Understanding Hirsutism in Women: Causes, Symptoms & Treatment Guide

Hirsutism is excessive hair growth in women, which usually occurs on the lower back, tops of legs, neck, abdomen, genital area, chest, buttocks, and face. The hair is usually thick and black. As well as this, there may be other symptoms, such as acne, an enlarged clitoris, a receding and thinning of the hairline, alopecia, and a deepened voice.

Hirsutism is due to male sex hormones in women called androgens, the most well-known being testosterone, and is caused by an excessive production of these or an increased sensitivity to them. These are found in small amounts in women, where they can affect fertility, sex drive, and the menstrual cycle. Testosterone levels are thought to be normal in around half of all women with Hirsutism.

In premenopausal women, this is often because of a condition called polycystic ovary syndrome (PCOS), where small fluid-filled sacs develop on the ovaries and, along with excessive hair growth, cause weight gain, acne, and irregular periods. Many premenopausal women simply have an increased sensitivity, which means they have a normal androgen level, but it has a greater effect on the body. Hirsutism can also be a result of other conditions such as congenital adrenal hyperplasia, medicines such as illegal steroids, a tumour, or obesity. Often, there is no known cause, which is known as idiopathic Hirsutism.

During and after menopause, hormone levels change significantly, and some women may be left with higher levels of testosterone.

There is no cure for Hirsutism, although there are hair removal methods and medications that can help control symptoms. Shaving, bleaching, waxing, or threading can all be effective, but in the long term may be inconvenient and cause problems like scarring and folliculitis. For more severe Hirsutism that affects daily life, treatments such as laser hair removal or electrolysis might be recommended, although these can be expensive. The contraceptive pill, especially certain types like co-cyprindiol, can also help, along with other anti-androgen medications. The suitability of these treatments depends on possible side effects and whether the patient has gone through menopause.