Introduction
The American Obstetricians and Gynecologists (ACOG) estimate that at least seven out of ten women with polycystic ovarian disorder have hirsutism or excessive hair growth. The excessive growth of sexual hair in a male pattern is known as hirsutism. Hypertrichosis, which can also be found with polycystic ovarian disorder, should not be confused with this. Excessive facial hair growth (hirsutism), particularly in androgen-sensitive regions like the mustache area, is a clear indicator of polycystic ovarian syndrome (PCOS).
What Is PCOS Facial Hair?
The most typical hormonal issue among females of reproductive age is polycystic ovarian syndrome. The excessive growth of dark or coarse hair on the face, chest, or back in a male-like pattern is one of the typical signs of polycystic ovarian syndrome. High levels of androgen are the cause of polycystic ovarian syndrome (PCOS). Rarely, high testosterone levels in women can also result in scalp hair thinning and hair loss.
What Is Hirsutism?
Hirsutism is a condition that causes excessive hair growth in specific regions of the body. It primarily affects women. Hirsutism has no recognized cause. However, it is a sign of other diseases like polycystic ovary syndrome. Weight loss, medicines, and other hair removal methods are among the treatment choices.
What Is Polycystic Ovarian Syndrome?
A hormonal imbalance known as polycystic ovarian syndrome happens when the ovaries produce too many hormones. Women with polycystic ovarian syndrome have ovaries that produce exceptionally high amounts of androgens. Hormones related to reproduction decrease. Thus, irregular menstrual cycles, missed periods, and uncertain ovulation are common in women with polycystic ovarian syndrome. Due to a lack of ovulation, ultrasound imaging of the ovaries may reveal small follicular cysts (fluid-filled sacs containing immature eggs). Ovarian cysts are neither harmful nor uncomfortable, one of the most prevalent reasons for infertility in women.
What Are the Symptoms Associated With Hirsutism?
Hirsutism is the presence of stiff or dark body hair, usually on the face, chest, lower belly, inner thighs, and back, areas of the body where women do not typically have hair. When elevated androgen levels result in hirsutism, other symptoms, or virilization, may appear over time. Possible symptoms of virilization include:
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Increasing voice.
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Balding or acne.
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A smaller breast size.
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A bigger muscle frame.
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Increasing the number of births where women were assigned the gender (AFAB). It may also raise the risk of developing additional medical problems.
What Is the Link Between PCOS and Excess Facial Hair?
Castration performed before puberty halted the growth of the beard and axillary hair, but castration performed after puberty led to the atrophy of the hair. Those who are androgen-insensitive also lack pubic or axillary hair. Since then, it has been discovered that androgens increase the number of hair follicles in various parts of the body, the diameter of the hair, and the percentage of time hair spends in the embryogenesis stage. Androgens are primarily responsible for promoting the conversion of vellus into terminal hairs by lengthening the embryogenesis stage. The length of the endometrium and subsequent hair cycles both help to enhance follicle size. In androgen-dependent body regions, these bigger follicles generate longer, thicker hair. Because of this, hirsutism is frequently linked to disorders caused by an excess of androgen, such as PCOS.
It is significant to highlight that androgen sensitivity of the hair follicles is also related to the occurrence and severity of hirsutism. In actuality, androgen metabolizing enzymes play a vital role in controlling the number of androgens in the hair follicle, in addition to the fact that hair follicles respond to androgens by widely expressing androgen receptors.
What Causes Hirsutism?
Hyperandrogenism is the root cause of hirsutism. In places that are sensitive to androgens, androgens cause the fine, downy, barely pigmented vellus hair to change into coarse, pigmented terminal hair. Increased levels of DHT in the hair follicle due to an increase in any androgenic steroid may result in hirsutism.
The liver produces sex hormone-binding globulin (SHBG), and low amounts of this protein may encourage hirsutism. Eighty-one percent of the testosterone in the blood is bound to sex hormone-binding globulin, 19 percent is bound to albumin, and one percent is free. The amount of free hormone that is accessible to androgen-sensitive hair increases as sex hormone-binding globulin levels drop. Even with normal amounts of circulating androgen, increased 5-alpha reductase activity can still result in hirsutism by the excessive conversion of testosterone to DHT (dihydrotestosterone).
What Are the Treatment Options for Hirsutism Associated With PCOS?
The principal causes of hirsutism, androgens, and insulin or growth hormones, may both exhibit aberrant metabolism in PCOS patients. Acne is prevalent in women with PCOS, and elevated levels of serum androgen, insulin, and IGF-I have all been connected to the condition.
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It has been demonstrated that treating women with PCOS with oral antihyperglycemic medications (OAM), primarily Metformin and Thiazolidinediones, improves insulin sensitivity and ovarian function.
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Metformin therapy decreases the levels of testosterone, androstenedione, LH (luteinizing hormone), and insulin in the blood.
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Oral antihyperglycemic medications may lessen hirsutism, according to a theory, by lowering levels of circulating insulin, which in turn lowers levels of free testosterone.
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Oral contraceptives, also known as birth control tablets, are the most frequently prescribed drug to treat hirsutism. They control the menstrual cycle, reduce testosterone levels, and prevent conception. Breast discomfort or swelling, headaches, irritability or moodiness, nausea, and spotting between periods are possible side effects of using oral contraceptive pills.
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Androgen-suppressing medicines like Flutamide, Finasteride, and Spironolactone can successfully treat minor cases of hirsutism by reducing the number of androgens the body generates. Dry skin, heartburn, menstrual spotting, lightheadedness, exhaustion, and liver damage are possible side effects of these drugs.
Conclusion
Women with polycystic ovarian syndrome typically experience the common and painful symptoms of hirsutism. Polycystic ovarian syndrome (PCOS), which has inherent hyperandrogenism, or an idiopathic condition connected to enhanced tissue sensitivity to androgens, is the underlying condition in about 90 percent of women with hirsutism. Polycystic ovaries are seen in a significant number of idiopathic hirsutism patients. Chronic anovulation (it is a condition where no egg is released from the ovary), hyperandrogenism (high amount of androgens), and hyperinsulinemia (high amount of insulin in the blood) brought on by impaired insulin sensitivity are all characteristics of the heterogeneous condition known as PCOS. Patients with PCOS may experience a decreased risk of hirsutism if they lose weight through balanced nutrition and regular exercise. To know more about this condition, consult the doctor online.
