Excess hair (hirsutism) is defined as the presence of terminal hair in women, in anatomical areas characteristic of male distribution (increased amount of hair in women in places such as chin, fluff, lower abdomen, around nipples, between the breasts, buttocks and inner thighs). It may manifest as an isolated complaint, or as part of a broader clinical picture, accompanied by other signs of hyperandrogenism, virilization, menstrual disorders and / or infertility.
Hirsutism, although rare, usually affects women during the childbearing years and after menopause, it is usually associated with menstrual irregularity, hormonal changes, infertility and acne. Many cases have no definite cause.
Symptoms, Etiology and Clinical Picture
The appearance of this disorder can be caused by genetic causes, use of drugs and glandular disorders (called endocrinological).
In “family” hirsutism, hair growth occurs, but not because of menstrual cycles or a predominantly androgenic hormonal imbalance (male hormones). In this case, the condition may be associated with some specific ethnic groups, being a “normal” finding for these women.
In androgenic hirsutism, hair growth is linked to the excess production of androgens (male hormones) by the adrenal glands and the ovaries. In general in these cases, a progressive appearance of hair occurs and should be investigated. There are several causes, the most common being disorders in the regulation of the production of sex hormones and their balance, and very rarely tumors in the ovaries or adrenal glands.
Hirsutism can be classified into three categories: excess androgens produced by the ovaries and / or adrenals, increased skin sensitivity to circulating androgens or other situations that involve secondary changes in androgen transport and / or metabolism.
The first category includes cases of polycystic ovary syndrome (PCOS), non-classical or late-onset congenital adrenal hyperplasia, Cushing’s syndrome and tumors producing ovarian or adrenal androgens.
The second group, corresponds to hirsutism called “idiopathic”, characterized by isolated hirsutism, in the presence of regular and ovulatory menstrual cycles.
In the third group, other situations such as thyroid disease, hyperprolactinemia, drug use (phenothiazines, danazol, metyrapone, cyclosporine, among others), can lead to a condition of hirsutism.