Polycystic ovary syndrome (PCOS) and excess hair
Hirsutism is the medical term for more hair than women would expect on the face and body. It can be one of the signs of polycystic ovary syndrome (PCOS). For some, it can be embarrassing and unsightly, as it can be dark, thick, coarse and difficult to get rid of. It’s also more likely to be in areas associated with males, such as the cheeks, neck, chin and chest.
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What causes excess hair in PCOS?
Many symptoms of PCOS are due to excess hormones called androgens, and testosterone is one of these. Men typically have much higher levels of androgens than women, but in PCOS, women can be androgen-sensitive. This leads to growth of hair that is thicker, darker and coarser, and it grows faster. The often-raised circulating testosterone also makes it grow in a male pattern distribution.
Hirsutism often goes hand in hand with acne, as excess androgens cause both.
Any non-medical treatments for hirsutism?
Self-care methods are often used first by individuals, such as waxing, depilation, shaving and bleaching.
Some explore other cosmetic treatments for excessive hair growth which include laser hair removal and hair electrolysis. During laser therapy a beam of light is focused on areas all over the body to destroy the hair follicles. Electrolysis involves passing a current via a fine needle into each hair follicle to destroy it. Electrolysis is best for a smaller area of the body.
Both treatments occur with moderate but temporary pain, may require several rounds of treatment and may not be a permanent solution. It is important to know that these treatments may not be covered by insurance.
Are there medical treatments for hirsutism?
Your doctor can refer you to a dermatologist for further advice on how to treat hirsutism. Dermatologists may be able to provide you with a medication called spironolactone, which has an effect of blocking androgen sensitivity. This drug can also be effective at reducing acne, too.
This drug is not safe in pregnancy (as it can cause birth defects) and so is usually used in combination with birth control pills to reduce your risk of pregnancy. It can take up to 6 months to notice a difference.
Birth control pills and contraceptives contain estrogen and progesterone and can also be used to treat hirsutism. You may be offered one with a higher estrogen content, but this requires careful consideration and monitoring, as it can increase your risk of getting blood clots in your legs or lungs.
The specialist may also consider a cream called Vaniqa (eflornithine) that helps slow new hair growth. It can be used alongside laser therapy to enhance the response.
How is the diagnosis confirmed?
Hirsutism can occur for several reasons, from hormonal conditions, to medications or cancer. If you think the cause is due to PCOS, speak to your doctor, who can arrange some hormonal blood tests. If you have other symptoms, your doctor may examine you and arrange further investigations like an ultrasound scan.
For a diagnosis of PCOS, you must have at least two features out of the following: irregular or infrequent periods, increased testosterone seen on a blood test (or signs of it, such as hirsutism or acne), or multiple follicles on your ovaries, seen on a scan.
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