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Introduction

Hirsutism or excessive hairiness on the face and the body in women is commonly caused by high level of male hormones - androgens (the main hormone is testosterone). Approximately, 10 percent of women in USA suffer from this problem to some degree. Hirsutism is characterized by hair growth in chest area, face, upper and lower part of the back, areola, bottom, thighs and outer genitalia. This is actually male pattern of body hair. Symptoms that follow hirsutism are: acne, erratic menstrual periods, deepened voice, smaller size breasts and increased muscle mass. There are various cosmetic and medical treatments for women with hirsutism. Women may ask their physician to prescribe anti-androgens and birth control pills. Other options can include: laser hair removal, waxing, bleaching, depilatories, electrolysis and shaving. You should discuss with your doctor about possible side effects of these medicines and hair removal methods.

Causes of Hirsutism

Causes for this condition can be sorted in five categories: connected to hormones, related to tumors, medications, miscellaneous and unidentified. But all in all they lie in increased level of androgens.

Endocrine system – this system is controlled by hypothalamus and pituitary gland. Disturbance of the system can result in alteration of blood levels of androgens that are normally secreted by adrenal gland and ovaries. This can cause: 1) Cushing’s syndrome – excessive secretion of androgens 2) Polycystic ovaries – higher level of male hormones 3) Acromegaly – growth hormone surplus 4) Hypothyroidism – lower level of thyroid hormone 5) Congenital adrenal hyperplasia – excessive production of male hormones 6) ObesityTumors – Tumors that can provoke hirsutism are: ovarian tumors, Brenner’s tumor, granulosa, lipoid cell tumors, gonadoblastoma, arrhenoblastoma, dysgerminoma, adrenal carcinoma, adrenal adenoma and adrenal tumors.Medications – Some of drugs can have influence on body hair growth, they are: oral contraceptives, minoxidil, phenytoin, Acetazolamide, penicillamine, androgens, Cyclosporine, diazoxide and heavy metals.Various causes- those that can not be classified under previous groups. This category includes: 1) syndrome of excessive insulin resistance 2) thecoma of pregnancy – brief androgen secreting tumor during pregnancy 3) hermaphroditism – presence of male and female internal genitals 4) hypereactio luteinalis of pregnancy - temporary increase of androgens during pregnancy and 5) functional adrenal hyperandrogenismUnknown reasons – causes that are not indentified. Condition usually emerges during and after puberty. Some of the affected patients have normal level of male hormones but may be oversensitive to androgens. In other cases this condition may have family traits and be followed by obesity or insulin resistance.

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