Hirsutism is a medical condition that causes excessive, unwanted hair growth in women, typically in areas where men usually grow hair, such as the face, chest, and back. Hirsutism affects about one in ten women in Australia¹, and can be very distressing due to its visible nature.

Women in Australia with hirsutism spend significant amounts of time, money and effort trying to rid themselves of the hair.²

The management of hirsutism is multifaceted, involving medical treatments, lifestyle adjustments, and sometimes surgical interventions. In this article, we’ll explore the causes, symptoms, diagnosis, and treatment options available for hirsutism in Australia, with a focus on the latest medical insights and practices.

What Is Hirsutism?

Hirsutism occurs when there is an imbalance of hormones that leads to the overproduction of androgens (male hormones such as testosterone) in women. This results in the development of coarse, dark hair in areas where men typically grow facial and body hair. Common areas affected include the upper lip, chin, chest, abdomen, and back.

Body hair growth is normal and what is normal for each person will depend on a range of things, particularly genetics and cultural heritage. It is important to distinguish hirsutism from common patterns of hair growth, such as those seen during pregnancy or menopause, as hirsutism is linked to a hormone imbalance.

Causes of Hirsutism

The main cause of hirsutism is an imbalance in androgens. Some common causes in Australian women include:

1. Polycystic Ovary Syndrome (PCOS)
   PCOS is one of the most common causes of hirsutism, affecting 5-10% of women of reproductive age. PCOS causes the ovaries to produce higher-than-normal levels of androgens, resulting in excessive hair growth. Women with PCOS often experience irregular periods, acne, and weight gain, which may exacerbate the condition.
   
   
2. Adrenal Disorders
   Disorders such as Cushing’s syndrome or congenital adrenal hyperplasia can lead to elevated androgen production from the adrenal glands, contributing to hirsutism.
   
   
3. Medications
   Certain medications, such as anabolic steroids or progesterone-based birth control pills, can increase androgen levels, leading to unwanted hair growth.
   
   
4. Genetics
   In some cases, hirsutism runs in families. If a woman has a family history of excessive body hair growth, she may be more likely to develop the condition.
   
   
5. Menopause
   As women approach menopause, the decrease in estrogen and the relative increase in androgens can contribute to the development of unwanted hair.
   
   
6. Other Medical Conditions
   Conditions such as thyroid disorders or tumors can also lead to hormonal imbalances that contribute to hirsutism.
   
   

Diagnosing Hirsutism in Australia

Diagnosing hirsutism typically involves a physical examination and a thorough medical history. Australian doctors may assess the pattern of hair growth and check for other signs of hormonal imbalance, such as acne, scalp hair thinning, or irregular periods.

To identify the underlying cause of the condition, additional tests may be required:

• Blood Tests: These can measure the levels of androgens in the blood. Elevated levels may suggest PCOS or adrenal disorders.
• Ultrasound: For women suspected of having PCOS, an ultrasound can examine the ovaries for cysts.
• CT or MRI Scans: In rare cases, imaging tests may be used to rule out tumors or other abnormalities that could be affecting hormone levels.

Treatment Options for Hirsutism in Australia

The treatment of hirsutism in Australia is individualized and typically aims to reduce hair growth, manage the underlying cause, and improve psychological well-being. The main treatment options include:

1. Medications

• Oral Contraceptives: Combined birth control pills containing both estrogen and progesterone can regulate menstrual cycles and lower androgen levels, helping to reduce hair growth. These are often the first-line treatment for women with PCOS.
  
  
• Anti-androgen Medications: Drugs like spironolactone work by blocking the effects of androgens on hair follicles, reducing hair growth. These medications are commonly used for women with PCOS and other conditions that cause high androgen levels.
  
  
• Topical Creams: Eflornithine hydrochloride is a topical treatment that can slow hair growth on the face. While it doesn’t eliminate hair, it can be used in combination with other treatments to reduce hair regrowth.
  
  

2. Hair Removal Techniques

For many women, medical treatments are complemented by cosmetic procedures for hair removal. Popular methods in Australia include:

• Laser Hair Removal: Laser treatments target hair follicles to reduce hair growth. This method is particularly effective on dark hair and lighter skin but may not work as well for those with darker skin tones. Laser hair removal can be more effective when used with medication at the same time.
  
  
• Electrolysis: Electrolysis uses an electric current to destroy hair follicles and prevent hair regrowth. While it can be time-consuming and may require multiple sessions, it’s a permanent solution for unwanted hair.
  
  
• Waxing, Shaving, and Depilatories: These are more temporary solutions for hair removal but are widely accessible and cost-effective. Some women shave more than once a day in some more extreme cases of hirsutism.
  
  

3. Lifestyle Changes

Diet and exercise can play a significant role in managing hirsutism, particularly for women with PCOS. Maintaining a healthy weight, engaging in regular exercise, and eating a balanced diet can help regulate insulin levels and improve hormonal balance, potentially reducing excessive hair growth.2

4. Psychological Support

Due to the emotional and psychological distress that hirsutism can cause, psychological support is a vital part of treatment. Support groups and counseling can help women cope with the emotional challenges associated with the condition. Additionally, educating patients about the medical aspects of hirsutism can reduce anxiety and help them make informed decisions about treatment.

While hirsutism can be challenging to manage, it is treatable, and most women experience improvement with the right combination of treatments. In Australia, healthcare providers offer personalized care to help manage both the physical and emotional aspects of the condition. Early diagnosis and intervention can significantly improve quality of life.

Women dealing with hirsutism should work closely with their healthcare providers to find a treatment regimen that suits their needs. While there is no cure for hirsutism, ongoing management can help reduce symptoms and improve self-esteem.

‍References

1. Better Health Victoria. Hirsutism (excessive hair). Retrieved on 6 December 2024 from
2. Anna Chisholm, ABC News (October 2024). How hirsutism impacts the time, wallets and wellbeing of many women with PCOS.
3. Journal of Family Medicine and Primary Care 6(4):p 755-759, Oct–Dec 2017. The evaluation of the relationship between some related hormone levels and diet in obese or overweight patients with hirsutism: A randomized clinical trial.

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