A woman with a beard – where does hirsutism come from, how to treat it?

Most often they worked in oddities circuses, gained considerable publicity, aroused sincere admiration, and at the same time earned quite well. They had admirers, got married, had children. Some of them ran their own businesses, usually quite prosperous thanks to their original appearance. In old photos they are dignified or flirtatious, they wear fashionable dresses, jewelry, carefully arranged hairstyles and… beards. And even beards and mustaches.

1. A woman with male hair suffers from hirsutism. Hair appears on the face, chest, abdomen, thighs, and around the nipples
2. The Ferriman-Gallwey scale is used to check whether we are really dealing with hirsutism. It assesses the density of hair growing in certain places
3. Formerly it was considered a disease, too much stubble was associated with madness
4. Hirsutism most often occurs in women struggling with polycystic ovary syndrome (PCOS), it also results from hyperandrogenemia, i.e. increased levels of male hormones
5. You can find more such stories on the TvoiLokony home page

All of these women suffered from hirsutism, a male pattern of hair on the face, chest, abdomen, thighs, and around the nipples. It is about the so-called terminal hair – thicker and more colored, at least 0,5 cm long – similar to those on the pubic mound and under the armpits. Hirsutism was not and is not a rare disease, as it is estimated that it affects one in fourteen women in varying degrees.

A little mustache, a big problem

Moderate hirsutism is often idiopathic, that is, for no apparent reason. Some women’s hair follicles are overly sensitive to male hormones, and we may blame this on our genes. And since hairless bodies are still in fashion in our culture, a real problem arises. Everyone knows at least one woman (though not always aware of it) who systematically I’m waxing a mustache above her upper lip.

The beauty industry, which produces various types, comes to the rescue in the fight against mild forms of hirsutism creams, patches or even lasers. Last year, the hair removal business in the United States alone was valued at $ 990 million. However, the business only goes on when we want to remove or bleach hated hair (which is as unrealistic as hair removal).

Already the appearance of a few can cause a kind of obsession. The same study found that two-thirds of women systematically check in the mirror for any unwanted hair, while three-quarters do so by touching their faces. And this is not the end yet, because excessive body hair causes frustration. Forty percent of British women with hirsutism feel uncomfortable in public, and 75 percent are uncomfortable. is afraid rejection in intimate relationships!

In Poland, the situation is not that dramatic, although there are many women affected by the problem of hirsutism. – The visible dark mustache above my upper lip makes me avoid company – says 33-year-old Martyna, a natural brunette. When I talk to someone face to face, I try to cover them, put my hand over my mouth. Besides, I can’t stop thinking about him.

1. Where does the hair in “male” places in women come from? And how to get rid of it?

Where the norm ends and hirsutism begins

All ladies who are not sure if the amount of hair on their body is excessive can check it. There is a measuring tool developed in 1961 by two English endocrinologists: Dr. David Ferriman and John Gallwey.

They published a paper on the clinical assessment of hair growth on the body of women, more specifically terminal hair. Doctors distinguished 11 areas of the body, assessing the hair growing there on a scale of zero to four.

1. 0 – no hair
2. 1 – fine hair or several individual hairs,
3. 2 – hair thicker, growing more evenly,
4. 3 – very dense hair, growing evenly,
5. 4 – hair typical of men.

This is how the scale was born Ferrimana-Gallweya. We are currently using a simplified version that covers only nine body regions (upper lip, chin, chest, upper abdomen, lower abdomen, arms, thighs, the area between the shoulder blades and the sacrum). Once assessed, the result should be summed – less than eight is normal, 8 to 15 is mild hirsutism, and more than 15 is moderate to severe hirsutism. Cases of moderate to severe hirsutism should be further investigated. Concomitant symptoms should also be taken into account, such as: menstrual cycle disorders or obesity.

It should be emphasized that the original scale was based on the characteristics of white women. Modern research suggests that this is a big drawback, as breed largely determines the type and degree of hair.

