Introduction
Hirsutism is a condition that causes excessive hair growth in certain parts, especially in females. This condition does not have a specific cause, but it acts as a symptom of other health conditions like polycystic ovarian syndrome (PCOS); this condition can be treated through medication, weight loss, and various hair removal methods.
What Is Meant by Hirsutism?
Hirsutism is a condition that leads to excessive hair growth. It primarily affects women. Dark hair growth is seen on the chin, upper lip, chest, abdomen, and back, where usually thin hair is grown called peach fuzz. Hirsutism is stressful but can be treated.
Most of the women with hirsutism condition have higher levels of androgen, which is a male sex hormone that is usually present in small amounts in females. These hormones usually stimulate and initiate male physical and sexual development. Women usually have less androgen, but its level can differ for various reasons. For example, an increased level of androgen can trigger and stimulate hair follicles resulting in the excess hair growth that a woman usually experiences. Polycystic ovarian syndrome (PCOS) and congenital adrenal hyperplasia are some conditions that increase the risk of hirsutism. Obesity can also be a reason for hirsutism.
Hirsutism affects about 5 to 10 % of women of childbearing age and about 40 % of women at some stages.
How Does Hirsutism Affect the Body?
Hirsutism does not affect physical health but harms a person's psychosocial and psychological behavior. As a result, the person may experience stress, depression, and anxiety.
What Are the Signs and Symptoms of This Condition?
A significant sign of hirsutism is dark hair growth. Another common symptom of hirsutism is virilization, a condition where people affected by hirsutism show the development of secondary sexual characteristics of males. This condition is seen when the androgen levels are high, a male sex hormone. Some of the secondary sexual characteristics that may develop due to virilization are:
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Deeper voice.
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Reduced breast size.
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Enhanced muscle development.
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Clitoromegaly (enlargement of the clitoris).
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Ace.
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Increased sex drive.
What Are the Causes of This Condition?
The common causes are:
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Natural Production of Androgen:
Males and females have androgen hormones, but males and those assigned as males at birth produce more androgen hormones. Women or those assigned as female at birth have higher secretion of androgen hormones. If their hair follicles are more sensitive to this hormone, then there are higher chances of the person experiencing hirsutism.
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Polycystic Ovarian Syndrome (PCOS):
Polycystic ovarian syndrome is a common hormonal condition that affects women due to excessive male hormone production called androgen. Some other common symptoms include acne, irregular menstrual cycle, diabetes, weight gain, and fertility issues.
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Postmenopause:
The hormonal alterations that occur in the body after menopause can result in enhanced facial hair, which includes a mustache or whiskers.
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Cushing’s Syndrome:
Cushing’s syndrome is caused when excessive cortisol hormone in the body affects a set of organs, including the hair, nails, skin, glands, and nerves. Some other common symptoms include
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Sudden weight gain.
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Slow wound healing.
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Hypertension.
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Diabetes.
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Other Conditions:
If hirsutism occurs with a sudden onset along with symptoms like deeper voice, acne, or enhanced muscle development, the person may be affected with a more serious condition. This may include adrenal gland disorder or ovary disorder, which may result in congenital adrenal hyperplasia or the formation of tumors on the adrenal gland or ovaries responsible for producing androgen.
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Medications:
Some medications can result in hirsutism, like
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Anabolic steroids.
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Testosterone.
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Cyclosporine.
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Danazol.
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Phenytoin.
How Is This Condition Diagnosed?
The doctor will perform a physical examination to see the extent of uncommon hair growth. They also note any other physical signs that may accompany the excessive hair growth, like acne. Once the doctor diagnoses hirsutism, they use a scale called Ferriman-Gallwey to grade the condition’s severity. These scales examine nine regions of the body:
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The upper lip.
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Chin.
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Chest.
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Upper abdomen.
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Upper arms.
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Thigh.
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Upper and lower back.
These regions receive zero to four scores based on hair growth. A lower score means hirsutism is mild, and a higher score means severe condition. After the physical examination, the doctor will add all the scores together. A score lower than eight is common if the person is black or white. A score lower than nine or ten is common if the person is Mediterranean, Hispanic, or Middle Eastern.
What Are the Tests Performed to Diagnose Hirsutism?
A variety of tests are performed, such as
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Blood tests check the levels of hormones.
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Ultrasound is performed to check the ovaries and uterus.
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X-ray to evaluate ovaries and adrenal glands to rule out other conditions.
How Is This Condition Treated?
Weight Loss:
Weight loss is the main step in treating the hirsutism condition. Reducing 5 % of body weight can reduce androgen levels and prevent excessive hair growth.
Medications:
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Birth Control Pills:
Birth control pills are the most common medication that is recommended to treat hirsutism. They reduce androgen levels, control the menstrual cycle, and prevent pregnancy. Side effects of these medications are breast tenderness or swelling, headache, irritability, nausea, and spotting between menstrual cycles.
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Androgen-Suppressing Medications:
These medications include Spironolactone, Finasteride, and Flutamide, which can treat mild cases of this condition by reducing the amount of androgen hormone. Side effects of these medications are:
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Dry skin.
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Heartburn.
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Spotting between menstrual cycles.
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Dizziness.
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Fatigue.
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Liver damage.
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Low-Dose Steroids Medication:
An overactive adrenal gland results in hirsutism; the doctors may recommend low-dose steroid medications. The adrenal gland is a small gland that produces sex hormones and adrenaline and cortisol. Side effects enhance appetite, weight gain, changes in mood, and blurred vision.
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Insulin-Lowering Medications:
These medications involve Metformin and Pioglitazone decrease blood levels of insulin and androgen hormones. Side effects of these medications are
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Allergic reactions.
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Breathing issues.
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Irregular heartbeat.
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Blood in the urine.
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Low blood sugar level.
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Gonadotropin-Releasing Hormone (GnRH) Agonist:
These substances reduce androgen production in the ovaries. These medications are in injection form. Side effects of these medications are
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Hot flashes.
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Weight gain.
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Fluid retention.
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Reduce libido.
Hair Removal Option:
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Electrolysis:
In this technique, small needles and mild electric zap are used to demolish the hair roots. Each hair follicle needs to be treated, so electrolysis over a huge area of the body can not be done practically. Side effects of these options are very rare, but some rare side effect is discoloration, temporary dark spots, and some tingling effect.
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Laser Hair Removal:
In this technique, the heat produced from the laser demolishes cells that have pigments. Dark hair contains many pigments, which absorb high heat. Heat is transferred to the heat follicle and demolishes them. Side effects include blisters, burns, scars, and dark and light areas of skin.
Home Redemies
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Shaving:
This is the common method of hair removal which is simple and safe, but regular shaving should be done to avoid stubble. Side effects include ingrown hair.
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Bleaching:
The bleaching method lightens unwanted hair, but it may cause irritation if these products remain in the skiing for long.
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Waxing and Plucking:
Waxing is done where the hair is removed from the root. This method is effective but painful. Side effects may occur such as ingrown hair and skin irritation.
Conclusion
Hirsutism is a condition that usually causes excessive hair growth in women. It does not cause any pain but may be a sign and symptom of other underlying conditions like PCOS, Cushing’s syndrome, and adrenal gland disorders. It condition can affect the mental health of a person. Medications and various methods of treatment are available to treat this condition.
