Most of the time women do not have noticeable hair on certain parts of their body and face where it is commonly found on men (abdomen * , mid-chest, chin, upper lip, inner thighs, and lower back). Such noticeable hair growth is also not normally found on women's breasts. However, when coarse, thick, dark hair appears in women in such typically masculine (male-pattern) places, the medical profession calls the problem hirsutism or hypertrichosis. This condition can affect both men and women, but especially for women it signifies a hormonal imbalance that could be caused by a serious disease. It can be a serious cosmetic and psychological issue for women. Women suffering from this condition should be examined for the presence of more serious medical problems.
Hirsutism occurs in about one out of 10 women, but ethnicity can alter that percentage. Women of Mediterranean, South Asian, and Middle Eastern descent are more likely to get this condition. Also, as hormonal levels change after menopause * , about one out of four women have unwanted facial hair. Excessive male-pattern hair growth can become a psychological problem for women, who may feel less feminine and experience bouts of severe stress and anxiety * (or even depression * ).
Generally, hirsutism is an inherited trait for women. It is usually caused by increased production of male hormones * (such as testosterone, which induces and maintains male secondary sex characteristics) or by abnormal sensitivity of hair follicles to male hormones. Although women produce primarily female hormones (such as estrogen, which promotes female secondary sex characteristics and the female reproductive system), they do produce small amounts of androgens (male hormones). However, when normal amounts increase drastically, hirsutism can occur.
A common cause of hirsutism is polycystic ovarian syndrome (PCOS), which is a condition that occurs when hormone levels become so erratic, especially during teenage and childbearing years, that cysts form in the ovaries * .
Another cause of hirsutism is high levels of insulin * , or what is called insulin resistance. This condition is observed in women who are exceptionally overweight because obesity forces higher levels of insulin to be produced, which then creates greater production of male hormones.
Other possible medical conditions that may increase the risk of hirsutism are Cushing's disease (excessive production of cortisol * ); congenital adrenal hyperplasia (abnormal production of steroid hormones by the adrenal glands); hyperthecosis (abnormal thickening of the inner ovary layer); and cancerous ovarian or adrenal gland tumors.
In rare cases, the condition occurs because of a serious problem. If hirsutism occurs along with the presence of acne, balding of the head, deepening of the voice, decreasing of breast size, enlarging of the clitoris, increasing muscle mass, or irregularity of menstrual periods, then a more serious disorder is possible. For instance, the more irregular the menstrual period, the more likely a woman is to develop hirsutism. If such symptoms occur, women ought to consult with their doctor.
A common way to diagnose hirsutism is with the use of the Ferriman-Gallwey score, which provides a measurement of the amount of female hair growth at nine locations on the body (chin, upper lip, chest, upper back, lower back, upper abdomen, lower abdomen, upper arms, and thighs).
Diagnostic tests for the following substances are also used to identify hirsutism:
Additional tests may be recommended if a menstrual problem is present. If the doctor thinks a serious medical condition is at the root of hirsutism, then other tests may also be recommended, such as an ultrasound * (to detect tumors or cysts in the ovaries or adrenal glands) and a computed tomography * (CT) scan (to analyze the adrenal glands).
Tests to analyze levels of thyroid function, glucose, cortisol, or lipids (cholesterol and triglyceride) may also be used.
There is not a medical cure for hirsutism. Therefore, women often use temporary hair treatment methods such as bleaching, depilatories (creams), electric hair removal, electrolysis and thermolysis, hair-retardant medicines, shaving, and waxing and plucking to eliminate excessive hair.
Permanent hair removal methods include anti-androgen drugs, birth control pills, and laser hair removal. Antiandrogen drugs, for instance, usually take at least three to six months to work. However, they should not be taken by women in their childbearing years because such drugs can harm male fetuses.
In all cases, it is best to seek medical advice and counseling first from a doctor or medical specialist. They can conduct examinations and tests designed to detect the underlying cause of hirsutism.
See also Body Image • Cushing's Syndrome • Hair and Hair Loss
American Society for Reproductive Medicine. Hirsutism and Polycystic Ovary Syndrome (PCOS): A Guide for Patients. 2012. http://www.reproductivefacts.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/hirsutismPCOS.pdf (accessed July 17, 2015).
MedlinePlus. “Excessive or Unwanted Hair in Women.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/007622.htm (accessed June 11, 2016).
Society for Endocrinology. “Endocrine Conditions: Hirsutism.” http://www.yourhormones.info/endocrine_conditions/hirsutism.aspx (accessed July 17, 2015).
Endocrine Society. 8401 Connecticut Ave., Suite 900, Chevy Chase, MD 20815. Toll-free: 888-363-6274. Website: https://www.endocrine.org (accessed June 11, 2016).
Global Library of Women's Medicine. Albyfield House, Wetheral, Carlisle CA4 8ET, United Kingdom. Website: http://www.glowm.com (accessed July 17, 2015).
* abdomen (AB-do-men), commonly called the belly, is the portion of the body between the thorax (THOR-aks) and the pelvis.
* menopause (MEN-o-pawz) is the end of menstruation.
* anxiety (ang-ZY-uh-tee) can be experienced as a troubled feeling, a sense of dread, fear of the future, or distress over a possible threat to a person's physical or mental well-being.
* depression (dih-PRESH-un) is a mental state characterized by feelings of sadness, despair, and discouragement.
* hormones are chemical substances that are produced by various glands and sent into the bloodstream carrying messages that have certain effects on other parts of the body.
* ovaries (O-vuh-reez) are the sexual glands from which ova, or eggs, are released in women.
* insulin is a kind of hormone, or chemical produced in the body, that is crucial in controlling the level of glucose (sugar) in the blood and in helping the body use glucose to produce energy. When the body cannot produce or use insulin properly, a person must take insulin or other medications.
* cortisol (KOR-tuh-sol) is a hormone that helps control blood pressure and metabolism, the process of converting food into energy and waste products. It plays a part in the stress response.
* ultrasound, also called a sonogram, is a diagnostic test in which sound waves passing through the body create images on a computer screen.
* computed tomography (kom-PYOO-ted toe-MAH-gruh-fee) or CT, also called computerized axial tomography (CAT), is a technique in which a machine takes many x-rays of the body to create a three-dimensional picture.