The study was funded by Procter & Gamble, which sells women’s razors, among others. Recall that as women discovered more and more of the body, there were pressures that everything exposed to public view should be hairless. As early as 1915, advertisements in magazines such as Harper’s Bazaar began to promote epilation.

What medical conditions cause moderate to severe hirsutism?

Medics classified male hair in women as a disease fairly early. As early as 1575, the Spanish physician Juan Huarte wrote: “Of course, a woman who has a lot of body and facial hair is also intelligent, but unpleasant and quarrelsome, muscular, ugly, has a deep voice and frequent problems with infertility.” In 1893, however, a study of madness was published in 271 women, indicating that the sick had facial hair.

1. Older women think they are doomed to it. Gynecologist: this is no reason for embarrassment

Testosterone is also produced in the bodies of women. If the level of this hormone exceeds the norm, libido may increase, the menstrual cycle may be disrupted, and excessive hair growth may occur.

Treatment always begins with the exclusion of neoplastic causes, i.e. a virilizing or masculinizing tumor of the ovary or adrenal glands – says Wojciech Zieleniewski, habilitated doctor, endocrinologist. – If we exclude cancer, we start pharmacological treatment with anti-androgens.

One of the main causes of high levels of male sex hormones in premenopausal women is polycystic ovary syndrome (PCOS). It is a hormonal disorder that causes cysts to grow around the edge of the ovaries, affecting 8 to 20 percent. world population. This disease causes 72 to 82 percent. all cases of hirsutism (according to a 2012 study published in American Family Physician).

Another 6 – 15 percent. cases are due to idiopathic hyperandrogenemia, i.e. elevated levels of male hormones such as testosterone. Some women with hyperprolactinaemia may also suffer from infertility or amenorrhea.

The cause of excess hair growth in postmenopausal women is usually a hormonal imbalance that results from the menopause itself.

Other causes of excessive facial hair in women include:

1. drugs, e.g. minoxidil used to treat high blood pressure, antidepressants, immunosuppressants, hypnotics, androgenic steroids, as well as drugs that alter hormone levels,
2. congenital adrenal hyperplasia, a disorder affecting the production of steroid hormones. It is a rare condition and mild cases are difficult to diagnose.
3. Cushing’s syndrome or acromegaly
4. overweight or obesity,
5. an ovarian tumor; and tumors that release extra hormones. The above-mentioned article in American Family Physician indicates that 0,2 percent. cases of hirsutism arise from an androgen releasing tumor. In such cases, body hair appears suddenly and is accompanied by additional symptoms.

To correctly diagnose the disease, endocrinologists usually order blood tests to measure the levels of androgens and other hormones.

– Hirsutism in tandem with a delay in the first menstruation in adolescent girls usually indicates congenital adrenal hyperplasia – says Dr. Zieleniewski. – The disease has probably occurred in the family before, and it could have appeared at any age. It results from an enzyme block that causes the adrenal glands to overproduce male hormones. Women with late-onset congenital adrenal hyperplasia look like athletes on anabolics. They represent the so-called tomboy type, have a low voice, tend to be obese with muscle gain. The treatment is inoperable, but long-term, it takes about 9 months and consists in taking anti-hormonal drugs that block the effects of androgens.

Polycystic ovary syndrome is treated with hormones, and the tablets also reduce hair growth. Dr. Zieleniewski adds that getting pregnant is the best way to deal with this ailment.

In addition, it is recommended to change the diet (reducing sugar and carbohydrate intake may help), weight control, exercise. Since PCOS is a complex disorder that not only changes her appearance, but also affects a woman’s fertility, support groups and therapy can help.

In any case of hirsutism, popular hair removal methods such as shaving, plucking, or the use of special creams and waxes can be temporarily effective. The terminal hair can also be lightened or removed with electrolysis or laser (the latter method is usually less painful). However, achieving the desired effect requires many treatments.

The editorial board recommends:

1. Preventive examinations for women of all ages. Do regularly
2. Contraception in Polish. How do women protect themselves most often? At all
3. Infertility hurts more than depression