Hirsutism in women
What is hirsutism?
Hirsutism is the name given to the problem of having too much hair on the face or body, a problem which mainly concerns women. For each woman, it is a matter of personal preference how much hair she considers to be too much.
Hair grows from tiny hair follicles. Men and women have the same number and distribution of these, although there is a difference between races. For example, Caucasians have more hair follicles than Asians, and people from the Mediterranean have more than those from Northern Europe.
In women, the hair on most parts of their bodies is very thin, pale and almost invisible. Under the stimulus of male hormones (known as androgens) the hair becomes coarser and darker, making it far more obvious. This is sometimes known as terminal hair.
What causes hirsutism?
All women have small amounts of androgens in their circulation, made primarily in the ovaries and adrenal glands. When androgens are produced in excess, or there is unusual sensitivity to normal levels, hirsutism is likely to occur.
The usual cause of excess androgen production is a condition called polycystic ovary syndrome (PCOS). Usually, women with this problem have irregular or absent periods and may experience difficulty becoming pregnant. Rarer causes are tumours of the ovary or adrenal gland and Cushing's syndrome, in which the adrenal gland is overactive.
In many cases, no abnormality of the hormones is found and it may be that in those people the hair follicle is more sensitive to normal amounts of androgen. Other family members are often affected.
How is hirsutism treated?
Treatment of hirsutism is through a combination of cosmetic measures and treatment of the hormone imbalance. Once hair has developed into terminal hair it cannot change back. Cosmetic methods such as electrolysis, laser hair removal, waxing, plucking, shaving and depilatory creams are therefore needed to remove the excess visible hair. At the same time, those with an excess male hormone can be treated in a variety of ways to prevent further unwanted hair appearing.
Last Reviewed: 16 December 2009
- 1. Hirsutism [revised June 2009, amended October 2009]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2009 Nov (Accessed 2009 Dec 17.) http://www.tg.org.au/
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