Hirsutism - Why Facial Hair Grows In Women, Causes And Treatment Of Hirsutism

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-17 02:10

Hirsutism - causes and treatment

Hirsutism is the excess growth of facial hair in women. Such a diagnosis can only be made to female patients. This disorder develops due to an excess of male sex hormones in their body. Although many ladies believe that the cause of excess facial hair is plucking. This opinion is incorrect.

Women suffer from the fact that hair grows on their face, as this negatively affects their appearance and causes aesthetic discomfort. Hair extends over the upper lip, chin, chest, belly and back. They are hard, with a shaft, long and dark. Fluffy hair comes from other hair follicles, so they have a different structure. Facial hair grows in every 20 women at a young age. During menopause, every 4 lady faces this problem. Hirsutism is often associated with infertility, menstrual irregularities, and depression.

Content:

• Male sex hormones as a cause of hirsutism
• Symptoms of hirsutism
• Causes of hirsutism
• Classification of hirsutism
• Diagnosis of hirsutism
• Hirsutism treatment
• Prognosis for hirsutism

Male sex hormones as a cause of hirsutism

Androgens are male sex hormones that lead to hirsutism. The main androgen is testosterone. In men, he takes an active part in the formation of sperm, and is also responsible for the main male characteristics: for a rough voice, the appearance of body hair, etc.

A woman has testosterone in her body, normally, too, but very little of it. This hormone influences to some extent the menstrual cycle, libido, fertility. If there is too much testosterone in a woman's body, then this leads to the appearance of male characteristics in her.

Also, male hormones include androstenedione and dehydroepiandrosterone. They undergo certain changes, after which they become testosterone.

Symptoms of hirsutism

Signs of hirsutism include:

• A woman has hair on her face, nipple halos, abdomen, back, buttocks and inner thighs that has a hard structure and a dark color.
• Hair becomes greasy, after which it begins to fall out. This is especially noticeable on the forehead.
• Acne appears on the skin.
• Menstruation becomes irregular or absent.
• The woman suffers from infertility.

If the disease progresses, and the level of male sex hormones continues to increase, then this is expressed by symptoms such as:

• Libido is enhanced.
• The muscle mass starts to come in. This is especially noticeable in the upper half of the body.
• Fat accumulates to a greater extent in the shoulder girdle and chest. The figure begins to resemble a man's.
• The voice becomes harsh.
• The whiskey is going bald.
• The clitoris increases in size, while the labia, on the contrary, shrink. The vaginal lubricant stops being produced.

Causes of hirsutism

Thin vellus hair that covers the body and face of a woman begins to degenerate into terminal hair. They become stiffer, longer and darker. This is due to the fact that certain pathologies develop in a woman's body. It has been established that more than 90% of all cases of hirsutism are a consequence of polycystic ovary syndrome. Hormonal imbalances can happen during pregnancy or during menopause.

Excessive production of male sex hormones in the female body occurs for the following reasons:

• Polycystic ovary syndrome with disruption of the reproductive system as a whole. At the same time, cystic cavities filled with fluid are formed on the ovaries themselves.
• Ovarian cancer.
• Ovarian hyperthecosis.
• Anovulation of the chronic course.
• Secondary hypothalamic amenorrhea.
• Climax.

Sometimes hair on a woman's face appears due to an increased sensitivity to male sex hormones. At the same time, there are no changes in the hormonal background, but the body reacts too much to the usual level of androgens.

Other causes of hirsutism include:

• Disorders in the adrenal glands. This happens due to the hypoplasia of their cortex, against the background of the growth of the adrenal tumor. At the same time, the production of steroid hormones increases in the body (androgens also belong to this group).
• Disorders in the work of the pituitary gland. This occurs with Itsenko-Cushing's syndrome, with acromegaly, against the background of the growth of a hormonal tumor (pituitary prolactinoma). Diseases of the pituitary gland negatively affect the work of the adrenal glands, which begin to produce too much male sex hormones.
• Genetic predisposition. Some women have a family history of hirsutism. This is especially often observed among the inhabitants of the Caucasus and the Mediterranean.
• Treatment with certain drugs: corticosteroids (Betamethasone, Hydrocortisone), androgens (Proviron, Andriol), progestins (Micronor), immunosuppressants (Cyclosporin, Sandimmun), antibiotics (Streptomycin), anabolic steroids (Nolvadex, Clomid).

Hirsutism, the causes of which cannot be established, are called idiopathic. Symptoms of such a disorder are poorly expressed, the hormonal background is almost normal, the function of procreation is preserved.

Classification of hirsutism

Depending on the cause that provoked excessive hair growth, hirsutism is distinguished:

• Dermatological (constitutional). It can be idiopathic or familial.
• Neuroendocrine, which are subdivided into ovarian, adrenal, and pituitary.
• Iatrogenic (exogenous), which is due to the intake of drugs.

Depending on the violations accompanying hirsutism, the following subspecies are distinguished:

• No accompanying violations.
• With piloseborrheic symptoms in which the patient develops acne and acne.
• With violations in ovulation.
• The woman begins to look like a man outwardly.

