Excessive hair growth (Hirsutism)

Subhashri has just got her admission to college. She is concerned because she feels that the hair growth on her face and her body are more than she notices in her friends. Her mother too is concerned. Is there a hormonal imbalance that is causing this? Should she seek medical advice?

Excessive hair growth (hirsutism) is usually a symptom that is disturbing to women. The normal amount of body hair varies widely among women. When coarse, dark hairs grow where women typically do not grow dark hair, such as the lip, chin, chest, abdomen or back, the condition is called hirsutism. Though often associated with infertility or irregular menstruation, it may occur with no menstrual or ovulatory disturbance.

Hirsutism must be differentiated from another medical term called virilisation. In virilisation, not only is there excess hair growth, there are other masculine features such as receding hairline, deepening of the voice, development of male-type pubic hair and enlargement of the clitoris. Invariably, virilisation in a female is caused by very high levels of male hormones such as testosterone, whereas hirsutism may be associated with milder levels of male hormone elevation or even normal levels.

What causes excessive hair growth in women?

Indian women tend to have more hair on their bodies as compared to other Asian women like the Japanese or the Chinese. This is called hypertrichosis. It is not due to abnormal hormones but occurs because of the genetic background. A woman who has pronounced hair growth might have a mother, an aunt or a grandmother who has excess body hair.

If the heavy hair growth is not due to the genetic make-up, hirsutism can be caused by several different factors and the best treatment to reverse the excess hair growth depends upon which of those factors are working in a specific case.

One of the most common causes of hirsutism is polycystic ovarian disease. In this case, the woman has irregular periods, is overweight and has a tendency to have excessive pimples. An imbalance between the hormones leads to an increased amount of testosterone in the blood stream. This leads to excess hair growth on the face and the body.

The adrenal gland can also produce excess male hormone in certain conditions and a blood test for a hormone called DHEAS may be done.