VERIFIED CONTENTConsultation: Jacek Tulimowski, MD, PhD, obstetrician gynecologist

Hirsutism can affect any woman. It manifests itself with excessive hair - on the face, breasts and lower legs. Before you start removing dark hair in unusual places and consult a gynecologist. Perhaps this is not a cosmetic defect, but the effect of hormonal disorders that need to be treated.

Does it alwayshirsutismmeanhirsutism ? Family predispositions, or more precisely - ethnic origin, determine the more intense facial hair. If your ancestors come from southern Europe (e.g. Italy, Sicily) or Asia (e.g. Georgia), dark hairs - also around the face - should not bother you, as they are typical of women living in these areas. But excessive hair does not have to be inherited from the father or mother, it can also be a result of a hormonal imbalance.

Excessive hair - a result of hormonal disorders

A woman's body works properly thanks to estrogens (female sex hormones), which are responsible for regular menstruation and allow you to get pregnant. The ovaries and adrenal glands also produce small amounts of androgens (male sex hormones). In ladies, they answer, among others for leadership qualities, male behavior, life energy and muscle strength. A mustache can therefore reveal that you are a temperamental woman or, for example, a great boss. But when there is a lot of androgens (hyperandrogenism), the excess hair can also be seen on the chin, between the breasts, around the nipples, between the navel and the pubic symphysis, on the shins. There is also rich pubic hair that even comes down to the inner surfaces of the thighs. This is called hirsutism.

It is often accompanied by oily hair, seborrheic changes on the skin or irregular menstruation. The excess of androgens also result in other male features, such as a lowered voice, overgrown muscles, and the inability to get pregnant.

Hirsutism - reasons

There are many reasons for hirsutism. The main ones are:

  • polycystic ovary syndrome (PCOS)- apart from the occurrence of excessive hair, it also manifests itself in oily skin and hair, menstrual disorders, alopecia on the head.
  • cortical hypertrophyadrenal glands - is characterized by excessive secretion of adrenal androgens. It can be proved by, inter alia, increased body hair, seborrhea, temporal alopecia, cycle disorders.
  • hyperprolactinemia(disease caused by hyperactivity of the anterior prolactin-producing pituitary gland) - the level of prolactin increases, among others, severe stress, exercise, sleep, pregnancy, breastfeeding, medications. In addition to hirsutism, there may be problems with getting pregnant, cycle disorders, and galactorrhea.
  • Cushing's disease and Cushing's syndrome- these diseases have characteristic symptoms: monstrous obesity with fat deposition in the area of ​​the hip belt, shoulder belt, neck, and slim arms and legs, the so-called a lunar face with strong hair, stretch marks on the skin of the hips, thighs, buttocks, breasts, arterial hypertension, osteoporosis, diabetes.
  • virilizing ovarian tumors- these are ovarian tumors (e.g. nucleolus, gonadoblastoma) that produce an excess of androgens.
  • use of androgenic drugs- such as anabolic steroids, progestogens (taken by women planning pregnancy to stimulate ovulation), danazol (a drug for the treatment of endometriosis), antihypertensive drugs (e.g. minoxidil - since it has been noticed to cause hirsutism, it has been used as a rub into the scalp in men to increase scalp hair), anti-epileptics, some antibiotics and histamine blockers (e.g. used to treat duodenal and stomach ulcers) .
  • anorexia- it results from a decrease in estrogen levels (menstruation cease) and an increase in androgen secretion. Amenorrhea causes permanent disorders in the body, the effects of which - if anorexia lasts a long time - will not reverse later.

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Hirsutism - necessarily to the gynecologist

If you are worried about dark hairs appearing on your face and body, you probably think about visiting a beautician. Before you go to her, however, visit the gynecologist, because only he will recognize the cause of the problem and apply the appropriate treatment.

At the beginning, the doctor will ask you about the origin, the presence of excessive hair in the family (parents, siblings), weight (check BMI; obese patients have excess testosterone and its metabolites), medications taken. He will also conducta detailed gynecological interview- incl. will ask if your periods are regular, heavy, how long are they lasting, were you pregnant (how many times), if you had problems getting pregnant and if you triedtreatment.

Important

Take care with epilation

There are many methods of counteracting hirsutism in cosmetology, but so far no one that permanently removes excessive hair has been found. Shaving with a razor (e.g. intimate areas) does not work, because the hair grows back darker and thicker. Additionally, this method often results in inflammation of the hair follicles and the formation of pimples.

Hair removal with gels or waxes also does not give good results, because the hair grows back after a few or several days. In addition, the ingredients of these preparations can irritate delicate skin. Hair removal with electrolysis or laser therapy gives longer effects, but it is worth remembering that the use of these methods may lead to the formation of microbes on the skin.

Then the gynecologist will check if the cause of the problem is PCOS (he will perform a transvaginal ultrasound, assessing the size of the ovaries, their structure, number of follicles, the thickness of the white sheath, etc. abdomen; the examination shows enlarged adrenal glands - right and left).

The next stage of research (if both PCOS or congenital adrenal hyperplasia is found) isendocrinological consultation(unless the gynecologist has this specialization). Hormonal blood tests are performed on specific days of the cycle, assessing the level of testosterone and its derivatives. If they do not give an answer, the endocrinologist also tests the level of hormones secreted by the thyroid gland (he may perform an ultrasound of the thyroid gland beforehand) and the pituitary gland.

Hormone tests usually make a diagnosis. It happens that all the tests performed do not reveal any disorders, and the woman does not have dermatological symptoms (e.g. acne). Then the so-called idiopathic hirsutism - is an excessive reaction of androgen receptors in the skin to the correct levels of androgens in the blood serum.

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Hirsutism - treatment

Treatment of hirsutism depends on the cause of the problems. Usually, however, drug treatment is used (if the cause of hirsutism is ovarian tumors, surgery is necessary).

The therapy uses, inter alia, drugs that reduce testosterone levels - you can use combined contraceptive pills, especially those containing modern progestogens, such as drospirenone, as well as anti-androgenic drugs, which include cyproterone acetate, e.g. Androcur, Diane-35.

WDepending on the cause of hyperandrogenism and hirsutism, treatment may last from several months to even several years.

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Female diseases