pcos & hirsutism
Metabolic Health

Treating Hirsutism In Women With PCOS

Hirsutism is a condition which mainly affects women and people assigned females at birth. It is a condition that causes excess hair growth on certain parts of your body, people can be observed having mild PCOS facial hair and hair growth in the following areas of the body, neck, tummy, lower back, thighs and excessive PCOS chest hair. Hirsutism does not have a known cause, but it’s a symptom of other conditions, including polycystic ovary syndrome. If you have lighter, finer hair on your face or body, it’s probably not hirsutism. Most women get more of this type of hair as they get older, particularly after menopause. Hirsutism can cause distress but it's treatable.

A person is more likely to have hirsutism if they have a family condition that causes it, especially Polycystic Ovary Syndrome (PCOS) and Congenital adrenal hyperplasia. Obesity can also increase your chances of having hirsutism. Also know about pcos pain.

What is Hirsutism?

Hirsutism is a frequent condition that causes excessive hair growth. It primarily affects women and people assigned female at birth (AFAB).

People who have hirsutism may be observed developing coarse, dark hair growth on their upper lips, chin, chest, abdomen or back instead of the fine hair seldom referred to as “peach fuzz” which commonly grows in those areas. Hirsutism might cause distress, but it is treatable.

What Is The Cause Of Hirsutism In Women?

In several cases, hirsutism doesn’t have a known cause. However, there are several conditions which cause hirsutism which includes the following:

·       The Natural Production Of Androgens: All humans have androgens, however, men and people who are assigned female at birth make more of them. If an AFAB (assigned female at birth) person has high androgen levels or their hair follicles are more sensitive to androgens, they may develop hirsutism.

·       Polycystic Ovarian Syndrome (PCOS): Hirsutism and unwanted PCOS stomach hair in females are ubiquitous in polycystic ovary syndrome. PCOS is a common hormonal condition which leads women and people AFAB to produce too many androgens. A few other symptoms of PCOS include acne, normal menstruation, diabetes, weight gain and fertility problems. The most found side effect is hair growth polycystic ovary syndrome.

·       Postmenopausal: The body goes through several changes after menopause, this may lead to increased facial hair, which includes moustaches or whiskers.

·       Cushing’s Syndrome: It is an after-effect of your body having too much of the hormone cortisol that can impact the set of organs that can affect your hair, skin, nails, glands, and nerves. Cushing’s syndrome may also have the following symptoms: rapid weight gain in your face, wounds that heal poorly, high blood pressure and diabetes.

·       Other Conditions: If hirsutism has occurred suddenly along with symptoms like a deeper voice, acne, or increased muscle development, you may have a severe condition. Serious conditions may include an adrenal gland disorder, such as congenital adrenal hyperplasia or a tumour on your adrenal glands or ovaries that produce androgen.

·       Medications: Few medications can also be the cause of hirsutism, including anabolic steroids, testosterone, cyclosporine, minoxidil, danazol and phenytoin.

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What Are The Methods Used to Diagnose Hirsutism

Your doctor will run tests that measure the number of certain hormones in your blood, including testosterone or testosterone-like hormones, which might help determine whether elevated androgen levels are causing your hirsutism.

They will also conduct a physical examination to determine the extent of the uncommon hair growth. They will also note any other physical signs that may accompany the hair growth, such as acne.

Once your healthcare provider has diagnosed hirsutism, they may use the Ferriman- Gallwey scale to grade its severity. This scale examines nine areas of your body: your upper lip, chin, chest, upper abdomen, lower abdomen, upper arms, thighs, upper back and lower back.

These areas receive a 0-4 score based on the amount of hair growth. A lower number means that your hirsutism is mild, and a high number means your hirsutism is more severe.

After examining the areas, your healthcare provider will add up the scores together. If you are black or white, a total score of less than 8 is common. If you are Mediterranean, Hispanic or Middle Eastern, a total score is less than 9 to 10 is common. If you are Asian a total score of less than 2 is common.

If you have hirsutism your healthcare provider may perform the following variety of tests, including:

·       Blood tests to check your hormone levels.

·       Ultrasound to examine your Ovaries and uterus.

·       X-ray to evaluate your ovaries and adrenal glands to rule out other conditions.

