Hirsutism in women — pictures, treatment, what it is, causes, reviews
Pathology may be expressed in different ways. In some cases, it is a slight «fuzz» on the upper lip, acne and menstrual irregularities. In other cases, in addition to changing the nature of the scalp this is known as virilization. The process of virilization affects a woman’s body and her behavior.
- reducing the size of the breast and labia majora, clitoral enlargement;
- reducing the amount of vaginal lubrication;
- the increase in volume and muscle mass;
- the roughness of the voice;
- the emergence of a large number of acne;
- the development of baldness male pattern in which hair falls out at the crown, temples;
- menstrual disorders, irregular periods;
- increasing libido;
- an increase in the excitability of the nervous system, the emergence of aggressive tendencies.
The reasons for the development
The basis for the development of disease is increased levels of male sex hormones androgens in a woman’s body. Cause of hyperandrogenism can disrupting three of the endocrine glands (ovaries, adrenals and pituitary).
Lead to malfunction of the endocrine glands and over-production of androgens:
- genetic and chromosomal defects;
- idiopathic syndrome of the androgen excess – a disease whose causes are not clear;
- acquired or congenital adrenal hyperplasia, adrenal tumors;
- certain medications: oral contraceptives, containing progestins, anabolic steroids, corticosteroids, Minoxidil and some others;
- polycystic and ovarian tumors, luteoma pregnant, chronic anovulation;
- the syndrome Itsenko-Kushinga;
- hypothalamic amenorrhea.
Types of hirsutism
There are several types of hirsutism according to the nature of the disease.
Considered to be the basis for the development of this form of hirsutism is an increased skin sensitivity to normal amounts of androgens.
External changes and are not expressed in the appearance of dark hair in the area above upper lip, acne. May disrupt the menstrual cycle.
It can occur in women of the same family as inherited. Often this form of the disease found in inhabitants of the Mediterranean and the Caucasus, than European women.
In women with constitutional hirsutism in young adulthood and the androgen excess may not be detected, but the hair on the body can be redundant from the start.
The most pronounced signs of hirsutism become at such women after menopause.
Is associated with the intake of women of androgens for the treatment of certain diseases or muscle building those who are involved in sports. If a woman taking androgens during pregnancy, hirsutism can be born child.
While a newborn may be changes in the structure of the external genitalia.
Is it possible to get pregnant with this diagnosis?
Really important in determining prognosis for pregnancy is not so much the diagnosis, preservation of ovarian function and absence of serious diseases that may cause the development body hair of male type, for example, tumors that require surgery.
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How to diagnose
Usually on reception to the gynecologist or the endocrinologist determines if the woman has excessive body hair, is the abundance of vegetation a sign of hirsutism or hypertrichosis, is there any evidence of virilization. And only then assigns instrumental investigations and laboratory tests. Need this stage in order not to send unnecessary investigations of those who are simply dissatisfied with their appearance because of the excess unwanted hair on body or face.
Those who have the nature of body hair growth or other indirect indications allow us to suspect this disease are:
- the definition of hormonal of the patient: ongoing study of serum hormones testosterone, Androstenedione, 17-hydroxyprogesterone, cortisol, gonadotropins, prolactin;
- Ultrasound of the pelvis to exclude pathology of the ovaries;
- detailed biochemical and General blood analysis.
Depending on the reason for the woman developed a pilosis on man’s type will apply one or the other treatment regimen.
Idiopathic and familial hirsutism usually require only the removal of unwanted hair. If the patient notes the menstrual cycle or going through due to heavy acne, it can be assigned to Coca korrelirovannykh violations.
If it is virilization, then apply a range of tools:
- oral contraceptives with antiandrogenic action (Janine, Diane-35) or medroxyprogesterone 150 mg/m 1 time per three months;
- antiandrogens, such as spironolactone or cyproterone in case of insufficient efficacy of oral contraceptives;
- the antifungal agent ketoconazole, which by the structure of its molecules are close to estrogens and has a strong feminizing effects in case of prolonged admission.
The first results of the treatment do not expect sooner than 6 months after the start of treatment.
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In that case, if the identified tumors of the endocrine system or serious diseases for which hirsutism is a consequence of and treatment for major diseases.
After treatment of major diseases or the correction of a hormonal background the growth of new hair in women is undesirable for the ground stop, but the existing hair will not fall out and continue to grow. Because the second stage in the correction of external manifestations of hirsutism is hair removal.
Be performed to remove unwanted vegetation has a way that will not provoke the activity of the hair follicles. This means that it is better to decide on electric, laser or ELOS hair removal, than every day to shave or pluck the hair with wax shugaring or once every three weeks.