TOO MANY MALE HORMONES

What Causes Hirsutism?

The hair follicles are sensitive to male hormones and increasing levels of these hormones promote the rate of hair growth and the transformation of fine, soft or "vellus" hair to coarser "terminal" hair. This effect occurs in hair on the face and the body but not on the scalp.
The most common cause of hirsutism is a slight over-production of male tiormones from the ovaries and from the adrenal glands. This slight increase in ovarian and/or adrenal male hormones can be detected in blood tests and although it does not cause any ill-effects upon health or fertility, it does stimulate the annoying growth of body hair. In some women with mild hirsutism, blood levels of male hormones are completely normal and the fault lies in excessive sensitivity of their skin and hair follicles to normal levels of male hormones.
There is often a family history of hirsutism in related females and it occurs most commonly in women of Southern-European and Middle-Eastern descent. Racial and genetic factors are obviously important. Hirsutism is rare among oriental women.
Women who are overweight are more likely to suffer with hirsutism because their excessive amounts of fat are associated with higher levels of male hormones. If they lose weight, their levels of male hormones usually decrease with a corresponding reduction in body and facial hair.
The gynaecological disorder of polycystic ovaries can cause hirsutism. In this condition, the ovaries may become enlarged and develop many small follicle cysts around the periphery. This problem is quite common, and around one in every six women probably has a tendency to polycystic ovaries. These polycystic ovaries secrete excessive amounts of male hormones which may result in hirsutism, acne and infrequent menstruation. Many women with polycystic ovaries are overweight and should try to lose their excessive weight which may in itself restore regular menstruation and normal levels of male hormones. Conversely, if such women gain weight their menstrual periods become less frequent and acne and excess hair increase. In some obese women, it seems that excessive amounts of male hormones from their fat somehow "virilize" their ovaries stimulating them to produce excessive male hormones and this can become a vicious circle. The tendency to polycystic ovaries is inherited and may be triggered by stress or weight gain.
Some medications may increase body and facial hair such as the anabolic steroids used by athletes and body builders. Other drugs such as Danazol, Dilantin and some brands of the oral contraceptive pill containing the masculine progestogen norgestrel may also increase facial hair.
Hirsutism is generally mild to moderate in degree but if it is severe or of rapid onset and progression, tests must be done to check for a severe glandular disorder that may lead to extreme masculine changes in appearance called virilization.
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