Hirsutism

Hirsutism is stiff or dark hair that appears on the body where women don't commonly have hair. That can include areas such as the:

• Face.
• Chest.
• Lower stomach.
• Inner thighs.
• Back.

When high androgen levels cause hirsutism, other symptoms might develop over time. This is a process called virilization. Symptoms of virilization might include:

• The voice deepens.
• The scalp loses hair.
• Acne appears.
• Breast size becomes smaller.
• Muscle mass increases.
• The clitoris becomes larger.

If you think you have too much coarse hair on your face or body, talk with your health care team. Ask about treatment options.

Extra facial or body hair can be a symptom of another condition. Get a health care checkup if over a few months you have heavy or rapid hair growth on your face or body. Also get checked if you notice symptoms of virilization. You may be referred to a healthcare professional who finds and treats hormone disorders, called an endocrinologist. Or you might be referred to a healthcare professional who finds and treats skin problems, called a dermatologist.

Hirsutism can be caused by:

• Polycystic ovary syndrome (PCOS). This condition causes a shift in the balance of sex hormones. It often starts during puberty. Over years, PCOS may slowly lead to extra hair growth, irregular periods, obesity, infertility and sometimes multiple small cysts on the ovaries.
• Cushing syndrome. This happens when the body makes high levels of the hormone cortisol. It can develop because the adrenal glands make too much cortisol. Or it can come from taking medicines such as prednisone over a long time.
• Congenital adrenal hyperplasia. This is a condition that's present at birth. It's passed from parents to children through genes. The condition causes the adrenal glands to make irregular amounts of steroid hormones. For example, the glands might make too little cortisol and too much androgen.
• Tumors. Rarely, a tumor in the ovaries or adrenal glands can cause hirsutism. It does this by releasing androgen.
• Medicines. Some medicines can cause hirsutism. These include minoxidil (Minoxidil, Rogaine); danazol, which is used to treat endometriosis; testosterone (Androgel, Testim); and dehydroepiandrosterone (DHEA). If your partner uses products that have androgens that go on the skin, the androgens may affect you through skin-to-skin contact.

Hirsutism may happen with no clear cause.

Some factors can raise the risk of hirsutism, including:

• Family history. Some conditions that cause hirsutism run in families. They include congenital adrenal hyperplasia and polycystic ovary syndrome.
• Ancestry. Women of Mediterranean, Middle Eastern and South Asian descent are more likely to have extra body hair with no clear cause than are other women.
• Obesity. Being obese causes the body to make more androgens. That can make hirsutism worse.

Hirsutism can be distressing. You might feel self-conscious about having unwanted hair. Some people become depressed. Hirsutism itself doesn't cause physical health problems. But if a medical condition is causing a hormonal imbalance, that may lead to other health concerns.

If you have hirsutism and irregular periods, you might have polycystic ovary syndrome. That can cause infertility. And people who take certain medicines to treat hirsutism should not try to become pregnant because of the risk of birth defects.

Hirsutism usually isn't preventable. But losing weight if you're overweight might help reduce hirsutism. That's especially true if you have polycystic ovary syndrome.