PCOS & Hirsutism

Although not every woman with PCOS will experience it, hirsutism is a common symptom of PCOS. Generally attributed to above average levels of androgens, the male hormones that are normally present in women at low levels, hirsutism causes women to experience an excess growth of hair all over their body.

What is Hirsutism?

Hirsutism is a condition that can affect both men and women, and is not only experienced by those with PCOS. It is a fairly common condition, affecting about 1 in 6 people in the United States. Signs of the disorder typically begin to appear between the ages of 12 and 16, about the same time as PCOS symptoms begin to exhibit for the first time.

Normally, hirsutism is the result of a hormonal imbalance. Unusually high levels of androgens, commonly referred to as male hormones and include the hormone testosterone, can lead to a number of unpleasant symptoms, the most obvious being excess hair all over the body including the face, neck, arms, and chest. However, in women, hirsutism can also induce irregular periods, a deepening of the voice, and cause acne and obesity. As much as 95% of women with hirsutism are also affected by PCOS.

Men and women who use anabolic steroids may also increase their levels of androgens, causing them to experience typical hirsutism symptoms.

Is it Always a Problem?

For many women, having to deal with excess facial and bodily hair can have significant psychological consequences. The fact that hirsutism, as well as PCOS, can contribute to fertility problems, a woman may find herself dealing with an even deeper extent of emotional damage. However, some women do not find the excess hair a problem, particularly if it does not affect their face, or it is blonde in colour. Sometimes excess hairiness is not abnormal and is a racial or genetic variation.

Getting Rid of the Hair

Typical hair removal techniques are often sufficient in removing the excess hair caused by hirsutism. Shaving, waxing, bleaching, and depilatories can all be easily performed at home while the tools for these hair removal methods can be bought at the local pharmacy or chemist.

Women looking for more permanent hair removal may prefer to try electrolysis or laser hair removal. However, it is important to note that these methods will only remove the excess hair cause by the condition; they will not contribute to any type of regulation of your hormones. In order to reduce your androgen levels, drugs maybe used.

Medical Treatment

The contraceptive pill contains oestrogen, which reduces androgen levels and will improve hirsutism as well as help with menstrual cycles. A formulation is available which includes a specific drug to reduce these symptoms further, known as ‘Dianette’. The other component of Dianette is called cyproterone acetate, and this is the next drug to try if hirsutism persists.

Cyproterone acetate is used in a higher dose than contained in the Dianette pill, but must be combined with adequate contraception, as it can cause fetal abnormality if taken during early pregnancy.

Spironolactone is another alternative, but this frequently causes erratic periods, so is often given with a low dose birth control pill. A newer drug is called flutamide, which appears promising, though its safety profile is less clear.

Are there any Risks with these Drugs?

Side effects of the anti-androgens include tiredness, mood changes and reduced sex drive. Both flutamide and higher dose cyproterone acetate have a rare but serious side effect of causing problems with liver function, and so regular blood tests are advised.

How Soon Will I See Results?

All hirsutism treatments must be continued for 8-18 months before a response can be expected, due to the slow rate of hair growth. At that time, electrolysis can be performed to remove the unwanted hairs already present, and less return growth can be expected.