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.
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:
Certain drugs, including:
Risk factors include:
Symptoms and signs may include:
Treatment is directed at the underlying cause of the hirsutism and may include:
Medications such as:
Local Hair Removal. Methods of removing hair include:
It has been a tradition to divide patients with hirsutism into those with no elevation of serum androgen levels and no other clinical features ('idiopathic hirsutism') and those with an identifiable endocrine imbalance (most commonly PCOS or rarely other causes). However, in recent years it has become apparent that most patients with 'idiopathic hirsutism' have some radiological or biochemical evidence of PCOS on more detailed investigation.
A study by the Royal College of Obstetricians and Gynaecologists, reported by the BBC in April of 2009, found that 70-80% of cases of female Hirsutism are caused by polycystic ovarian syndrome, an abnormality of the ovaries where many small cysts appear due to elevated testosterone levels.
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