Many women all across the globe have made hair removal (whether short- or long-term) a part of their routine. However, there are some women who are struggling with this particular problem. These women have hirsutism, which is a condition that causes excessive hair growth (mostly unwanted).
The sight of excess hair growth in different parts of the body is distressing. It can also result in loss or decrease in self-esteem.
This blog post aims to discuss what you need to know about hirsutism (excessive hair growth) such as:
- Treatment options
Physiologic amount of hair is healthy but when it comes excessive – that’s when it affects a woman’s self-perception. Hirsutism affects thousands (if not millions) of women worldwide. Thus, it is crucial to understand this condition in order to manage it effectively. Let’s get to know the nitty gritty details of this condition.
What Causes Hirsutism in Females?
According to an article published in 2006, it is defined as a male pattern of hair growth that affects about five to ten percent of women. Hirsutism is a condition that is primarily caused by an increase in androgen hormones. Androgen hormones are typically a male hormone, which women have lower levels of. However, this is just one of the causes of hirsutism in females.
Other causes of hirsutism include the following:
- Increase in ovarian testosterone levels (commonly caused by polycystic ovarian syndrome or PCOS)
- Idiopathic cause (meaning the cause is unknown)
- Congenital adrenal hyperplasia (genetic condition affecting the adrenal glands)
- Cushing’s syndrome (a condition where the body produces too much stress hormone – cortisol)
- Tumors (particularly androgen-secreting adrenal or ovarian tumors)
Which Hormone is Responsible for Unwanted Hair Growth in Females?
Testosterone is the culprit of unwanted hair growth in females. This hormone is present in both men and women but women typically have lower levels of testosterone than women. However, when it is present in excess, it can cause unwanted hair growth.
The hormone responsible for unwanted hair growth in females is testosterone. Testosterone is a male hormone that is present in both men and women. However, women typically have lower levels of testosterone than men.
When the female body produces excess testosterone, it can cause unwanted hair growth. Apart from testosterone, dehydroepiandrosterone (DHEA) and androstenedione are two other culprits responsible for unwanted hair growth. Both of these hormones are produced by the adrenal gland, which is converted to testosterone in the body.
Can Stress Cause Hirsutism?
Stress does not directly cause hirsutism. However, stress can affect hormone levels in the body (particularly the hormone cortisol), which can lead to excess hair growth. When cortisol is increased so does the levels of androgen hormones. A continued increase in cortisol can result in unwanted hair growth over time.
What Deficiency Causes Hirsutism?
There is no specific deficiency that causes hirsutism. However, a study showed that a mild deficiency in 3-beta-hydroxysteroid dehydrogenase may also be an underlying cause of hirsutism.
Symptoms of Female Hirsutism
The primary symptom of female hirsutism is dark hair growth (usually unwanted due to its unsightly appearance).
However, it can cause symptoms of virilization as well, including the following:
- Excessive hair growth on the face (particularly the upper lip and chin), chest, back, and stomach
- Dark, thick hair
- Oily skin and acne
- Irregular periods
- Weight gain
Many of these symptoms are often found in PCOS as well, which means the symptoms could overlap.
Does Hirsutism Always Mean PCOS?
No, hirsutism does not always mean PCOS.
PCOS is just one of the most common causes of hirsutism. But there are other conditions that can cause unwanted hair growth in women as well.
Does Hirsutism Mean Infertility?
Hirsutism does not always mean infertility.
Some cases of PCOS can affect fertility in some women. However, not all women with hirsutism have fertility problems.
Diagnosis and Tests for Female Hirsutism
The diagnosis of female hirsutism always starts with a good medical history and physical evaluation. However, there are several diagnostic tests that your doctor may perform to obtain what causes hirsutism. The diagnosis of the underlying cause is important to effectively manage it.
