What Causes Hirsutism?

In order to hopefully treat and prevent recurrence of hirsutism we need to understand and — if possible — remove the underlying causes and risk factors.  We need to ask: "What else is going on inside the body that might allow hirsutism to develop?"

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Accurate diagnosis of the factors behind hirsutism consists of three steps:

Step 1: List the Possible Causative Factors

Identify all disease conditions, lifestyle choices and environmental risk factors that can lead to hirsutism.  Here are six possibilities:
  • Polycystic Ovary Syndrome
  • Cerebral Gland Dysfunction
  • High Female Testosterone
  • Low Progesterone
  • Ovarian Cysts
  • Adrenal Fatigue

Step 2: Build a Symptom Checklist

Identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
late term miscarriage
occasional unexplained fevers
excessive thirst
inability to work under pressure
having hot flashes
frequent colds/flus
frequent infections
unusual vaginal bleeding
significant left iliac pain
having heavy periods
elevated basophil count
adverse reaction to stress
... and more than 80 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of hirsutism:
Cause Probability Status
Low Progesterone 93% Confirm
Adrenal Fatigue 66% Possible
Cerebral Gland Dysfunction 23% Unlikely
Ovarian Cysts 5% Ruled out
Polycystic Ovary Syndrome 4% Ruled out
High Female Testosterone 2% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

In the Hair-Related Symptoms section of the questionnaire, The Analyst™ will ask the following question about hirsutism:
Do you have any hair growth pattern that is usually seen in males? This means increased hair on the chest/nipples, above the pubic area toward the navel, or on the chin or upper lip.
Possible responses:
→ Don't know
→ No
→ Very minor
→ Somewhat / one or two areas
→ Very noticeable / in several areas
Based on your response to this question, which may indicate absence of hirsutism, minor hirsutism, mild hirsutism or hirsutism, The Analyst™ will consider possibilities such as:
Ovarian Cysts

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.

Polycystic Ovary Syndrome (PCOS)

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.

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