Definition

Hirsutism is excess male-pattern hair growth in women. The coarse, dark hair can occur in areas such as the face, chest, and back.

Causes

True hirsutism is often due to an increased level of a male sex hormone called androgen. The main circulating androgen is called testosterone. This hormone is normally found in both men and women. There are certain medical conditions or medications that may cause an elevation in the levels of this hormone in women.

The most common cause of hirsutism is polycystic ovary syndrome. Sometimes the cause is unknown, Other less common include:

  • Congenital adrenal hyperplasia
  • Some forms of Cushing syndrome
  • Adrenal tumors
  • Ovarian tumors
  • Pituitary tumors
  • Certain medications, including:
    • Minoxidil
    • Cyclosporine
    • Phenytoin
    • Anabolic steroids
    • Diazoxide
    • Progestin-containing medications (such as oral contraceptives)

Sometimes excess hair growth is due to the person's ethnic background or family tendencies.

Risk

There are no known risk factors for hirsutism.

Symptoms

Presents as excess hair growth on the face, arms, back, armpits, groin, or chest. Symptoms and signs of some disorders associated with hirsutism may include:

  • Abnormal or absent menstrual periods
  • Acne
  • Male-pattern baldness
  • Deepened voice
  • Increased size of clitoris
  • High blood pressure
  • Increased muscle mass
  • Enlarged ovaries
  • Enlarged adrenal glands
  • Abnormal cholesterol levels and glucose intolerance

Adrenal Glands

Kidney and adrenal
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Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. The diagnosis is made by the distribution and degree of hair growth.

Your bodily fluids may be tested. This can be done with blood tests.

Images may be taken of your brain or abdomen if tumors are suspected. This can be done with:

Treatment

Treatment is directed at hair removal, reducing hair growth, and the underlying cause of the hirsutism.

Hair removal

Methods of removing hair include:

  • Shaving
  • Bleaching
  • Chemical treatment (depilatories)
  • Waxing
  • Electrolysis
  • Laser treatment
  • Intense pulsed light (IPL)—uses high-intensity pulses of light to remove hair; unlike laser treatment, IPL uses a range of wavelengths

Medications

Medications that may help reduce hair growth include:

  • Spironolactone
  • Finasteride
  • Flutamide
  • Oral contraceptives
  • Metformin
  • Eflornithine

Treatment of other conditions

If you are diagnosed with a condition that may be causing hirsutism, proper treatment may resolve the hirsutism. Weight loss may also play a role in reducing underlying hormonal imbalances.

Prevention

There are no current guidelines to prevent hirsutism.