Healing Hirsutism
You have hair on parts of the body that usually isn’t there. For instance, you have excess hair on your chin, underneath your chin, and hair above the upper lip like a mustache. You have hair growing out of your butt, literally. All of this makes you uncomfortable as a woman. You may have hirsutism.
Hirsutism describes excessive hair growing on the body. Each hair grows out of a little pit in the skin called a follicle. Cells that live in the base of that pit cause the hair to form when androgens (male hormones) in the blood reach those cells. So two things are required: androgens in the blood and cells that respond to androgens by making hairs.
Women have measurable amounts of androgens in the blood, though they are much lower than in a man’s blood. The cells in hair follicles on a woman’s face also make hairs in response to androgens.
When a woman has an unusually high androgen levels, she can start to grow hair in places that most women don’t. Such growth may also be caused by cells in the hair follicles that are easily stimulated by androgens to make hairs, even when androgen levels are normal.
In some cases, the extra androgen comes from medications. Some birth control pills and certain steroids contain androgens or have effects similar to androgens. Other drugs indirectly cause the body to make extra androgen hormones, these include some medicines to treat schizophrenia, seizures, migraines, bipolar disorder, and high blood pressure.
Occasionally, an abnormality in the ovaries, the adrenal glands or pituitary gland can cause overproduction of androgens. One such common condition is polycystic ovarian syndrome. Blood tests can rule out these causes.
Hirsutism occurs in approximately 7 percent of women and has an estimated economic burden in the United States of more than $600 million annually.
Women with polycystic ovarian syndrome are likely to have insulin resistance. As a result, this syndrome is related to the development of Type 2 diabetes. Therefore, women with polycystic ovarian syndrome should be checked yearly for Type 2 diabetes.
Idiopathic hirsutism accounts for 50 percent of all cases. In this form, the appearance of male-type hair is not associated with problems with a woman’s menstrual cycle. Also, when properly measured by the doctor, the blood levels of male hormones are not increased.
One factor that separates idiopathic hirsutism and polycystic ovarian syndrome from worse conditions is how quickly the hirsutism occurs. Most women with idiopathic hirsutism and polycystic ovarian syndrome develop hirsutism over a year or longer.
The first signs of hirsutism tend to present between 15 and 25 years of age. The rapid onset of severe hirsutism or development of other male characteristics (called virilization) is a sign of a more aggressive and serious problem. Signs of virilization of a woman include losing scalp hair along the temples, male pattern baldness, developing a male-type muscle profile, increased sex drive, and deepening of the voice.
The general approach to treating the root cause of hirsutism is to lower male hormone levels by either slowing down their production, blocking their action or both. Medication is an option.
In polycystic ovarian syndrome, the source of male hormone excess is the ovaries. Medications to suppress male hormones produced by the ovaries is a common therapy. Only certain combination medications have the best response, and improvement is gradual. These same medicines will normalize irregular periods.
Up to 90 percent of women will see reductions in male-type hair patterns within two years. But if these medicines are stopped after only two years, up to 80 percent of women will relapse within the next two years. Assuming that an improvement is seen in the first couple of years, hirsute women should stay on these medications for at least four to five years to reduce their risk of relapse.
Long-term use of medical treatments can decrease levels of androgens or their impact on hair follicles. Medical treatments include the following:
· Estrogen-containing medicines. Several medicines, including birth control pills that contain both estrogen and progesterone, can alter the impact of androgens.
· Anti-androgen medicines. The most commonly used medicine is spironolactone (Aldactone).
All women with hirsutism can benefit from cosmetic procedures such as plucking, waxing, shaving or depilatory creams, laser hair-remover techniques which uses light to generate heat inside follicles (destroying their ability to produce hair) and electrolysis which also destroys the ability to grow hair (uses electricity to produce heat inside the hair follicle).
If you have excessive hair growth, talk to your doctor to learn about the best options for you. Remember you can’t stop hair from growing. But you can reduce the amount of hair that grows back. Hirsutism can be distressing. But it is manageable with the right solutions for you.
