Hirsutism - Symptoms and Treatment

Hirsutism is defined as excessive and increased hair growth in women in locations where the occurrence of terminal hair normally is minimal or absent. It refers to a male pattern of hair, i.e. in the moustache and beard areas (chin), or occurring more thickly than usual on the limbs. Hirsutism is very common. Hairs may also grow on the chest or extend from the groin area on to the abdomen and thighs. What is considered normal for a woman and what is considered hirsute depends on factors such as culture and race. At least 25% and as much as 85% of normal middle-aged women remove unwanted facial and body hair, although few of these women are termed hirsute. For most women, the tendency towards hirsutism is inherited. Excess hair growth may be present in both the female and male family members. Hirsutism usually begins around puberty, but mild hirsutism can start at any age. Most women gradually develop more facial or body hair with age. Hirsutism is usually caused by an increased sensitivity of the skin to a group of hormones called androgens or increased production of these hormones. Androgen disorders (hyperandrogenism) affects between 5% to 10% of all women. Hyperandrogenism is increased levels of male hormone production in women. The most commonly seen symptom is irregular menstrual cycles. A doctor can do some tests to see if this is caused by a treatable condition. Testing usually includes testosterone (T) levels and dehydroepiandrosterone sulfate (DHEAS). Others tests such as 17-hydroxyprogesterone, prolactin, T4, TSH, breast exam, and an endometrial biopsy may be indicated. Treatments for hyperandrogenism include oral contraceptives, spironolactone and flutamide. A prescription cream that stops facial hair growth, Vaniqa is also available. Studies show it helps most women and has no major side effects.

Hirsutism is the excessive growth of body hair and it usually found in women and children. This type of disease mostly occurs spontaneously but it may also occurs as a secondary disorder of various underlying diseases. It is a fairly common condition, affecting about 1 in 6 people in the United States. Signs of the disorder typically begin to appear between the ages of 12 and 16, about the same time as PCOS symptoms begin to exhibit for the first time. Normally, hirsutism is the result of a hormonal imbalance. Unusually high levels of androgens, commonly referred to as male hormones and include the hormone testosterone, can lead to a number of unpleasant symptoms, the most obvious being excess hair all over the body including the face, neck, arms, and chest. However, in women, hirsutism can also induce irregular periods, a deepening of the voice, and cause acne and obesity. As much as 95% of women with hirsutism are also affected by PCOS.

Causes of Hirsutism

The common causes and risk factor's of Hirsutism include the following:

• Idiopathic hirsutism.
• Tumor or cancer of the ovary
• Some medicines can cause hirsutism. These medicines include birth control pills, hormones and anabolic steroids.
• Polycystic ovarian syndrome.
• Adrenal tumors are a rare cause of androgen excess.
• Danazol and the androgenic progestins present in some oral contraceptives such as norgestrel (contained in Ovral) can cause hirsutism.
• Should be considered in patients with hirsuitism and ameorrhea plus a breast discharge.

Symptoms of Hirsutis

Some common Symptoms of Hirsutism :

• Obesity.
• Acne.
• Malodorous perspiration.
• Irregular menstrual periods.
• Enlarged muscles.
• Balding
• Decreased breast size

Treatment of Hirsutism

• Chemical depilation may be suited best to treatment of large hairy areas in patients unable to afford more expensive treatments such as electrolysis and laser epilation.
• Spironolactone 50-200 mg daily can slowly reduce excessive hair growth. It is sometimes combined with the oral contraceptive pill.
• This uses light to generate heat inside hair follicles, which destroys the ability of hair to grow from the follicle.
• A medicine called an anti-androgen to help control the male hormones that cause hirsutism.
• Hirsutism may be cause by elevated androgen levels. So for this treatment, it require low-dose dexamethasone or prednisone, oral contraceptives, or androgen receptor-competitive inhibitors, such as spironolactone, cyproterone acetate, or ctmetidine. But these drugs vary in effectiveness.

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