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Hirsutism is the term used for excessive hair growth in women. It refers to a male pattern of hair, i.e. in the moustache and beard areas, or occurring more thickly than usual on the limbs. There may be hairs on the chest or an extension of pubic hair on to the abdomen and thighs. What is considered normal for a woman, and what is considered hirsute, depends on cultural factors and race. Hirsutism is very common.
Causes & Development; Risk Factors
Hirsutism is nearly always genetic in origin. In families where hirsutism is normal, both female and male relatives may have more hair than average.
Although some women with hirsutism have increased amounts of male hormones (e.g. DHEA or testosterone), most have normal levels. The problem in these women is that the hairs are more sensitive than normal to small amounts of hormone. The hairs grow more quickly and thicker in response to it. The increased growth is usually first noted in late teenage years and tends to gradually get more severe as the woman gets older. If it occurs either with or without acne after hormone use, it is a sign of elevated DHEA or testosterone levels.
True hirsutism may be due to:Risk factors include:- Family members with hirsutism
- Lack of ovulation
- Disorders of the adrenal glands
- Use of androgens
- Older age
Signs & Symptoms
Symptoms and signs may include:- Excess hair growth (on the face, arms, legs, or chest)
- Abnormal or absent menstrual periods
- Decreased breast size
- Male-pattern baldness (in a woman)
- Deepened voice
- Increased size of clitoris
- High blood pressure
- Enlarged adrenal glands
- Enlarged ovaries
Diagnosis & Tests
An ultrasound examination of the ovaries may be necessary as one common cause of hirsutism is polycystic ovaries.
Treatment & Prevention
Treatment is directed at the underlying cause of the hirsutism and may include:- Medications such as:
- Spironolactone
- Finasteride (Proscar, Propecia)
- Flutamide
- Oral contraceptives
- Glucophage (Metformin)
- Local Hair Removal. Methods of removing hair include:
- Shaving
- Chemical treatment (depilatories)
- Waxing
- Electrolysis
- Laser treatment
- Bleaching
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Signs, symptoms & indicators of Hirsutism:
Conditions that suggest Hirsutism:
Risk factors for Hirsutism:
Recommendations and treatments for Hirsutism: | | | | | Lab Tests/Rule-Outs |  Test for Hormones | Blood, saliva or urine tests may be arranged to make sure that the hirsutism is not due to excessive male hormone levels. |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | Very strongly or absolutely counter-indicative | | | Highly recommended |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Acne
A chronic skin disorder due to inflammation of hair follicles and sebaceous glands (secretion glands in the skin).
Adrenal (Adrenal Gland, Adrenal Glands, Adrenals)
The adrenal glands sit on top of each kidney and consist of an outer cortex and an inner medulla. Of the 50 or so hormones the adrenals make, only cortisone and adrenaline are recognized by most people. Some of these hormones must be produced to preserve life, while others help resist stress. Other hormones from the adrenals control normal energy output (along with the thyroid) and govern the breakdown of stored energy into quick energy sources. The medulla produces epinephrine and norepinephrine, which are specifically designed to help the body deal with stressful situations. The adrenals control the body's potassium/sodium balance, which is vital for energy production. They also produce sex hormones in minute amounts, which is important for later years when the gonads drop or cease their production.
Anabolic (Anabolism)
Promoting anabolism: Allow the conversion of nutritive material into complex living matter in the constructive metabolism. Specifically, an agent or function that stimulates the organization of smaller substances into larger ones. Examples: making a starch out of sugars, a protein out of amino acids, or making triglycerides out of fatty acids are anabolic functions. Anabolic steroids are internal or external substances that will induce increased body size or mass. The opposite of catabolic.
Androgen
Any steroid hormone that increases male characteristics.
DHEA (DHEA-S)
Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Idiopathic
Arising spontaneously or from an obscure or unknown cause.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Ovary (Ovaries)
Ovaries are about the size of an almond and lie on either side of the lower abdomen beside the uterus. They usually produce one egg each month and whether the egg is fertilized or not, the reproductive process follows a monthly cycle, with constant changes in various hormone levels, preparing another opportunity for conception. The ovary is responsible for most of the estrogen production in women. At menopause (sometime after middle-age), egg production ceases and hormone levels drop significantly.
Saliva (Salivary)
The watery mixture of secretions from the salivary and oral mucous glands that lubricates chewed food and moistens the oral walls.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Steroid (Steroids)
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Ultrasound
Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc. In this procedure, a gel is applied to the patient's skin, and a small device that emits ultrasonic pulses is slowly passed over the area. The sonic image produced is viewed on a monitor.
Last updated: Sep 28, 2008
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