hirsutism

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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:
  • malfunctions of the pituitary or adrenal glands
  • use of male hormones or minoxidil (Loniten), a drug used to widen blood vessels
  • adrenal or ovarian tumors.

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:
  • cutting
  • electrolysis
  • shaving
  • tweezing
  • waxing
  • using hair-removing creams (depilatories)
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.

Resources

Organizations

American Society for Reproductive Medicine. 1209 Montgomery Highway, Birmingham, AL 35216-2809. (205) 978-5000. http://www.asrm.com.

Key terms

Idiopathic — A term for a disease with no known cause, from the Greek stems idio (peculiar or separate) and pathy (disease).

hirsutism

 [her´soo-tizm]
abnormal hairiness, especially in women.

hir·sut·ism

(hĭr'sū-tizm),
Presence of excessive bodily and facial hair, usually in a male pattern, especially in women; may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of nonandrogenetic or other drugs.
Synonym(s): hirsuties, pilosis
[L. hirsutus, shaggy]

hirsutism

/hir·sut·ism/ (hir´soot-izm) abnormal hairiness, especially in women.

hirsutism

(hûr′so͞o-tĭz′əm, hîr′-, hər-so͞o′-)
n.
Heavy growth of hair, often in abnormal distribution.

hirsutism

[hur′so̅o̅tiz′əm]
Etymology: L, hirsutus, hairy
excessive body hair in a masculine distribution pattern as a result of heredity, hormonal dysfunction, porphyria, or medication. Treatment of the specific cause usually stops growth of more hair. Excess hair may be removed by laser, electrolysis, chemical depilation, shaving, or waxing. Fine facial hair may be most effectively minimized by bleaching. Topical eflornithine (Vaniqa) can retard hair growth, as can oral medications. Also called hypertrichosis. hirsute, adj., hirsuteness, n.
enlarge picture
Hirsutism
Excess body hair, which is divided into
(1) Androgen-independent hirsutism—entire body is covered with vellous hair evenly distributed over androgen-dependent and independent regions
Aetiology Congenital disease (e.g., Cornelia de Lange and Seckel syndromes), drugs (e.g., androgen analogues, anticonvulsants, corticosteroids, cyclosporine, minoxidil, phenytoin and progesterone analogues), metabolic disorders (e.g., anorexia nervosa, porphyria cutanea tarda)
(2) Androgen-dependent hirsutism—increased terminal hair over ‘androgenic’ regions of the face and upper chest

hirsutism

Excess body hair, which is divided into
1. Androgen-independent hirsutism–entire body is covered with vellous hair evenly distributed over androgen-dependent and -independent regions Etiology Congenital disease–eg, Cornelia de Lange and Seckel syndromes, drugs–eg, androgen analogues, anticonvulsants, corticosteroids, cyclosporine, minoxidil, phenytoin and progesterone analogues, metabolic disorders–eg, anorexia nervosa, porphyria cutanea tarda.
2. Androgen-dependent hirsutism– ↑ terminal hair over 'androgenic' regions of the face and upper chest.

hir·sut·ism

(hir'sū-tizm)
Presence of excessive bodily and facial terminal hair, in a male pattern, especially in women; may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors or drugs (e.g., nonandrogenetic drugs).
[L. hirsutus, shaggy]

hirsutism

Excessive hairiness. Hirsutism in women is due to an excess of male sex hormone (androgen). Hirsutism results from interaction between the androgen level and the sensitivity of the hair follicles to androgen, both of which may vary. It also relates to the levels of sex hormone-binding globulin. Pubic hair is entirely dependent on the presence of androgen. Hirsutism may rarely occur from an ovarian or adrenal gland tumour. but is usually hereditary, ethnic or just unfortunate. Hypertrichosis-generalized excessive hair growth-can be caused by certain drugs such as STEROIDS, PHENYTOIN and STREPTOMYCIN.

hirsutism

excess body and facial hair, especially in women; related to hormonal imbalance, e.g. polycystic ovary syndrome

hir·sut·ism

(hir'sū-tizm)
Presence of excessive bodily and facial hair, usually in a male pattern, especially in women; may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors.
[L. hirsutus, shaggy]

hirsutism (hir´sootizəm),

n increased body or facial hair, which is especially noted in the female.

hirsutism, hirsuties

abnormal hairiness. Seen in aged horses with functional pituitary neoplasms and hyperadrenocorticism.
Enlarge picture
Hirsutism in a horse with pituitary adenoma. By permission from Knottenbelt DC, Pascoe RR, Diseases and Disorders of the Horse, Saunders, 2003