Suffering from Hirsutism?

Hirsutism may be defined as the terminal hair on the body of women in the same pattern and sequence which develops in the normal post pubertal male, caused by a high level of Androgen in the female. This means excessive growth of hair where normally you wouldn't find hair. And the main reason for Hirsutism is the increase in the male hormone Androgen.

Women with hirsutism have increased androgen activity, either due to increased production by the ovaries, the adrenals, exogenous sources (primarily anabolic steroids), or from increased number of androgen receptors in the hair follicles. Androgens convert the fine unpigmented vellus hairs to pigmented and coarse terminal hairs at sex-hormone dependent sites, such as the face and lower abdomen. Most hirsutism is benign. However, sometimes it is a warning sign of a serious underlying condition (e.g., neoplasm, Cushing's syndrome) and typically manifests along with signs of virilization. Hirsutism affects 8% of adult women.

Causes

Identifiable causes of hirsutism are generally related to increased secretion of androgens from the ovaries or adrenal glands.

This can result from a variety of conditions, including:

Polycystic ovarian syndrome (PCOS) – often associated with infertility

Tumors on the adrenal glands or ovaries

Cushing's syndrome

Severe insulin resistance

Genetic: Inherited growth patterns due to parental growth structure.

Tweezing, waxing, moles and birthmarks.

Obesity

Hirsutism may also be caused by:

Medications that can cause hair growth – phenytoin, minoxidil, diazoxide, cyclosporine, and hexachlorobenzene

Anorexia nervosa

Anabolic steroids

Danazol – a substance used to treat endometriosis

Hormone replacement therapy (HRT) containing androgens

Birth control pills containing high levels of androgen hormones

Risk Factors:

The following factors may increase an individual's risk of hirsutism:

1) Genetics – hair patterns are inherited

2) Anorexia nervosa

3) Race, ethnicity/ climate: people in warm Mediterranean countries tend to have a heavier hair growth than those from colder climates. The condition is more common in women predominantly of European ancestry than it is in those of Asian, native American or African ancestry; it is also more common in dark-skinned women

4) Menopause

5) Obesity

Signs and Symptoms

1) Male-pattern hair growth in women (e.g., abdomen, breasts, upper lip)

2) Irregular menses, anovulation—signs of defeminization

3) Acne

4) Malodorous perspiration

5) Loss of female contour—sign of defeminization

6) Virilization—deepening of voice, frontal balding, clitoromegaly, enlarged shoulder muscles

7) Overweight

8) Cushing's syndrome—central obesity, hypertension, diabetes, thinning of skin

Diagnosis

The first step is to conduct a physical examination. During the physical exam, the doctor will inspect the body for all sites of abnormal hair growth and ask questions about the onset and progression of the condition. A doctor may also perform a pelvic examination to determine whether tumors or cysts are present on the ovaries. After performing the physical examination, one of the following may be necessary to identify the cause of hirsutism:

Laboratory tests - may detect elevated androgen levels

CT scan, MRI, pelvic ultrasound - used to identify cysts or tumors on the ovaries or adrenal glands

Laparoscopy - an instrument is inserted into the abdominal wall to detect cysts or tumors on the ovaries.

Warnings and Precautions

Studies suggest that obese women with PCOS may be less likely to develop hirsutism if they consume a low-calorie diet.

Certain herbs and dietary supplements may boost androgen levels thereby promoting hirsutism. They should therefore be avoided by those with the condition.

These include:
Dehydroepiandrosterone (DHEA)
Pregnenolone
Licorice root (Glycyrrhiza glabra)

Integrative Treatment Strategy

The main goal in treating hirsutism is to identify and treat the underlying cause. The secondary objective is to control symptoms. Treatment of the underlying cause may involve one or more of the following:

1) Discontinuing drugs and/or herbs that can induce hirsutism.

2) Surgical removal of adrenal or ovarian tumor if present.

3) Weight loss programs for obese patients, particularly if insulin resistance is also present.

4) Administration of antiandrogen drug therapy as indicated.

5) When no cause is identified and/or the cause is not readily treatable, approaches to control symptoms and for adjunctive care include:

6) Employment of various cosmetic therapies to conceal or remove hair, including bleaching, depilation (shaving, chemical removal), and epilation (temporary hair root removal by waxing or plucking, permanent removal by electrolysis).

7) Psychological support, needed by many .

Lifestyle

Eating a balanced diet and getting adequate exercise can help control weight, which may diminish or prevent hirsutism related to obesity.

Drug Therapies

There is no drug that is FDA approved for hirsutism. Therapy, usually lifelong, takes 6 months or longer prior to results becoming visible.

Glucocorticoids—suppress ACTH and inhibit androgen secretion; used for 21-hydroxylase deficiency; however, they can induce Cushing's syndrome and cause hirsutism as well; care should be guided by an endocrinologist.

