We all have varying amounts of hair on our bodies. What's considered so-called normal or acceptable can depend on ethnicity, where you live, your own individual genes, and even your own personal preference. But there are cases where extra hair growth indicates something could be out of balance with your hormones and should be investigated by your provider.
Hirsutism is a condition of excess hair growth, most often due to higher-than-normal levels of androgens, sometimes referred to as “male hormones,” but make no mistake—women need them too. Causes vary, but the most common is polycystic ovary syndrome (PCOS), a complex metabolic and hormone condition that comes with a whole host of symptoms, including unwanted hair growth.
If you deal with hirsutism, you're not alone. It's estimated that up to 80 percent1 of women with PCOS experience it. Hirsutism can be a significant source of anxiety for some, affecting self-esteem and quality of life, but there are things you can do to address it. Here, I'll share the details on hirsutism — what it is, why it happens, and natural solutions that can help.
What Is Hirsutism?
Hirsutism is the medical term for excess hair growth, occurring in about 5 to 10 percent2 of women. With hirsutism, hair can grow in places where women typically don't have it, such as the upper lip, chin, chest, back, or upper abdomen. This isn’t what some people call “peach fuzz,” but rather, the hair is coarse, thick, and dark.
In general, hirsutism occurs when your body produces too many androgens3, especially testosterone, although some women with hirsutism can have normal testosterone and instead elevated dihydrotestosterone (DHT) or other androgens. These are sometimes called “male hormones,” even though women need these hormones too—in the right amounts. You can read why women do need testosterone here.
Androgens influence the growth of hair follicles and can make existing hair thicker and darker. They also stimulate the growth of new hair.
Sometimes hirsutism is accompanied by symptoms like:
- Acne
- Weight gain
- Irregular or no menstrual periods
But you can also have hirsutism without any other symptoms.
How is Hirsutism Diagnosed?
If you're concerned about excess hair growth, the first step is to see your healthcare provider. They can do a physical exam and ask you questions about your family history and menstrual cycle.
They may also recommend one or more of the following tests:
- Blood test. This can measure the levels of androgens in your blood. Read this on when to test hormones.
- Ultrasound. This imaging test can be used to check for cysts on your ovaries.
- Glucose tolerance test. This test is used to check for insulin resistance, which is common in women with PCOS.
The Ferriman-Gallway Scale4 is also sometimes used to assess the severity of hirsutism. This involves giving a score for hair growth depending on how much hair is on specific body parts. A score of zero means no hair growth, while anything above a 15 indicates moderate or severe hirsutism.
Testing isn't always necessary, especially if you've already been diagnosed with PCOS and you notice extra hair growth.
Possible Causes of Hirsutism: Hormone Imbalance and PCOS
As we've already established, hirsutism is most often caused by an imbalance of androgens in the body. Androgens are sometimes called “male hormones,” but both men and women have them.
There are several possible causes of hirsutism, but hormone imbalance and PCOS is the most common. It's estimated that PCOS5 affects up to 20 percent of women worldwide.
@drjolenebrightenCould this be your sign? #pcos #pcosawareness #polycysticovariansyndrome #hormoneimbalance #hormonehealth #hormonedoctor
♬ Golden – Harry Styles
Androgen Hormones in Women
PCOSirregular cycles
PCOS is linked to insulin resistance when your body can't efficiently use the hormone insulin. Insulin is necessary because it helps regulate blood sugar levels, so insulin resistance means blood sugar stays higher than it should. As a result, the body keeps secreting more and more insulin.
Androgens and insulin are connected because insulin6 can stimulate the production of androgens and inhibit sex hormone-binding globulin7 (SHBG), which binds testosterone making it inactive. This can create a feedback loop, causing even more androgen production.
Other possible causes8 of hirsutism include:
- Cushing's disease9. This condition occurs when you're exposed to high cortisol levels over a long period.
- Congenital adrenal hyperplasia. This group of inherited disorders causes the adrenal glands to produce abnormally high amounts of androgens.
- Tumors. Tumors on the ovaries or adrenal gland can lead to excess androgen production.
- Medications. Certain medications, such as anabolic steroids, birth control pills, and testosterone replacement therapy, can cause hirsutism.
In 4 to 7 percent of hirsutism cases, androgen levels are normal, but these are usually mild10.
How is Hirsutism Typically Treated?
The treatment for hirsutism depends on the underlying cause, but usually, Western medicine focuses on one of two approaches:
- Reducing androgen levels with medication, such as birth control pills, spironolactone, or flutamide.
- Increasing insulin sensitivity with the help of medications like metformin, or lifestyle changes like exercise and a healthy diet.
Many women with hirsutism may also choose to remove the excess hair with methods like shaving, waxing, or depilatory creams.
Once the follicle forms, it’s likely that the hair will continue to grow. So, you may opt for a longer-term solution like laser hair removal or electrolysis. Addressing the underlying cause by supporting hormone balance may help slow or stop new hairs from appearing.
