Hirsutism refers to coarse or colored hair that grows on the face and body of some women. It might sometimes result from a medical condition.
Most women have fine, pale, faintly visible hair on the face and body, but this hair might sometimes be thicker and more visible.
About half of all people with hirsutism have an excess of androgens. These hormones usually trigger male physical and sexual development. Women normally have low androgen levels, but these levels might vary for a range of reasons.
Higher levels can overstimulate the hair follicles, leading to more hair growth than a woman would normally experience.
Hirsutism could occur in anywhere between 5 and 10 percent of women depending on local and cultural definitions of a “normal” amount of hair.
Prevalence increases with age, especially after the menopause.
Hirsutism is the excessive growth of thick body hair in women.
A woman with the mildest form of hirsutism may notice significant growth of hair on the upper lip, chin, sideburn area, and around the nipples or lower abdomen.
This hair will be mature hair, or hair that is the same color as that growing on the scalp.
More advanced hirsutism will cause mature hair to grow on the upper back, shoulders, chest, and upper abdomen and usually begins during puberty.
If hirsutism starts before or after puberty, the cause could relate to hormonal problems, and a doctor should evaluate the symptoms.
Besides excessive hair growth, a woman with hirsutism may also experience other symptoms, including:
hair loss, known as alopecia
a receding hairline
an enlarged clitoris
a deeper voice
Increased levels of androgens or oversensitivity of the hair follicles to androgens can cause hirsutism.
Although androgens are available to men at higher levels, women also have these hormones in smaller quantities.
Male hormones, such as testosterone, stimulate hair growth, increase body size, and intensify the growth and pigmentation of hair.
High levels of insulin, a hormone that “unlocks” cells to absorb energy from sugars, might also contribute to the development of hirsutism. Insulin can stimulate the ovarian cells to produce androgens.
This might occur in women with insulin resistance, such as in those who have type 2 diabetes.
High levels of insulin may also activate the insulin-like growth factor-I (IGF-1) receptor in those same cells, similarly increasing androgen production.
Since type 2 diabetes can result from obesity, this too may be a risk factor. High cholesterol may also play a role.
Hirsutism can be an adverse effect of certain medications. Androgen therapy that includes testosterone, dehydroepiandrosterone (DHEA), or the drug Danazol, may contribute to hirsutism.
The body naturally produces DHEA, and some people take it as a supplement to combat age-related conditions, such as osteoporosis. Danazol is a synthetic steroid that sometimes forms a part of endometriosis treatment. Both may raise testosterone as a side effect.
Excessive hair growth in women with normal androgen levels, regular menstrual periods, and no other underlying conditions is called idiopathic hirsutism. This means that the disorder has no identifiable cause.
Hirsutism does not always indicate a significant medical anomaly. However, if it starts before puberty, if it is accompanied by other male-related traits such as a deeper voice, or if it may be due to a tumor, the person should seek medical attention.
Tumors of the adrenal glands, pituitary glands, and ovaries can sometimes lead to hirsutism. However, hirsutism that occurs for this reason will generally be more severe and onset more quickly than with hormonal causes.