Hirsutism 

Hair — except for the soles of your feet and the palms of your hands, your body is covered with it. There are two main types: vellus, the fine peach fuzz that you usually don’t notice, and terminal, the kind on your head, your pubic area and armpits, and your face (eyelashes, eyebrows).  

Men generally have more terminal hair than women (90% vs. 30%, respectively). The reason for this disparity lies in the different hormone levels in men and women. Whenever hormones tip out of balance, there are consequences, including hirsutism, or excessive hair growth in women. 

At Palmetto Endocrinology, our team can help you get to the bottom of your unwanted hair growth and find the solution that’s right for you.  

Here’s what may be causing your hirsutism and what you can do about it. 

The Androgen Factor 

Androgens — often called male sex hormones — dictate the development of the male physique. When puberty hits, boys experience a surge of androgens, which, among other changes, affect hair follicles. 

The hormones stimulate receptors within each follicle and cause thicker, darker hair to grow in certain places, which is why men can grow beards, and women can’t. Even though women’s bodies contain some androgens, their level is lower and is balanced by other hormones. 

Menopause and Hair Issues 

Menopause isn’t an event, it’s a long journey. The first stage, called perimenopause, begins in your late 40s or 50s when your body slows its production of female hormones, namely progesterone and estrogen. This triggers symptoms such as hot flashes, insomnia, vaginal dryness, irregular periods, increased belly fat, and more.  

When your ovaries finally stop producing these hormones altogether, and you’ve stopped menstruating for 12 consecutive months, you’ve reached menopause. Then, you immediately enter the final phase called post menopause, the time when your body acclimates to its new normal. 

Hormones are interdependent and have complex relationships and interactions. Without estrogen and progesterone coursing through your veins and keeping androgens in check, the scales tip. Although you aren’t producing more androgens than before menopause, the ratio imbalance changes the way your hair follicles function. 

You may notice that some of your terminal hair becomes thinner and more sparse and that your vellus hair becomes thicker and more abundant, particularly on your face, chest, back, and abdomen, a condition called hirsutism. Although only about 10% of women in the United States suffer from hirsutism, if you’re one of them, there's good news — treatments work. 

Treatment 

Menopause isn’t the only thing that causes hirsutism. Certain medications can trigger unwanted hair growth, as can polycystic ovary syndrome (PCOS), and hyperproduction of androgens. You may experience hirsutism if you produce a normal amount of androgens but have hair follicles that are hypersensitive. In many cases, the exact cause is simply unknown.  

There are a number of ways to address unusual hair growth and we will help you develop a treatment plan that fits your unique symptoms.  

Weight Loss 

Losing weight is one of the best ways to lower your androgen level, so diet and exercise may be a key part of your treatment. 

Hormone Therapy 

As endocrinologists, we specialize in hormones, and we understand the delicate balance necessary to keep you healthy and feeling like yourself. Once we identify deficiencies or surpluses, we can restore your hormonal balance with treatments such as steroids, birth control pills, androgen suppressants, or gonadotropin-releasing hormones.  

Insulin Control 

One of the potential causes of increased androgen levels is increased insulin levels. Because insulin stimulates your ovaries to produce androgens, you may end up with hirsutism as a result. 

Insulin — or insulin resistance, to be more exact — is also one of the factors in PCOS. If your body is insulin resistant, your pancreas keeps producing more insulin in an attempt to lower your blood sugar, to no avail. The excess insulin causes an increase in androgens, so we may prescribe insulin-lowering medication to correct the imbalance. 

Of course, you can also choose to stop the hair growth by destroying the hair follicle with laser therapy or electrolysis. While this won’t address the root cause, it certainly addresses the hair root. 

If you have unwanted hair growth and suspect menopause or some other hormone-related condition, schedule an appointment with our team at Palmetto Endocrinology today. 

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.