Oral contraceptives—suppress ovarian secretion of androgens, as in cases of PCOS; appropriate if fertility not desired; lowest level of progestogen should be used (e.g., desogestrel or norgestimate). Often used in combination with antiandrogens.

Dexamethasone—for androgen suppression; 1 mg at bedtime; especially effective for late-onset 21-hydroxylase deficiency; treatment failure indicates possible adrenal tumor

Antiandrogens reduce hair growth in up to 70% of patients.

Spironolactone—inhibits androgen production and blocks receptors; 50 to 200 mg/day; contraindicated with renal insufficiency; common side effect is increased frequency of menses which can be controlled by oral contraceptives.

Cyproterone acetate—available in Australia, Canada, and some European countries; available in the United States for compassionate use only; 25 to 50 mg/day taken in combination with, and for first 10 days of, oral contraceptive cycle; can cause hepatic failure; teratogenic.

Finasteride—5a-reductase inhibitor 1 to 5 mg/day (approved for benign prostatic hypertrophy in men); studies suggestive for value in case of hirsutism in women; teratogenic.

Flutamide—effective but may cause hepatic failure; teratogenic.
Glucophage (metformin)—normalizes insulin levels and lowers luteinizing hormone and testosterone (Nestler and Jakubowicz 1996).

Surgery and Other Procedures

A physician may recommend the following surgical procedures in severe cases of hirsutism:

Tumor removal – if a tumor on the ovaries or adrenal glands is the cause

Ovary removal after childbearing years – if ovaries are producing elevated levels of androgens

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination. Talk with your health care provider about which herb may be best for you.

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.

Saw palmetto ( Serenoa repens ) standardized extract, 160 mg two times daily, for hormonal support. Used for antiandrogen effects in clinical practice. Two in vitro studies have demonstrated that a liposterolic extract of saw palmetto inhibited androgen activity in human tissue cells

Chaste tree (Vitex agnus castus) standardized extract, 20 - 40 mg daily before breakfast, for hormonal balance. Has been used by trained clinicians during treatment of early stages of PCOS; the herb is thought to reduce levels of androgen.
Black cohosh ( Actaea racemosa ) standardized extract, 20 - 40 mg two times a day, for hormonal balance. Used by some herbal specialists with the intention of reducing both LH and excess androgen.

Milk thistle ( Silybum marianum ) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.

Rhodiola ( Rhodiola rosea ) standardized extract, 100 - 600 mg daily, for antioxidant and anti-stress activity.

Goats rue (Galegae officinalis herba) the constituent galegin has demonstrated a hypoglycemic effect in vitro (Blumenthal 1998; Gruenwald et al 2000);

Fenugreek (Trigonella foenum-graecum) taken orally, fenugreek has a hypoglycemic effect (Gruenwald et al 2000) and, therefore, may have some application in the case of hirsutism secondary to insulin resistance.

Spearmint tea:Women with excess body hair are often advised to take birth control and/or a variety of other prescriptions and/or undergo painful hair removal processes. However, a new study from Turkey suggests that simply drinking two cups of spearmint tea a day may significantly reduce mild hirsutism. You should be able to get spearmint tea in most health stores. Spearmint tea is similar to mint tea, but naturally sweeter.

Nutrition and Dietary Supplements

Following these nutritional tips may help reduce symptoms:

1) Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.

2) Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell peppers).

3) Avoid refined foods, such as white breads, pastas, and especially sugar.

4) Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.

5) Use healthy oils in foods, such as olive oil or vegetable oil.

6) Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.

7) Drink soy milk, for bone health and hormonal balance.

8) Avoid coffee and other stimulants, alcohol, and tobacco.

9) Drink 6 - 8 glasses of filtered water daily.

10) Exercise at least 30 minutes daily, five days a week.

You may fulfil nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc and selenium.
Calcium-D-Glucarate, 200 mg two times daily, may help the body detoxify hormones and decrease symptoms of hirsutism.

Diindolylmethane, a natural supplement commonly sold under the trade name Indolplex, 120 mg daily, can help the body process hormones in the most beneficial way, creating helping balance the underlying hormonal balances which may be causing hirsutism.

Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tablespoonfuls oil daily, to help decrease inflammation and help with immunity.

Vitamin C, 500 - 1,000 mg, one to three times daily, as an antioxidant and for immune support.

Probiotic supplement (containing Lactobacillus acidophilus ), 5 - 10 billion CFUs (colony forming units) a day, when needed for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.

Astaxanthin, 2 - 6 mg daily, for immune and antioxidant support.

Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.

Ipriflavone (soy isoflavones) standardized extract, 200 mg three times a day, for breast cancer support.

Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.