Diagnosis of hirsutism

If hair appears on the face, you should contact your gynecologist and endocrinologist. The doctor will prescribe the necessary tests for the woman.

Features of the hormonal background in women with hirsutism (according to laboratory diagnostics)

Features of the development of the disease	If symptoms increase gradually, then polycystic ovary disease, which develops against the background of hormone-producing tumors, can be suspected.	If the level of testosterone is less than 200 ng in% and decreases when taking oral contraceptives or prednisolone, then this indicates polycystic disease. If the testosterone level is higher than 200 ng in%, then this indicates a neoplasm of the ovaries.
Taking medications.	The woman is being treated with drugs that can cause side effects in the form of hirsutism.	A DHEA sulfate level of less than 700 ng in% indicates adrenal hyperplasia (if it continues to decrease with dexamethasone). If the level of DHEA sulfate is below 700 ng in% and does not decrease, then this indicates tumor neoplasms of the adrenal glands.
Features of the menstrual cycle.	If the cycle is regular, then familial or idiopathic hirsutism can be suspected.	Androstenedione levels are elevated in ovarian disease. The level of luteinizing hormones is higher than the level of follicle-stimulating hormones in polycystic disease. The level of 17-hydroxyprogesterone is elevated in congenital adrenal hyperplasia.

In addition to passing laboratory tests, a woman will be assigned such diagnostic procedures as:

• Ultrasound of the adrenal glands and ovaries.
• MRI and CT of the adrenal glands and brain.
• Laparoscopy of the ovaries is carried out for diagnostic purposes when the doctor suspects tumor neoplasms of the organs.

Hirsutism treatment

If hirsutism has mild symptoms, and the menstrual cycle is not disturbed, then therapy is not carried out.

Since hirsutism is not an independent pathology, but only a symptom of a certain disorder in the body, it is necessary to direct efforts to eliminate it.

If a tumor of the pituitary gland, adrenal glands or ovaries is found, the patient is referred for surgery. If excess facial hair growth is due to medication, then therapy should be reviewed. Medical correction is carried out for Itsenko-Cushing's syndrome, acromegaly and other diseases that do not require the help of a surgeon.

Taking medicines

Hormone therapy is prescribed for women with diseases such as:

• Hyperandrogenism. Women are shown taking medications that reduce the level of testosterone in the body (Diane-35, Janine, Yarina).
• Congenital adrenal hyperplasia (Prednisolone, Cortisone).
• Polycystic ovary disease. A woman is shown taking oral contraceptives (Janine, Yarina, Androkur) and antiestrogens (Clomiphene).
• Tumor growths require chemotherapy and surgery.

Hormonal drugs are prescribed to patients only after a comprehensive examination. These drugs prevent the growth of facial and body hair, but they have no effect on hair that has already appeared. Before starting therapy, you must make sure that there are no contraindications. These include pregnancy and breastfeeding, cancerous tumors. You also need to remember about individual drug intolerance.

Psychological assistance and diet

If a woman is overweight, then she will need to follow a diet. The diet reduces the number of meals that contain fast carbohydrates.

When a patient develops neurosis or depression, she needs the help of a psychologist.

Cosmetological solution to the problem

You can remove hair in unwanted areas using cosmetic procedures. They allow you to solve the problem of an aesthetic plan, but do not affect the underlying disease. Therefore, you should not refuse hormone therapy if the doctor insists on it.

Low cost cosmetic treatment options:

• Hair lightening. To do this, you can use preparations containing hydroperite or hydrogen peroxide. They will lighten the pigment in the hair, making it less visible. This method is suitable for women in whom the symptoms of hirsutism are not pronounced.
• Plucking hair. For the procedure, you can use tweezers. After processing the problem area, you need to disinfect it with antiseptic agents. This method is available when there is little facial hair. However, the more often a woman removes them in this way, the rougher her skin will become. The new hair will keep getting longer. In addition, the likelihood of infection of the dermis increases.
• Epilation and shaving. These methods are suitable for removing hair from the trunk and limbs.

High cost cosmetic procedures:

• Photoepilation. The hair follicles are influenced by a light wave. This leads to the destruction of the hair follicle. The procedure has a good effect on dark hair. It lasts for 5 months.
• Laser epilation. The laser beam destroys the hair follicle and the hair stops growing. The laser has no effect on sleeping bulbs. Therefore, several procedures are required. The full course can last from 1 month to six months.

Both photoepilation and laser hair removal have a number of contraindications. It is forbidden to carry out procedures for pregnant women, patients receiving steroids or Isotretinoin, patients with porphyria. Do not treat areas of skin with tattoos. The procedure should be abandoned for women who recently rested at the sea or visited a solarium (their skin will be weakened by the action of ultraviolet rays). Also a contraindication is the presence of damage in the treatment area.

Prognosis for hirsutism

Each hair lives for about six months. Getting rid of them will take time and effort. Sometimes it is not possible to completely cope with the problem. However, it is still possible to slow down hair growth.

The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist

Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).