These tests may include:
- Blood tests to measure hormone levels (testosterone, DHEA, follicle-stimulating hormone or FSH, and luteinizing hormone or LH)
- An ultrasound to check for ovarian cysts (a more expensive test that yields the same is MRI)
- An adrenal gland function test (usually ACTH or adrenocorticotropic hormone stimulation test)
When to See a Doctor for Hirsutism
If you are experiencing excessive hair growth, it is imperative that you speak with your attending physician. This is important for early diagnosis and treatment. Your doctor will request some tests to know the exact underlying cause for your hirsutism. Even if hirsutism per se is not a dangerous condition, some underlying causes are sinister like tumors (even though rare).
Management and Treatment of Female Hirsutism
After medical history, physical examination, and diagnostic tests are done, the next step is management and treatment. There are several treatment options that can manage hirsutism (depending on what the underlying cause is). Treatment options may include:
Weight Loss and Its Impact on Hirsutism
If PCOS is the underlying problem that causes hirsutism, the primary method of treatment is firstly lifestyle changes including weight loss. According to the study we reviewed, weight loss is only one of the benefits of lifestyle changes. More than this, it also improved insulin sensitivity in patients with PCOS. Thus, it decreased the risk of metabolic syndrome and even type-2 diabetes.
Medications for Treating Hirsutism
Pharmacologic treatments can help manage hirsutism by reducing hair growth. These medications may include:
- Combined oral contraceptives (often first-line treatment as it reduces male hormones, which can improve symptoms)
- Anti-androgens (block the effects of androgen like spironolactone and finasteride)
- Topical creams (eflornithine can be applied to delay the growth of hair – particularly facial hair)
It is important to understand that the medications used to treat hirsutism depend on the cause. These treatments are usually tried for six months before failure of treatment is declared.
Hair Removal Options for Excessive Hair Growth
Hair removal options for excessive hair growth include:
- Shaving [most commonly employed as the result is fast. However, the effect is short-term]
- Laser hair removal [it is a targeted treatment, which focuses on hair follicles hence the effect is long-term]
- Intense pulsed light [otherwise known as IPL, which uses broad-spectrum light to destroy hair follicles]
Do note that the effects of shaving, waxing, or plucking are short-term. Meaning, they are temporary. The laser hair removal and IPL methods are more long-term but are not permanent either. Studies have shown that laser hair removal and IPL are more effective in increasing the hair-free period than other methods.
How Can I Reduce My Body Hair Growth Naturally
It can be very challenging to reduce your body hair growth naturally. However, there are some options you can consider, such as:
- Herbal preparations (papaya has the enzyme papain and according to research it acts on the hair follicles to prevent hair growth)
- Eating a healthy diet
- Reducing stress
- Exercising regularly
- Getting enough sleep
Other Relevant Questions
Who Does Hirsutism Affect?
Hirsutism can affect women of all ages, but it is more common in women who have hormonal imbalances or those with underlying medical conditions.
How Common is Hirsutism?
However, it is essential to note that some hair growth is normal and healthy. It is only when hair growth becomes excessive and affects a woman’s quality of life that it may be a sign of hirsutism.
Is Hirsutism Contagious?
No, hirsutism is not contagious. It is a medical/dermatologic condition that is caused by hormonal imbalances in the body or other underlying medical problem
How Soon After Treatment Will I Feel Better?
The length of time it takes to feel better after hirsutism treatment varies depending on the underlying cause and the treatment options used.
- Laser hair removal – a study among 50 females showed 56% clearance rate one month after laser treatment
- Intense pulsed light (IPL therapy) – this treatment has been shown to be safe and effective. In a study of 40 patients, 70% of them had good responses, while 15% had excellent responses.
Hirsutism can be distressing and affect a woman’s quality of life. However, with the right diagnosis and treatment options, it can be managed effectively. If you are experiencing excessive hair growth, it is essential to speak with your doctor. They can perform tests to determine the underlying cause of your hirsutism and recommend treatment options to manage it effectively.
When hair growth becomes excessive and affects your quality of life, the diagnosis leans more to hirsutism. Which means, you need to talk to your doctor so that appropriate treatment can be given.
For medical professionals:
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