|Also Listed As:
|| Hair Growth,
Hirsutism is excessive growth of dark, coarse body and facial hair in women.
The abnormal hair growth typically occurs in a pattern seen in adult males.
While some body and facial hair growth is normal, women with hirsutism tend to
produce elevated levels of male sex hormones called androgens from their ovaries
and adrenal glands. Most cases of hirsutism are not excessive and have no
underlying cause, but some may indicate the presence of a more serious
underlying condition, such as Cushing's syndrome. An estimated 8% of adult women
in the United States have hirsutism.
|Signs and Symptoms|
The primary signs and symptoms of hirsutism include:
- Hair growth on the abdomen, breasts, and upper lip (male-pattern hair
growth in women)
- Irregular menstrual periods
- Abnormally malodorous perspiration
- Loss of feminine body shape
- Signs of masculinity - deepening voice,
frontal balding, enlarged clitoris, enlarged shoulder muscles
- Cushing's syndrome - a condition marked by
obesity (especially around the abdomen), high blood pressure, diabetes, and
thinning of the skin
Identifiable causes of hirsutism are generally related to increased secretion
of androgens from the ovaries or adrenal glands. This can result from a variety
of conditions, including:
- Polycystic ovarian syndrome (PCOS) - often
associated with infertility
- Tumors on the adrenal glands or ovaries
- Cushing's syndrome
- Severe insulin resistance
Hirsutism may also be caused by:
- Medications that can cause hair growth -
phenytoin, minoxidil, diazoxide, cyclosporine, and hexachlorobenzene
- Anorexia nervosa
- Anabolic steroids
- Danazol - a substance used to treat
- Hormone replacement therapy (HRT) containing androgens
- Birth control pills containing high levels of androgen
The following factors may increase an individual's risk of
- Genetics - hair patterns are inherited
- Anorexia nervosa
- Race and ethnicity - the condition is more
common in women predominantly of European ancestry than it is in those of Asian,
native American or African ancestry; it is also more common in dark-skinned
The first step is to conduct a physical examination. During the physical
exam, the physician will inspect the body for all sites of abnormal hair growth
and will ask questions about the onset and progression of the condition. A
physician may also perform a pelvic examination to determine whether tumors or
cysts are present on the ovaries. After performing the physical examination, one
of the following may be necessary to identify the cause of
- Laboratory tests - may detect elevated
- CT scan, MRI, pelvic ultrasound - used to
identify cysts or tumors on the ovaries or adrenal glands
- Laparoscopy -an instrument is inserted into
the abdominal wall to detect cysts or tumors on the
Even if an individual is at risk for hirstutism, there are steps she can take
to prevent it. For example, studies suggest that obese women with PCOS may be
less likely to develop hirsutism if they consume a low-calorie diet.
The specific treatment for hirsutism depends on the extent of the problem,
whether or not an underlying cause can be identified, and if so, what the root
of that cause is. For example, an individual with hirsutism will usually be
advised to discontinue medications that may be contributing to the condition. If
a tumor is located on the ovaries or adrenal glands, the physician will likely
recommend that it be
surgically removed. Overweight individuals
with hirsutism may be urged to participate in a weight loss program since
calorie restriction may lower
androgen production in the body. Although no medications for hirsutism have been
approved by the US Food and Drug Administration (FDA), some
drugs may suppress androgen secretion
and reduce hair growth. If no underlying cause that can be treated by
conventional medication is identified, it may be possible to control the
symptoms of hirsutism with
acupuncture, and cosmetic therapies
that conceal or remove excess hair (such as bleaching and waxing). Psychological
support may also be helpful since hirsutism is often a frustrating and
Eating a balanced diet and getting adequate exercise can help control weight,
which may diminish or prevent hirsutism related to obesity.
While there are currently no medications approved by the FDA specifically for
the treatment of hirsutism, certain medications may be used to suppress the
production and secretion of androgens in the body. Up to 70% of individuals with
hirsutism may respond to these medications, but it can take 6 months or longer
for the medications to effectively reduce hair growth and they must be taken
indefinitely to keep the symptoms under control. These medications
- Glucocorticoids (such as Dexamethasone)
- Certain birth control pills with low levels of androgen hormones, such
as desogestrel or norgestimate
|Surgery and Other Procedures|
A physician may recommend the following surgical procedures in severe cases
- Tumor removal - if a tumor on the ovaries or
adrenal glands is the cause
- Ovary removal after childbearing years - if
ovaries are producing elevated levels of androgens
|Nutrition and Dietary Supplements|
Some studies indicate that obese women with PCOS who lose weight by limiting
their overall calorie intake may experience reduced symptoms of hirsutism.
Interestingly however, restricting fat intake alone does not appear to have any
added benefit for reducing symptoms of hirsutism.
Two laboratory studies have shown that an extract of saw palmetto (Serenoa
repens) may inhibit androgen activity in human cells. More research is
necessary, however, to determine whether these laboratory findings will have any
practical applications in terms of treating hirsutism in humans.
Professional herbalists may also recommend the following herbs to relieve the
symptoms associated with hirsutism:
- Black cohosh (Cimicifuga racemosa)
- Goats rue (Galegae officinalis herba)
- Fenugreek (Trigonella foenum-graecum)
- Chaste tree (Vitex
One small study of women with hirsutism found that acupuncture markedly
reduced both hair density and hair length and significantly reduced their levels
of the male sex hormone testosterone (a type of androgen). This study is
promising, but further research will be required to determine whether greater
numbers of women with hirsutism would benefit from acupuncture and what causes
of hirsutism respond best to acupuncture.
|Warnings and Precautions|
Certain herbs and dietary supplements may boost androgen levels thereby
promoting hirsutism. They should therefore be avoided by those with the
condition. These include:
- Dehydroepiandrosterone (DHEA)
- Licorice root (Glycyrrhiza
- Medications that alter androgen levels should generally not be taken
during pregnancy; a physician can provide guidance and appropriate medical
- Hair growth may increase during the third trimester, especially on the
face, extremities, and breasts. This hair growth is considered normal and is not
a sign of hirsutism.
|Prognosis and Complications|
If the underlying cause of hirsutism can be identified and treated, the
symptoms of hirsutism may be effectively controlled. Long-term medication, when
appropriate, will slow hair growth, but it generally won't eliminate existing
hair patterns on the face and body. There are some cosmetic therapies that can
reduce the appearance of excessive hair growth. Counseling with a trained
professional may also be helpful for women who experience psychological stress
as a result of their hair growth.
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|Review Date: March 2001|
|Reviewed By: Participants in the review process include: Robert A. Anderson, MD, President
, American Board of Holistic Medicine, East Wenatchee, WA; Ruth Debusk, RD, PhD,
Editor, Nutrition in Complementary Care, Tallahassee, FL; Jacqueline A. Hart,
MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard
University and Senior Medical Editor Integrative Medicine, Boston, MA; Dana
Ullman, MPH, Homeopathic Educational Services, Berkeley,
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