Hirsutism: Strategies for unwanted female hair growth

At Sure Hair International we are involved in helping clients regrow their hair. In this blog we will look at the opposite situation: how to deal with unwanted female hair growth.

Hirsutism is the appearance of male-patterned hair growth such as beards as well as chest and back hair in females. It affects between 5 – 15% of women, and in most cases is believed to be the result of higher-than-normal levels of male hormones referred to as androgens (1–4). This is why it is important for hirsuate women to seek professional consultation, as there may be additional underlying issues. Nonetheless there are a variety of treatment options available and a recent article has analyzed both the efficacy and potential for side-effects of each. Use of drugs to suppress or block the excess androgens as well as very low calorie diets were among the therapies investigated.

Oral Contraceptive Pills

As a method of hormone suppression, oral contraceptives are used in mild cases as a first-line treatment, and may be combined with  androgen blockers after 6 months if required (5,6). Multiple types of oral contraceptives were evaluated and were found to be equally effective (7).  Combining oral contraceptives with additional therapies such as cyproterone acetate was believed to boost results versus oral contraceptives alone (7).

Flutamide and Spironolactone

Flutamide and spironolactone are examples of androgen blockers and are generally used in more severe cases. Flutamide and spironolactone treatment were shown to produce similar results (7). Use of flutamide led to reports of breast tenderness and dry skin while some spironolactone-users  reported irregular bleeding (7).

Finasteride and Gonadotropin-Releasing Analogues   

Finasteride and gonadotropin-releasing analogues are more examples of drugs designed to block or suppress the actions of the unwanted androgens. They were both shown to have some success for this purpose but results were inconsistent (7). Finasteride use resulted in reports of breast tenderness and dry skin while hot flushes and headaches were related to gonadotropin-releasing analogue use (7).

Very Low Calorie Diets

As weight and insulin sensitivity can be linked to hirsutism, very low calorie diets were investigated but did not improve the condition (7). They did however lower body mass index (BMI)(7).

Cosmetic Procedures

Cosmetic procedures such as waxing, shaving, bleaching and chemical depilation can be useful for removing previously established hair until treatment has taken effect.  More permanent options such as electrology (electrolysis) or laser hair removal are sometimes recommended for any growth still present after 6-12 months of hormone therapy (8).

Overall, multiple methods for treatment are available. Depending on the severity of the disease, a specialist can help determine the best option for each individual case, or even combine several strategies for faster, more effective results.

Article by: Dr. J.L. Carviel, Mediprobe Research Inc.

References

1. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961 Nov;21:1440–7.
2. Mcknight E. THE PREVALENCE OF “HIRSUTISM” IN YOUNG WOMEN. Lancet Lond Engl. 1964 Feb 22;1(7330):410–3.
3. Hartz AJ, Barboriak PN, Wong A, Katayama KP, Rimm AA. The association of obesity with infertility and related menstural abnormalities in women. Int J Obes. 1979;3(1):57–73.
4. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998 Sep;83(9):3078–82.
5. Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL, et al. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008 Apr;93(4):1105–20.
6. Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al., Endocrine Society. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013 Dec;98(12):4565–92.
7. Van Zuuren EJ, Fedorowicz Z. Interventions for Hirsutism. JAMA. 2015 Nov 3;314(17):1863–4.
8. Azziz R. The evaluation and management of hirsutism. Obstet Gynecol. 2003 May;101(5 Pt 1):995–1007.

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