Hirsutism can be a challenging condition for many women, characterized by excessive hair growth in areas typically associated with men. In this blog post, we will delve into what hirsutism is, its prevalence, and the hormonal imbalances that contribute to its development. We will also explore the role of polycystic ovary syndrome (PCOS) and discuss potential treatment options. So, let’s unravel the mysteries behind hirsutism.

What is Hirsutism?

Hirsutism refers to the excessive growth of hair in women on parts of the body where men usually have hair, such as the face, upper lip, chin, chest, abdomen, and back. It is important to note that some hair growth in these areas is normal, but hirsutism involves a more significant and noticeable increase in hair.

Prevalence and Causes

Studies indicate that hirsutism affects approximately 5-25% of women of reproductive age. The primary cause of hirsutism is often attributed to hormonal imbalances, particularly elevated levels of androgens, which are male hormones. Testosterone, androstenedione, and dehydroepiandrosterone (DHEA) are examples of these androgens.

Understanding the Role of DHT

One specific androgen, dihydrotestosterone (DHT), plays a crucial role in promoting excessive hair growth in hirsutism. Hirsute patients often exhibit increased activity of an enzyme called 5 alpha-reductase, which converts testosterone into DHT. Higher levels of DHT contribute to the growth of terminal hair in the dermal papilla, resulting in the visible symptoms of hirsutism.

The Link with Polycystic Ovary Syndrome (PCOS)

PCOS is a common underlying condition associated with hirsutism. It is a hormonal disorder that affects women of reproductive age, causing a range of symptoms, including irregular periods, ovarian cysts, and, in many cases, hirsutism. The exact mechanisms linking PCOS and hirsutism are complex but are thought to involve the overproduction of androgens by the ovaries.

Idiopathic Hirsutism

Some PCOS patients might suffer from what is known as idiopathic hirsutism (IH). IH is defined as hirsutism with regular ovulation, normal testosterone levels, and normal ovaries. IH is prevalent in about 5-20% of PCOS patients with hirsutism. With respect to monitoring IH, it is important to keep track of the androgen hormones and their variation, even if these hormones are within range.

Insulin resistance and Hirsutism

In some cases, PCOS patients experience insulin resistance, a condition in which cells become less responsive to the effects of insulin. Insulin resistance can lead to hyperinsulinemia, an increased level of insulin in the blood. This elevated insulin level has several implications for hirsutism development in PCOS. Hyperinsulinemia resulting from insulin resistance can stimulate the production of hormones in the ovaries and adrenal glands. This increased hormonal production, particularly androgens (male hormones), contributes to the development of hirsutism. Insulin resistance also inhibits the production of sex hormone-binding globulin (SHBG), a protein that binds to and regulates the activity of testosterone. When SHBG production is reduced, free testosterone levels increase, leading to a greater impact on hirsutism symptoms. Insulin appears to have a direct effect on the severity of hirsutism in PCOS patients. Studies suggest that insulin acts synergistically with total testosterone, enhancing the androgenic effects and exacerbating hirsutism. This means that managing insulin levels may have a positive impact on reducing hirsutism symptoms.

Treatment Options

There are multiple treatment options available that encompass hormonal contraceptives, androgen blockers, and natural supplements.

Hormonal contraceptives

Hormonal contraceptives containing both estrogen and progesterone (progestin), are frequently prescribed to reduce hirsutism, primarily in patients who are not planning to conceive. These contraceptives aim to suppress ovarian function, thereby reducing ovarian androgen production. Studies have shown that hormonal contraceptives may not completely suppress ovarian function, leading to a higher failure rate in hirsutism treatment. Incomplete suppression means that some androgen production by the ovaries may still occur, limiting the effectiveness of hormonal contraceptives in reducing hirsutism symptoms. Progestin, a component of hormonal contraceptives, contains derivatives of testosterone. These derivatives can have an impact on the androgenic hormonal production by the ovaries, potentially exacerbating hirsutism symptoms. This aspect raises concerns about the ability of hormonal contraceptives to effectively address the root cause of excessive hair growth. While hormonal contraceptives may provide temporary relief for hirsutism, exploring alternatives that target the underlying hormonal imbalances can yield more comprehensive and sustainable results.

Anti-Androgen Medications

Anti-androgen medications offer a targeted approach to managing hirsutism. By blocking the action of androgens, these medications can help reduce excessive hair growth and acne associated with hirsutism. Spironolactone, a commonly prescribed anti-androgen, inhibits the effects of androgens on the skin. It’s however important to note that spironolactone carries risks, such as birth defects and electrolyte imbalances, so it should be used with caution under the guidance of a healthcare professional. Also, spironolactone is not currently FDA-approved for PCOS and its usage is considered “off-label”.

Supplements

Natural supplements have shown promising results in reducing hirsutism symptoms and controlling androgen levels. Two supplements worth considering are N-acetylcysteine (NAC) and spearmint tea.

NAC, derived from the amino acid cysteine, acts as a precursor for glutathione, a potent antioxidant. Research suggests that NAC can reduce LH, free and total testosterone levels, and increase SHBG levels in PCOS patients. This supplement shows potential in addressing hormonal imbalances associated with hirsutism.

Spearmint tea, with its refreshing flavor and aroma, has gained attention for its anti-androgenic properties. Regular consumption of spearmint tea has been linked to decreased free testosterone levels, potentially alleviating hirsutism symptoms. Its anti-inflammatory and antioxidant effects may also contribute to hormonal balance.

Understanding the Root Cause: Empowerment through Knowledge

When addressing hirsutism, it’s essential to understand its root cause. Blood tests that measure hormone levels, such as testosterone, androstenedione, and DHEAs, can provide insights. Additionally, assessing insulin resistance is crucial, as it often exacerbates hirsutism symptoms. Armed with this knowledge, you can make informed decisions about treatment options.

Choosing the Right Path: Individualized Strategies

Tailoring your hirsutism management approach is key. If androgen levels are high without insulin resistance, starting with supplements like NAC and spearmint tea can be beneficial. For idiopathic hirsutism (normal androgen levels), these supplements can still be considered, with regular monitoring of androgen levels. If insulin resistance is a factor, reducing insulin levels through supplements like inositol and dietary modifications becomes important.

Embracing Your Unique Beauty: a journey of self-love

No matter which path you choose to reduce hirsutism symptoms, remember that your beauty is not defined by societal standards. You are strong, resilient, and unique. Focus on nurturing your health and well-being, rather than adhering to conventional beauty norms. Embrace the journey of balancing your hormones and becoming the healthiest version of yourself.

Let’s fight PCOS together..

Join our waitlist for early access..

Join the waitlist

#Hirsutism #PCOD #supplement #excessivehair #pcos #Androgen