Title: The hirsute female.

POPLINE Document Number: 017103

Author(s):

White MC
Ginsburg J

Source citation:

In: Crosignani PG, Rubin BL, ed. Endocrinology of human infertility: new aspects. London, England, Academic Press: New York, Grune and Stratton, 1981. :307-25. (Proceedings of the Serono Clinical Colloquia on Reproduction No. 2)

Abstract:

Attention in this discussion of the hirsute female is directed to the following: factors influencing hair growth (plasma androgens in hirsuitsm, sex hormone binding globulin--SHBG--in hirsutism, sources of androgen production in hirsutism, ovarian function in hirsutism, hyperprolactinemia and hirsutism, and calcitonin and hirsutism); investigation of hirsutism; and management of hirsutism. With the exception of the eyelashes and eyebrows, most other terminal pigmented body hair growth is androgen dependent. Observations of patients with male pseudohermaphroditism--both testicular feminization and 5a-reductase deficiency--have delineated testosterone and dihydrotestosterone dependent areas. The former, such as the lower pubic and axillary areas, are common to both sexes and reflect normal hair growth. Such dihydrotestosterone areas as the beard, the course hair of the trunk and limbs, and upper abdominal hair are normally present only in the male. In the hirsute female, the primary abnormality appears to be an increase in androgen production. This probably accounts for the increased utilization of androgens in the skin of hirsute women compared with normals, which might otherwise tend to suggest a primary skin abnormality. It has also been suggested that a relative deficiency of estradiol leading to a reduced estradiol/testosterone ratio may contribute to hirsutism by potentiating the effects of testosterone on hair growth. Wherever this is ever a primary phenomenon in hirsutism has not been established, but estrogen administration has been shown to inhibit the initiation of hair growth in animals. The fact that women occasionally complain of hirsutism at the menopause may be related to the decrease in circulating estradiol which occurs after ovarian failure. The goals of investigation should be to define an endocrine abnormality and to discover the reasons for an associated problem such as infertility. It also may be helpful to obtain a set of endocrine parameters as a baseline for any proposed therapy. When hirsutism is mild, local treatment alone may suffice. The goal of drug therapy should be 3 fold: to reduce the increased androgen production rate; elevate SHBG levels and thus increase the binding of testosterone and dihydrotestosterone, and reduce the growth rate of hairs in the follicle. A major problem of some therapies is that while they may decrease the androgen of some therapies is that while they may decrease the androgen production rate they have little or no effect on the growth of hair itself, which may be very variable and take place over very long cycles. Overall improvement in hirsutism has not been particularly encouraging.

Keywords:

Hirsutism
Dermatological Effects
Treatment
Androgens
Hormones
Stanolone
Testosterone
Menstruation Disorders
Signs and Symptoms
Diseases
Physiology
Biology
Endocrine System