What is hirsutism?
Hirsutism is a common disorder affecting approximately 5-10% [1] of the women after puberty. This may cause women to have male-like growth of dark and course hair in unusual places of their body, such as chin, neckline, upper lip, and chest.
What factors cause hirsutism?
Excess androgen is the main culprit of hirsutism. Although, women naturally produce androgens in their body, some factors may drive higher than normal levels.
These factors are –
Stress
Stress is the biggest cause of hormone disorder. Adrenal glands release too much cortisol under chronic stress. Overactive adrenal glands may cause Cushing syndrome, a pituitary gland disorders, that causes excessive body or facial hair-growth in women. Taking corticosteroids for a long period of time may also lead to this syndrome.
Polycystic Ovarian Syndrome or PCOS
It is highly likely that the women dealing with hirsutism have polycystic ovarian syndrome or PCOS. PCOS is characterized by excessive production of testosterones (primary androgens), largely by ovaries and small quantities by adrenal glands.
Insulin resistance
Insulin resistance or hyperinsulinemia or excess insulin in the body (type 2 diabetes) converts into androgens or it may directly stimulate healthy ovary cells (called thecal cells) to produce androgens. Further, PCOS is caused by insulin resistance and is the most common cause of hirsutism, however when a person develops PCOS, a physiological level of insulin is able to produce similar effects [3].
Obesity
Obesity is greatly associated with androgen secretion, metabolism, and function. Our fat cells are able to produce active androgens. In obese man, progressive loss of testosterone was observed with increasing body weight, whereas this trend was opposite in women, particularly with abdominal fats [2].
Menopause related hormonal imbalances
During menopause, ovaries stop producing estrogens; low levels of estrogens may cause hirsutism because estrogen helps liver to produce a protein called sex hormone-binding globulin (SHBG) which tightly binds testosterone thereby preventing excess testosterone to stimulate hair follicles.
Some other factors like adrenal gland disorders, and long-term usage of certain medications, including corticosteroids, immunosuppressive drugs, and an anticonvulsant drug called Phenytoin have been found to cause hirsutism.
How to stop disease progression?
-What triggers stress may also cause overactive adrenal glands to produce excess androgens. Thereby finding a way to manage daily stress in check could be a viable option to stop producing excessive levels of androgens.
-Becoming insulin sensitive by following a low carb diet, intermittent fasting/time restricted eating, and having an active lifestyle is probably the best way to stop the disease getting worse.
Takeaway
Hirsutism causes psychological and emotional distress in women. There is no medical treatment yet that completely reverses hirsutism, although the symptoms are manageable with modern medicine and cosmetic treatments. However, lifestyle changes are critically important to stop recurring the disease in future.
References
1. Sachdeva, S. (2010). Hirsutism: evaluation and treatment. Indian journal of dermatology, 55(1), 3.
2. Pasquali, R. (2006). Obesity and androgens: facts and perspectives. Fertility and sterility, 85(5), 1319-1340.
3. Baptiste, C. G., Battista, M. C., Trottier, A., & Baillargeon, J. P. (2010). Insulin and hyperandrogenism in women with polycystic ovary syndrome. The Journal of steroid biochemistry and molecular biology, 122(1-3), 42-52.
Comentarios