How to Balance Hormones for Women with Hirsutism
Since androgen imbalance is the leading cause of hirsutism, one of the best things you can do is focus on hormone balance. Hormone balance requires a holistic approach that addresses all areas of health, from diet and lifestyle to stress levels and supplements.
Here are some of my favorite tips for balancing hormones in women with hirsutism.
Want to get started now? I’ve created a Hormone Balancing Starter Kit packed with the essential information you need to optimize your hormones, plus a free 7-day meal plan.
Consider Saw Palmetto Benefits for Androgens
If you're looking for a more targeted approach, saw palmetto is a plant that may help to block the effects of excess androgens. Saw palmetto supports your body’s ability to lower a potent androgen related to excess hair growth on the body (and hair loss on the head) by inhibiting the enzyme that helps convert testosterone to DHT. It also may increase how quickly DHT is broken down.
Unfortunately, there isn't a ton of research available on saw palmetto and hirsutism. Still, I've seen saw palmetto work well when used in combination with other supportive habits, like the ones you’ll find below.
Eat a Blood Sugar Balancing Diet
There's no one-size-fits-all diet for everyone, but a diet that promotes blood sugar balance can address the insulin resistance element that accompanies PCOS and exacerbates hirsutism.
Here are simple approaches to blood sugar balance:
- Eat regular meals and snacks spaced evenly throughout the day. This helps to stabilize blood sugar levels and prevent spikes.
- Focus on foods that are high in fiber and protein, which help to slow down the absorption of sugar into the bloodstream.
- Limit refined carbohydrates and sugary foods, which can cause blood sugar levels to spike.
Additionally, maintaining a healthy body composition11 can support a healthy insulin response (although body size does not always predict whether someone has insulin resistance).
Support Adrenal Health with Adaptogens
Stress12 is implicated in PCOS and could make it worse, so supporting stress resilience and adrenal health is a must-do.
One way to help your body better respond to stress is by experimenting with adaptogens like Ashwagandha and Rhodiola, which may help promote stress resilience and support adrenal function. Reishi13 is another adaptogenic mushroom that also has androgen lowering effects.
You’ll find ashwagandha, rhodiola, and other stress targeting nutrients in a comprehensive Adrenal Support supplement.
Try Inositol to Support Blood Sugar
Inositol is a nutrient that's closely related to the B-vitamin family. It's involved in many different biochemical processes in your body, including cell signaling and fat metabolism. One of its most important roles is helping to regulate insulin levels.
For people with PCOS, inositol may help improve insulin sensitivity and dial in blood sugar, which can turn down androgen levels. One study14 found that inositol lowered total androgens and reduced hirsutism in women with PCOS.
Fill up on Antioxidants
Antioxidants may help to protect your cells from damage, and they also have a calming effect on inflammation. This is important because inflammation15 is closely linked to PCOS.
Some of the best antioxidant sources are berries, dark leafy greens, and nuts. You can also get antioxidants from supplements like vitamin C, green tea extract, and resveratrol.
Use Vitex for Better Hormone Balance
Vitex, or chaste tree, is a popular herbal remedy for hirsutism and other hormonal imbalances. It supports healthy progesterone and prolactin levels and may lower androgen levels16. Since vitex is so supportive of restoring hormone balance in PCOS, it helps reduce the impact of androgens on hair growth. Our most popular supplement, Balance Women’s Hormone Support, contains Vitex, along with other nutrients that promote balanced hormones.
Sip Some Spearmint Tea
If you're looking for a delicious way to reduce hirsutism, try spearmint tea. This refreshing beverage has been shown to lower androgen levels in women with hirsutism.
In one small study17, participants who drank 2 cups of spearmint tea per day for 5 days during the follicular phase (the first part of your menstrual cycle) had significantly lower testosterone levels than those who didn't drink the tea.
Get Enough Zinc
Zinc is a mineral that's essential for many cellular processes, including hormone production. Supplementing18 with zinc may support improvements in hirsutism, and it's also an essential nutrient when you’re dealing with insulin resistance19.
Zinc-rich foods include oysters, beef, poultry, beans, nuts, and seeds. You can also find zinc in supplements, but you want to ensure you get enough copper because too much zinc can lead to a copper deficiency.
Key Takeaways
- Hirsutism is a condition characterized by excess hair growth on the face, chest, and back.
- Elevated androgens are the leading cause of hirsutism.
- Lifestyle changes that may help reduce hirsutism include eating a healthy diet, managing stress, and getting enough sleep.
- Herbal remedies such as vitex saw palmetto, spearmint tea, and zinc supplements may also be effective.
Addressing the root cause of your hormone imbalance, especially with PCOS, is vital for long term success in managing hirsutism.
References
- https://pubmed.ncbi.nlm.nih.gov/27510481/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419053/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/18252793/ ↩︎
- https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879843/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680959/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/23121642/ ↩︎
- https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418744/ ↩︎
- https://jamanetwork.com/journals/jamadermatology/article-abstract/547982 ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519190/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892097/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/16029938/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/18854115/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962967/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528347/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/17310494/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/26315303/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468694/ ↩︎
About The Author
Dr. Jolene Brighten
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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.
