Hirsutism

Hirsutism

Definition

Excessive growth of facial or body hair in women is called hirsutism.

Description

Hirsutism is not a disease. The condition usually develops during puberty and becomes more pronounced as the years go by. However, an inherited tendency, over-production of male hormones (androgens), medication, or disease, can cause it to appear at any age.

Women who have hirsutism usually have irregular menstrual cycles. They sometimes have small breasts and deep voices, and their muscles and genitals may become larger than women without the condition.

Types of hirsutism

Idiopathic hirsutism is probably hereditary, because there is usually a family history of the disorder. Women with idiopathic hirsutism have normal menstrual cycles and no evidence of any of the conditions associated with secondary hirsutism.

Secondary hirsutism is most often associated with polycystic ovary syndrome (an inherited hormonal disorder characterized by menstrual irregularities, biochemical abnormalities, and obesity). This type of hirsutism may also be caused by:

Causes and symptoms

Hirsutism is rarely caused by a serious underlying disorder. Pregnancy occasionally stimulates its development. Hirsutism triggered by tumors is very unusual.

Hair follicles usually become enlarged, and the hairs themselves become larger and darker. A woman whose hirsutism is caused by an increase in male hormones has a pattern of hair growth similar to that of a man. A woman whose hirsutism is not hormone-related has long, fine hairs on her face, arms, chest, and back.

Diagnosis

Diagnosis is based on a family history of hirsutism, a personal history of menstrual irregularities, and masculine traits. Laboratory tests are not needed to assess the status of patients whose menstrual cycles are normal and who have mild, gradually progressing hirsutism.

A family physician or endocrinologist may order blood tests to measure hormone levels in women with long-standing menstrual problems or more severe hirsutism. Computed tomography scans (CT scans) are sometimes performed to evaluate diseases of the adrenal glands. Additional diagnostic procedures may be used to confirm or rule out underlying diseases or disorders.

Treatment

Primary hirsutism can be treated mechanically. Mechanical treatment involves bleaching or physically removing unwanted hair by:

Low-dose dexamethasone (a synthetic adrenocortical steroid), birth-control pills, or medications that suppress male hormones (for example, spironolactone) may be prescribed for patients whose condition stems from high androgen levels.

Treatment of secondary hirsutism is determined by the underlying cause of the condition.

Prognosis

Birth-control pills alone cause this condition to stabilize in one of every two patients and to improve in one of every 10.

When spironolactone (Aldactone) is prescribed to suppress hair growth, 70% of patients experience improvement within six months. When women also take birth-control pills, menstrual cycles become regular and hair growth is suppressed even more.