What Causes Hirsutism in Females?

The main cause of hirsutism in females is androgens

The main cause of hirsutism in females is androgens. Androgens are the substances that cause the growth of the beard and muscles in males. The amount of androgens present in a female is minuscule. However, certain conditions may cause increased androgen production in the body. There may be increased sensitivity of androgens to body cells leading to hirsutism in females. There are two types of hirsutism:

Idiopathic hirsutism: The cause is still unknown.

• However, it is essentially attributed to hereditary or the family trait factor.
• A woman is more likely to have this condition if her immediate female family members, such as mother or sisters, also have the condition.
• Hirsutism is also more common in women of Middle Eastern, Mediterranean, and South Asian descent.

Secondary hirsutism: Below are few common causes of secondary hirsutism:

Polycystic ovary syndrome (PCOS):

• It is the most common cause of hirsutism along with other signs such as irregular or absent periods, increased body weight, infertility, and, of course, multiple cysts in the ovaries (although the cysts may be present in women even without COS).
• In PCOS, the normal estrogen-to-progesterone ratio is reversed. The excess progesterone causes excess androgen production.
• Treatment may include birth control pills, weight management, or hormone therapy depending on the age of the woman. Spironolactone, a diuretic, is effective against hirsutism when administered in doses of 100-200 mg daily.
• The treatment however needs to be continued for more than 6 months to be effective.

Premenopausal and menopausal women:

• Sometimes, hirsutism may be seen in menopausal women (when a woman’s periods stop). There may be number of different causes that may explain hirsutism in premenopausal women.
• Hirsutism may be caused by an increased sensitivity to the androgens in premenopausal stages. This means although they have the same amount of these hormones, they are more sensitive to them, and they have a greater effect on your body.
• During menopause, hormonal changes may cause symptoms such as hot flushes.
• In some women, as hormone levels change, high levels of testosterone (an androgen) may be noted, which can cause hirsutism.

Cushing’s syndrome: It is a rare hormonal disorder that causes sudden weight gain and bloating around the chest and stomach.

Congenital adrenal hyperplasia: An inherited condition that affects the adrenal glands (two glands above the kidneys that produce steroid hormones and male and female sex hormones).

Tumor: Sometimes, a tumor (growth) produces excess androgens.

Side effects of medicines: Examples may include anabolic steroids (drugs that are often used illegally to build muscle and improve athletic performance).

Acromegaly: It is a hormonal disorder that causes the body to produce too much growth hormone, causing abnormal growth of the hands and feet.

Symptoms of hirsutism may include:

• Irregular menstrual cycle.
• Excessive hair growth in females is just one part of the bodily change.
• There may be other masculine traits such as reduced breasts, large muscles, and a husky, deeper tone of voice.
• In both the idiopathic and secondary conditions, females will have more than normal hair growth due to enlarged hair follicles and darker and thicker hair texture. Like in the case of facial hirsutism, a woman will witness more than normal hair growth. Apart from the excessive hair growth, there will be a visible change of hair texture as well.

Treatment options: There are many options for treatment. Treating hirsutism will be different for each woman and will depend on condition severity and the patient’s preferences and resources.

• Birth control pills are the most common means of treating hirsutism hormonally.
• Other prescribed medications include androgen, spironolactone, prednisone, and enzyme inhibitors.
• If a woman is overweight and she can lose weight, she will have less free circulating hormones, which should reduce the amount of unwanted male-pattern hair.

Treatments to remove excess hair:

• Electrolysis: This is a permanent and expensive method that uses an electric current to remove hair. A few treatments are needed to ensure the hair is gone for good.
• A face cream that includes the medicine eflornithine will slow down hair growth.
• Laser hair removal: Lasers and heat are applied to remove undesired hair. This method doesn’t always provide permanent results and may be painful and could cause scarring.
• Shaving: Easy, quick, but temporary, shaving will remove unwanted hair. Shaving is needed on a regular basis to keep hair growth unnoticeable.

A physician may help to determine which form of treatment is best for each patient.