Hirsutism
Hirsutism (or hirsutes) is the term used for increased hair growth in women. It refers to a male pattern of hair, i.e. in the moustache and beard areas (chin), or occurring more thickly than usual on the limbs. Hirsutism is very common.
There may be hairs on the chest or an extension of pubic hair on to the abdomen and thighs. What is considered normal for a woman, and what is considered hirsute, depends on cultural factors and race.
Hirsutism
What is the cause of hirsutism?
Hirsutism is nearly always genetic in origin. Female and male relatives may also have more hair than the average so hirsutism is normal in that family. Unfortunately in our society, to be hirsute is thought unattractive.
The only reason that fashion models appear to have little hair, is that they spend a lot of time and energy removing it.
Although some women with hirsutism have increased amounts of male hormones or androgens (e.g. testosterone), most have normal levels. The problem in these women is that the hairs are more sensitive than normal to small amounts of hormone. The hairs grow more quickly and thicker in response to it. The increased hair growth is usually first noted in late teenage years and tends to gradually get more severe as the woman gets older.
The main conditions associated with excessive androgens are polycystic ovaries and less often, congenital adrenal hyperplasia.
Investigations
Blood tests may be arranged to evaluate male hormone levels, which could be due to a tumour or overactivity of the pituitary gland, the adrenal gland or the ovary. Other causes of excessive hair and associated medical problems may also need to be evaluated. The tests may include one or more of the following:
Total and free testosterone
Sex hormone binding globulin
Free androgen index
Dihydroxyepiandrosterone sulfate
Androstenedione (drawn after 10 a.m.)
If there is also menstrual disorder, additional tests may be requested.
Luteinizing hormone (LH) and follicle stimulating hormone (FSH)
Oestradiol, 17-hydroxy progesterone
Prolactin
Tests may be requested to evaluate other related aspects of health, for example:
Thyroid function
Cortisol or overnight dexamethasone test
Glucose
Lipids (cholesterol and triglyceride)
A pelvic examination and abodominal / transvaginal ultrasound examination of the ovaries may be necessary as one common cause of hirsutism is polycystic ovaries.
Physical methods o
