Hirsutism: A Common Condition with Many Causes and Treatments

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Hirsutism is a condition that causes excessive hair growth in women, especially on the face, chest, back, abdomen, and inner thighs. The hair is usually dark, coarse, and thick, unlike the fine, light hair that normally grows in these areas. Hirsutism can affect a woman's self-esteem and quality of life, but it is not a dangerous or life-threatening condition.

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Hirsutism is caused by an imbalance of sex hormones, particularly androgens, which are responsible for male characteristics. Androgens are produced by the ovaries, adrenal glands and fat cells. Women normally have low levels of androgens, but some factors can increase them, such as:

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• Polycystic ovary syndrome (PCOS): This is the most common cause of hirsutism, affecting 5% to 10% of women of reproductive age. PCOS is a disorder that affects the ovaries and causes irregular periods, infertility, acne and weight gain. Women with PCOS have high levels of androgens and insulin, which stimulate hair growth.

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• Cushing syndrome: This is a rare condition that occurs when the body is exposed to too much cortisol, a hormone that regulates stress and metabolism. Cortisol is produced by the adrenal glands, but it can also come from taking certain medications, such as prednisone. Cortisol can increase the production of androgens and cause hirsutism.

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• Congenital adrenal hyperplasia (CAH): This is an inherited disorder that affects the adrenal glands and causes them to produce too much androgen. CAH can cause hirsutism, as well as other symptoms such as early puberty, short stature and ambiguous genitalia.

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• Tumours: In some cases, hirsutism can be caused by a tumour in the ovaries or adrenal glands that secretes androgens. This is a rare but serious cause that requires immediate medical attention.

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• Medications: Some medications can cause hirsutism by increasing androgen levels or affecting hair follicles. These include minoxidil (a drug for hair growth), danazol (a drug for endometriosis), testosterone (a hormone replacement therapy) and dehydroepiandrosterone (DHEA) (a dietary supplement).

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Diagnosing Hirsutism

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The diagnosis of hirsutism is based on the appearance and distribution of the excess hair, as well as the medical history and physical examination of the patient. Blood tests may be done to measure hormone levels and rule out other conditions. Imaging tests such as ultrasound or CT scan may be done to check for tumours or cysts in the ovaries or adrenal glands.

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How to Treat Hirsutism

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The treatment of hirsutism depends on the underlying cause, the severity of the symptoms and the patient's preferences. The main goals of treatment are to reduce hair growth, remove unwanted hair, and improve self-image. The treatment options include:

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• Hormonal therapy: This involves taking medications that lower androgen levels or block their action on hair follicles. These include oral contraceptives (birth control pills), anti-androgens (such as spironolactone or finasteride) and gonadotropin-releasing hormone (GnRH) analogs (such as leuprolide or goserelin). Hormonal therapy can take several months to show results and may have side effects such as weight gain, breast tenderness, mood changes and irregular bleeding.

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• Hair removal methods: These involve removing the unwanted hair from the skin surface by physical or chemical means. These include shaving, plucking, waxing, bleaching, depilatory creams, electrolysis and laser therapy. Hair removal methods can provide immediate results but may need to be repeated regularly and may cause skin irritation, infection or scarring.

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• Lifestyle changes: These involve modifying factors that can affect hormone levels or hair growth, such as weight loss, exercise, stress management and diet. Lifestyle changes can improve overall health and well-being but may not have a significant impact on hirsutism.

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Hirsutism is a common condition that affects many women in different ways. It is important to seek medical advice if you have excessive hair growth that bothers you or affects your quality of life. There are many causes and treatments for hirsutism that can help you manage your symptoms and improve your self-confidence.

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Sources

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- Debbo Africa: https://debbo.africa

- Hirsutism - Symptoms & causes - Mayo Clinic 

- Hirsutism: What It Is, In Women, Causes, PCOS & Treatment 

- Hirsutism - Wikipedia