By Aisha Dow
September
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Irregular periods. Anxiety and depression. Difficulty falling pregnant. These are some of the symptoms of polycystic ovary syndrome (PCOS), a complex hormonal condition that affects about one in 10 Australian women.
But there’s another common side effect that’s less talked about: hirsutism, in which excess coarse and pigmented hair grows on the face, chest, stomach, thighs, back and other places it might not usually be expected.
“I have some patients who have to shave their face every day because of their hair growth, and it has a significant impact on quality of life,” said Dr Anju Joham, a senior research fellow at the Monash Centre for Health Research and Implementation.
“That’s the extreme … but it wouldn’t be unusual to have a patient who needs to remove hair every few days.”
Key medical specialists, including a leading global expert on PCOS, are now calling on the federal government to offer a Medicare subsidy for laser hair removal for PCOS patients.
The call is bolstered by a new systematic review that concluded that laser and light-based therapies, either alone or combined with medication, can reduce hirsutism for some PCOS patients and improve quality of life.
Monash University’s Professor Helena Teede, an author of the review and a leading PCOS expert, said while some young women were unbothered by what she would consider quite severe hirsutism, for others, it could be devastating.
She is concerned about adolescent girls already dealing with severe acne and more rapid weight gain, which are also symptoms of PCOS.
“You’ve got lots of things that are challenging that feminine identity,” said Teede, an endocrinologist.
“So many of them have already got anxiety and depression, and then they … don’t want to go to the gym and exercise outdoors because they’re worried about people seeing their body hair. Then it impacts on social isolation.”
Laser hair removal can be costly, with packages for 10 facial treatments ranging between about $400 to $800. PCOS patients may need more sessions than others.
“There are young girls who have to get their parents to buy it for their birthday presents … because that’s the only way they can afford it,” Teede said.
Several years ago, Joham established a multidisciplinary PCOS service at Monash Medical Centre in Clayton, in Melbourne’s south-east.
The clinic, which receives state government funding, offers low-cost laser hair removal for PCOS patients. But Joham said they had faced some initial hurdles.
“Normally, as part of a public health service, we wouldn’t offer cosmetic treatments. So it took a little bit of convincing to [successfully make the point that], whilst it is cosmetic treatment, it is treating hirsutism – excess hair – which is one of the key symptoms of PCOS and often is a really distressing symptom of PCOS.”
Social, youth and disability support worker Lorna Berry was diagnosed with PCOS in her early 30s. Facial hair is one of the symptoms she has experienced.
“I’m a redhead … If I leave it, it will grow,” said Berry, now 56.
Although Berry said she is not a great candidate for laser because of her lighter-coloured hair, she argues making laser more accessible will benefit many.
“Women [with PCOS] often shave. They will have a five o’clock shadow at one o’clock in the afternoon. So it’s a real issue, and it’s really disempowering too. If you’re a woman ... you’re not supposed to have hair on your face. You’re not supposed to have a snail trail up your belly.
“It’s not just a vanity thing. It’s a mental health thing. It impacts on people’s ability to move through the world.”
To add laser therapy for hirsutism or excess body hair to the Medicare Benefits Schedule, an application must be made to the Medical Services Advisory Committee. Assistant Health Minister Ged Kearney acknowledged the difficulty of managing PCOS, but no application requesting funding for laser therapy for hirsutism has been made so far.
The Royal Australian College of General Practitioners (RACGP) is yet to develop a position on the issue.
Carolyn Ee, deputy chair of the RACGP’s specific interests faculty, acknowledged the review supporting the use of laser for hirsutism.
“But I think women should be aware laser will just treat the hirsutism and not the underlying hormonal condition,” she said.
One of the medicines commonly prescribed to address symptoms of PCOS is the combined contraceptive pill.
“That works really well to suppress levels of male hormones, and it’s also got other benefits as well. It can help relieve acne, it can help regulate menstrual cycles, and also it will provide protection against endometrial cancer,” Ee said.
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