytoin.
Home Care
There are a variety of ways to remove unwanted hair:
- Bleaching - lightening hair to make it less noticeable.
- Hair removal - shaving, plucking, waxing, or chemical depilation.
- Electrolysis - using electrical current to damage individual hair follicles so they do not grow back. This is expensive and requires multiple treatments.
- Laser hair removal - using laser to damage individual hair follicles so they do not grow back. This is expensive and requires multiple treatments.
- Weight loss - in overweight women, weight loss can decrease male hormone levels and reduce hair growth.
Birth control pills and anti-androgen medications can also help reduce hair growth. A doctor must prescribe these medications.
When to Contact a Medical Professional
Call your doctor if:
- The hair grows rapidly.
- The hair growth is associated with male features such as acne, deepening voice, increased muscle mass, and decreased breast size.
- You are concerned that medication may be worsening unwanted hair growth.
What to Expect at Your Office Visit
Your doctor will perform a physical examination, including a pelvic examination if appropriate. The doctor will ask questions such as:
- Do other members of your family also have excessive amounts of hair?
- What medications are you taking?
- Have your periods been regular?
- Are you pregnant?
- Have you noticed other signs of excess male hormones such as increased muscle mass, deepening voice, acne, or decreased breast size?
Diagnostic blood tests may be performed to measure levels of:
- Testosterone - pronounced - teh-stass-tuh-rone, a hormone made mostly by the testes of the male. This hormone causes many of the changes males deal with during puberty - deeper voices, body and facial hair, and the making of sperm.
- Dihydroepiandrosterone sulfate (DHEA-S)
- Luteinizing hormone (LH) - LH is a protein hormone released by the anterior pituitary gland. In women, an increase in LH levels at mid-cycle causes ovulation. In men, LH stimulates production of testosterone.
- Follicle stimulating hormone (FSH) - this hormone is released by the anterior pituitary gland. In women, FSH stimulates production of eggs and a hormone called estradiol during the first half of the menstrual cycle. In men, FSH stimulates production of sperm.
- Prolactin - prolactin is a hormone released by the pituitary gland.
- 17-hydroxyprogesterone - a hormone produced by the adrenal glands and gonads.
If a tumor is suspected, x-ray tests such as a CT scan or ultrasound may be recommended.
References:
1) Department of Health and Human Services - National Institutes of Health - National Heart, Lung, and Blood Institute - ClinicalTrials.gov - www.nhlbi.nih.gov - clinicaltrials.gov
2) National Library of Medicine (NLM) - MedlinePlus - July 2007 - www.nlm.nih.gov/medlineplus/
This summary is a general overview about the topic discussed and does not include all the facts, or include everything there is to know about any medicine and/or products mentioned. Do not use any medicine and/or products without first talking to your doctor. Possible side effects of medications, other than those listed, may occur. Full Disclaimer & General Safety Advisory