Hirsutism is a medical condition that causes women to have excessive hair growth in a male pattern on their face, chest, and back.
This abnormal hair grown is usually caused by high levels of androgen hormones. If you have too much testosterone in your system due to polycystic ovary syndrome (PCOS), hirsutism is a common symptom.
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- What Is Hirsutism?
- What Are the Symptoms of Hirsutism?
- How Do You Diagnose Hirsutism?
- How Do You Treat Hirsutism?
What Is Hirsutism?
Doctors define hirsutism as excessive hair growth in women in a male pattern — on the face, chest, and back. Its cause is high levels of the male hormone, androgen.
All women naturally produce androgens. However, when androgen levels are elevated, fine hair follicles start to produce larger, darker hairs, which leads to hirsutism.
When women have more male hormones than normal, it's can be due to polycystic ovary syndrome (PCOS). In addition to hirsutism, women with PCOS may have other symptoms, too.
Other PCOS symptoms include:
- Acne.
- Increased risk of diabetes.
- Infertility.
- Irregular or absent menstrual periods.
- Obesity.
Sometimes, women who seem to have PCOS instead have an adrenal gland disorder called nonclassic congenital adrenal hyperplasia (NCCAH) due to 21-hydroxylase deficiency.
People with NCCAH need to know about their diagnosis before trying to get pregnant. Your doctor may recommend prenatal genetic testing to see if your baby could have a more severe form of the disease.
How common is hirsutism?
Hirsutismwomen
What causes hirsutism?
The cause of hirsutism is hyperandrogenism, or high levels of the male hormone, androgen (also known as testosterone). This increased androgen in women may be produced by the adrenal glands or due to an ovarian disease.
Adrenal causes of hirsutism
- Cushing syndrome — This condition occurs when your body has high levels of the hormone cortisol. High cortisone levels can develop when your adrenal glands make too much cortisol or from taking certain medications – such as prednisone – over a long time period.
- Androgen-producing tumors — Rarely, a tumor that secretes androgens in adrenal glands can cause hirsutism.
- Congenital adrenal hyperplasia (CAH) — This inherited condition is caused by the adrenal glands’ abnormal production of the steroid hormones cortisol and androgen.
Ovarian causes of hirsutism
- Polycystic ovary syndrome (PCOS) — A condition that causes an imbalance of the sex hormones. Over time, PCOS may cause symptoms like irregular periods, infertility, and obesity, along with hirsutism.
- Ovarian tumors — Rarely, tumors in the ovaries can cause hirsutism.
Other causes of hirsutism
- Medications — Certain medicines can cause hirsutism. They include minoxidil, which treats hair loss; danazol, which treats endometriosis; androgenic drugs, such as testosterone and anabolic steroids; and dehydroepiandrosterone (DHEA), an antiaging therapy. You can also be affected by androgens through skin-to-skin contact if your partner uses topical androgen products.
- Idiopathic — In about 20% of cases, the cause is unknown.
What are hirsutism risk factors and complications?
Hirsutism risk factors
Factorshirsutism
- Ancestry — People of Mediterranean, Middle Eastern, and South Asian ancestry are more likely to have unexplained excessive hair than others.
- Family history — Several conditions that cause hirsutism, including CAH and PCOS, tend to run in families.
- Obesity — Having a high body mass index (BMI) can cause increased androgen production, which can cause hirsutism.
Complications of hirsutism
Hirsutism may indicate an underlying medical condition — such as PCOS or puberty disorders — that may affect fertility.
Because of hirsutism's cosmetic effects, it may have a huge psychosocial impact, especially on young women.
How can I prevent hirsutism?
Although you can't prevent hirsutism, you can reduce your risk of developing it by losing weight if you're overweight. This is especially helpful if you have PCOS.
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What Are the Signs and Symptoms of Hirsutism?
The main symptom of hirsutism is stiff or dark hair appearing on the body where women don't commonly have hair. Primarily, this includes the face, chest, lower abdomen, inner thighs, and back.
Light-colored hair, including blond and white hair, isn't considered hirsutism.
When hirsutism is caused by high androgen levels, other signs may develop over time. This process is called virilization.
Signs of virilization include:
- Acne.
- Balding.
- Decreased breast size.
- Deepening voice.
- Enlargement of the clitoris.
- Increased muscle mass.
When should I see a doctor about my hirsutism symptoms?
Call your doctor if you experience excessive or rapid hair growth on your face or body, or signs of virilization, over a few months.
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How Do You Diagnose Hirsutism?
Your women's health provider, primary care provider, or pediatric gynecologist can diagnose hirsutism with a physical exam. They may also run tests, or refer you to a doctor who specializes in hormone disorders (endocrinologist) or skin problems (dermatologist).
Women who have visible symptoms of hirsutism but normal menstrual cycles and androgen levels may be diagnosed with idiopathic hirsutism. Idiopathic means there's no obvious cause.
Tests to diagnose hirsutism
Your doctor
- Blood tests — To check your hormone levels.
- Imaging tests — Such as a pelvic ultrasound, CT scan, or MRI, if virilization is present.
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How Do You Treat Hirsutism?
Hirsutism treatment often focuses on hair removal, rather than on what's causing the abnormal hair growth. Many women feel self-conscious, embarrassed, and anxious about hirsutism and PCOS facial hair.
But if hirsutism is a marker for another medical condition, your doctor will focus on treating the underlying condition.
Medicine for hirsutism
Your doctor
- Contraceptive medication (birth control pill, hormone patches, or vaginal rings) — Usually the first course of treatment.
- Antiandrogen medication — Can be added if the pill doesn't improve your condition.
Cosmetic treatments for hirsutism
If you have hirsutism and it bothers you — even if your case is mild — ask your provider for treatment options. Hair removal won't make hair thicker, but it can cause skin irritations.
Cosmetic hair management techniques include:
- Bleaching agents.
- Plucking/tweezing.
- Shaving.
- Threading.
- Topical hair removal creams.
- Waxing.
- Electrolysis.
Lifestyle changes
Weight loss may improve unwanted hair growth. People with hirsutism and PCOS should consider making lifestyle changes to improve their overall health.
