Hirsutism - a purely feminine endocrine disease, manifested by excessive growth of hair on the face and / or body in the androgenic (male) type. There is such a hairiness usually on the abdomen, back, in the thoracic region cells, chin and upper lip. With hirsutism, the menstrual cycle is often disrupted, uterine bleeding, anemia and infertility are observed. According to long-term observations it was found that 7% of women have hirsutism to some extent and sometimes it can be so pronounced that a woman needs to use different mechanical methods to remove excess hair.
Hirsutism in women is not only a cosmetic problem, since the presence of excess hair growth indicates the presence in the female body of certain fairly serious pathological processes that require appropriate correction by the endocrinologist and gynecologist. With hirsutism in androgen-dependent zones (hips, back, abdomen, chest, face, area around the areola of the nipple), pigmented coarse hair shafts grow. It is specifically attached to certain zones of increased hairization allows you to differentiate hirsutism with hypertrichosis , in which excessive hair growth is observed in androgen-independent zones.
Hirsutism - Causes
Due to the influence of a number of certain factors, unpigmented soft thin fleece hair, are transformed into pigmented, hard and long. The main causes that cause hirsutism include an idiopathic excess of androgens, side effects of drugs, a hereditary factor and hyperandrogenism.
Hyperandrogenia, or as it is called - increased production of androgens, develops under the following conditions:
- Disorders of the pituitary function in acromegaly, prolactinoma, Itenko-Cushing syndrome, etc. The development of hirsutism of pituitary origin is caused by primary damage to the pituitary gland, followed by involvement in the adrenal pathology process, characterized by increased secretion of androgens and cortisol
- Disorders of adrenal function in adrenal tumors, acquired and / or congenital hyperplasia of the adrenal cortex, etc. The development of adrenal hirsutism is due to increased production of adrenal hormones (androgens including)
- Disorders of ovarian function in hypothalamic amenorrhea, ovarian hypertrophy, ovarian malignancies (malignant and / or benign), chronic anovulation, polycystic ovary syndrome, etc. Development of ovarian hirsutism is characterized by ovarian hypertrophy, menstrual irregularities and often infertility
Genetic (family) hirsutism develops due to chromosomal and genetic features that have been observed in individual ethnic groups or families over the past several generations. Somewhat more often hirsutism is observed in women of Mediterranean and Caucasian nationalities, less often in Asian and Northern European countries.
To the development of hirsutism may cause side effects of such drugs as corticosteroids (cortisol, hydrocortisone, etc.), progestins, anabolic drugs, androgens, acetazolamide, streptomycin, cyclosporine, interferon, carbamazepine, minoxidil, diazoxide, etc.
If hirsutism develops for reasons that can not be determined, it is given the name - an idiopathic syndrome of an excess of androgens. With this form of hirsutism, hypersensitivity to androgens of hair follicles and skin receptors is noted. The symptomatology of idiopathic hirsutism is less pronounced, the reproductive function and the hormonal cycle are usually not violated, hormonal abnormalities are negligible.
Also, the reasons for the development of hirsutism include the age and physiological conditions of the female body, in which a shift in the ratio of androgens and estrogens (postmenopause, pregnancy , etc.) is observed. In about 90% of cases, the development of hirsutism is caused by idiopathic syndrome or polycystic ovary syndrome.
Hirsutism - symptoms
The main manifestation of hirsutism in women is the male type of hair, in other words, the growth of pigmented short hard hair on the buttocks, inner surfaces of the hips, abdomen, back, around the areola of the mammary glands, breast and face.
Due to the increase in the level of androgens, women suffer from alopecia , increased greasiness of the hair and skin, acne. Often, hirsutism accompanies certain disorders of menstrual function (amenorrhea, irregular menstruation) and infertility .
With the further course of hirsutism caused by hyperandrogenism, in women there may be signs of virilization (strengthening of masculine traits): the mammary glands decrease in size, the sex drive increases, the temples appear bald, the voice coarsens, the muscle mass builds up, the fat deposits on the body are localized in the male type . Female genital organs also undergo some changes: the formation of vaginal lubrication stops, the labia decreases, the clitoris increases.
Hirsutism - treatment
If there is an easy degree of hirsutism, in which there are no violations of menstrual function, special treatment is usually not carried out.
Due to the fact that usually hirsutism is not an independent disease, but acts as a manifestation of any pathology present in the body of the woman, the treatment tactics are aimed at eliminating the primary factor provoking the development of hirsutism (treatment of such diseases as acromegaly , hypothyroidism , Itenko-Cushing syndrome , removal of tumors ovaries, pituitary gland or adrenal glands, the abolition of hair growth-inducing medications).
Drug therapy with hirsutism is prescribed only after excluding the presence of androgen-secreting tumors in women. Because Usually hirsutism develops due to hyperandrogenism, anti-endronic drugs have proven to be effective, which reduce the sensitivity of hair follicles to androgens and suppress testosterone levels.
In diagnosed congenital adrenal hyperplasia, dexamethasone, prednisolone or cortisol is usually used. In polycystic ovaries, in order to suppress excessive production of androgens, reception of such drugs as clomiphene, aldalactone and oral contraceptives (Diane-35, Janine, etc.) is indicated. The usual cycle of treatment with hormonal drugs is from 3 to 6 months, and sometimes these cycles are carried out repeatedly at short intervals. In pregnancy, treatment with anti-androgens is best not done, because these medications have rather serious contraindications.
In the event that hirsutism accompanies obesity , women are recommended a diet low in carbohydrates. To help make unwanted hair less visible or to remove it, various cosmetic treatments for hirsutism (hair removal, shaving, plucking, lightening, etc.) help. If the manifestations of hirsutism are negligible, excess hair is well masked by their discoloration with hydrogen peroxide. Despite a rather wide range of cosmetology services, laser epilation and photoepilation have proved to be the most effective in combating increased hairiness.
Treatment of hirsutism lasts long enough and the first effect of reducing hair growth usually becomes evident only after five to ten months from the start of treatment. In this case, it should be taken into account that in the case of the effectiveness of treatment, only the growth of new hair is suspended, but the already existing ones do not disappear anywhere.
Most women suffering from hirsutism are prone to developing serious psychological complexes, which greatly hamper their communication in society and interfere with full intimate and family life.
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