What Are The Methods Used To Treat Hirsutism

Hirsutism is treatable the treatment for hirsutism includes the following:

Weight Loss

Weight loss is often the first step in treating hirsutism. Losing even 5% of your body weight can lower your androgen levels and stop excessive hair growth.

Medications

·       Birth Control Pills(Oral Contraceptives): They are the most common medication used for PCOS hirsutism treatment. Birth control pills lower androgen levels, regulate your menstrual cycle and prevent pregnancy. The side effects may include breast tenderness or swelling, headaches, irritability or moodiness, nausea and spotting between periods.

·       Androgen- Suppressing Medications: There are medications available that can effectively treat mild cases of hirsutism by lowering the number of androgens your body produces. Side effects of these medications may include dry skin, heartburn, spotting between periods, dizziness, fatigue and liver damage. The medications include spironolactone, finasteride and flutamide.

·       Low Dose Steroid Medications: Your adrenal glands are small just above each kidney. They produce sex hormones, including adrenaline and cortisol. If you have overactive adrenal glands which cause your hirsutism, your healthcare provider may prescribe you low-dose steroid medications. Side effects may include increased appetite, weight gain, changes in mood and blurred vision.

·       Insulin- Lowering Medications: These medications are controversial and shouldn’t be a first-line treatment because of their significant side effects. These medications, including metformin and thiazolidinediones like pioglitazone, reduce blood levels of insulin and androgens. Side effects of these medications may include allergic reactions, breathing problems, slow or irregular heartbeat, blood in your urine and signs and symptoms of low blood sugar.

·       Gonadotropin-Releasing Hormone Agonists: This therapy requires injection and can be expensive and it doesn’t offer any more benefits than birth control pills. These substances reduce androgen production in your ovaries.

Hair Removal Options

·       Electrolysis: In this technique, they use tiny needles and a mild electrical zap to destroy your hair roots one by one. Each hair follicle requires treatment, so it is practical to use electrolysis over large areas of your body. Side effects are rare, but they may include slight discolouration, temporary dark spots, and a slight tingling sensation.

·       Laser Hair Removal: In this technique, heat from a laser destroys cells that have a lot of old pigment. Dark hair has a lot of pigment, so it absorbs heat the most. Hair transfers heat to the follicles and destroys them so hair cannot grow. Side effects may include blisters, burns, scars, dark areas of skin and light areas of skin.

Home Remedies

·       Shaving: This is the most common method of hair removal for various areas of the body including PCOS stomach hair. It’s simple and safe, but you’ll have to shave regularly to prevent stubble. Side effects of shaving may include cuts and ingrown hair.

·       Bleaching: Bleach lightens unwanted hair. Be aware that some bleaching products can cause skin irritation if they remain on your skin for too long.

·     Waxing and plucking (tweezing): Waxing or using tweezers to remove hair from the root is effective but painful. Side effects may include skin irritation and ingrown hair.

Bottomline

Hirsutism is a common condition which affects women and people assigned female at birth (AFAB). It doesn’t cause any pain, but it may be a symptom of another condition, including polycystic ovarian syndrome, Cushing’s syndrome, an adrenal gland disorder or an ovary disorder.

It is advised to reach out to your healthcare provider as soon as you notice signs of hirsutism, especially if it causes stress, anxiety or depression. Medications and treatments are available to limit your unwanted hair growth.

FAQs

Does hirsutism always mean PCOS?

No, PCOS is not always the cause of hirsutism. There have been cases where women’s hormone levels and menstrual cycles are normal but still, they have hirsutism. In such cases, it is presumed that these women were born with hair follicles that are more sensitive to androgens. Androgens are produced by ovaries or the adrenal glands.

Does hirsutism get worse with age?

The prevalence of hirsutism and acne decreases with age. Ovarian volume and follicle number also decrease with age, with the age-related decrease in follicle number seemingly greater than that of ovarian volume. Ageing may also be associated with an increased risk of insulin resistance and metabolic disturbances.

Does hirsutism go away with weight loss?

Weight loss in women who are overweight can decrease levels of androgens and lessen hirsutism. Women with menstrual irregularities may also notice that their cycles become more regular after losing weight.

Why does PCOS facial hair grow so fast?

In women, androgens are produced by the ovaries and the adrenal glands. If your hair follicles are hormone sensitive androgens may cause some vellus hairs to change to terminal hair. Terminal hair is longer and more coarse than vellus hair and grows faster and thicker.

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