Melatonin, 2 - 6 mg at bedtime as needed, for immune support and sleep. Consult your health care provider if you are taking prescription medications, as melatonin.

Acupuncture

One small study of women with hirsutism found that acupuncture markedly reduced both hair density and hair length and significantly reduced their levels of the male sex hormone testosterone (a type of androgen). This study is promising, but further research will be required to determine whether greater numbers of women with hirsutism would benefit from acupuncture and what causes of hirsutism respond best to acupuncture.

Homeopathy

The most common medicines are Thuja, Bryonia, Pulsatilla, Lycopodium and Apis mel, medorrhinum, sabal serulata, thyroidinum, calc carb, Radium brom, calcarea flour, calcarea phos, belladonna colocynthis, mag phos, Cimicifuga racemosa, senecio Q, thalaspi, kreosote, Sabina, pulsatilla, sepia, nat mur, ignatia, etc.

Sepia: for facial hair in women, yellow tinting of skin.

Thuja occidentalis: for unwanted hair growth especially in moles.

Oleum Jacoris: The use of a special cream in Homeopathy, using the homeopathic medicine Oleum Jacoris, has proved to give wonderful result in the reduction on the growth of hair in people suffering from Hirsutism. Richfeel Oleum Jacoris Cream for Hirsutism.A unique cream that gradually discourages the growth of unwanted hair on the face or body.

Try these Facial Hair Removal Tips

1) Mix 30 grams of sugar with 10 ml of freshly squeezed lemon juice in 150 ml of water. Mix well and then apply it on the face in the direction of the hair growth. Leave it on for 15 minutes. Then rinse with cold water, rubbing the facial area gently. The granular sugar and lemon mixture will act as a gentle exfoliating agent and remove facial hair. The lemon juice will act as an astringent and natural anti septic. Repeat once every week to find an improvement.

2) Another face mask that can help in reducing hair growth on the face and remove unwanted hair is easy to make and use every week. Squeeze 10 ml lemon juice into 40 ml honey and prepare a mixture. Take a cotton swab and rub this mixture in the direction of the hair growth. Rinse after 15 minutes. Repeat twice a week for 2 weeks and then use it every week to find an improvement in the facial hair condition.

3) An easy to use facial mask to help remove unwanted hair is to squeeze 10 ml lemon juice into a cup of water (150ml). Add 30 grams of Gram flour into this mixture and mix thoroughly. Apply this yellow mixture on the face. Wait for 15 minutes and then scrub your face in the direction of the hair growth to remove unwanted hair.

There are various Other Method to Treat Hirsutism. The common ones are:

a. Plucking;
b. Threading;
c. Waxing;
d. Electrolysis;
e. Use of medicine which are hormonal by nature;
f. And lastly laser therapy for hair removal.

The laser therapy for hair removal is the latest therapy in the world to remove excessive growth of hair. But its efficacy and efficiency is still not proved.

Removing Unwanted Hair - Depilation & Epilation

Temporary hair removal can be achieved through depilation or epilation. Continued use of these methods works well for many women.
Depilation is the removal of the part of the hair above the skin's surface. It can produce results lasting several hours to several days. Two main depilation methods are shaving and creams. Shaving is inexpensive, virtually painless, and provides good results in the privacy of your own home.

Epilation is the removal of the entire hair from the follicle. Tweezing can work well for small areas. Waxing or sugaring works by applying a sticky paste and then peeling it off the skin, along with the hairs embedded in it. Friction, using a mitt with a rough surface, is used mainly for fine leg hair. Threading involves rolling a twisted thread across the hairs to catch and pull them out. Rotary epilators are similar to electric razors, except they have tweezers that pull your hairs out.

Removing Unwanted Hair - Electrolysis

Electrolysis is one of the oldest hair removal methods and has a reliable track record for hirsutism. In the hands of a well-trained and experienced technician, it is safe and effective. A thin metal probe is slid into a hair follicle and electricity flows along the probe to damage the follicle so that the hair does not re-grow. Electrolysis can be expensive, painful, tedious and difficult for large amounts of hair. If done improperly, it can result in infection, scarring, and possible re-growth of hair.

Removing Unwanted Hair - Laser Treatment

Laser hair removal is newer than electrolysis. Lasers use a special light wave that is absorbed by dark hairs and damages the hair follicle. Laser therapies have not been in use long enough for hirsutism to fully determine how permanent the hair destruction is.
Laser treatment should not be used by dark-skinned women and is less effective with blond, red or white hair. Light-skinned women with dark hair get the best results. Laser treatment is useful for large areas of hair. Most types of laser hair removal are considered safe if performed properly. Hair re-growth will occur in some women.

Reducing Hair Growth with Natural Methods

A healthy diet, supplementation, exercise, stress management, and quality healthcare will have a profoundly beneficial effect for PCOS women with hirustism.