Hirsutism is stiff and pigmented body hair, appearing on the body where women don't commonly have hair — primarily the face, chest and back.
When excessively high androgen levels cause hirsutism, other signs may develop over time, a process called virilization. Signs of virilization may include:
- Deepening voice
- Decrease in breast size
- Enlargement of the clitoris
At puberty, a girl's ovaries begin to produce a mix of female and male sex hormones. This causes hair to grow in the armpits and pubic area. Hirsutism can occur if the mix becomes unbalanced with too high a proportion of male sex hormones (androgens).
Hirsutism can be caused by:
- Polycystic ovary syndrome. This common condition is caused by an imbalance of sex hormones that may result in irregular periods, obesity, infertility and sometimes multiple cysts on your ovaries.
- Cushing's syndrome. Cushing's syndrome occurs when your body is exposed to high levels of the hormone cortisol. It can develop when your adrenal glands make too much cortisol, or it can occur from taking medications such as prednisone over a long period of time.
- Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands.
- Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands may cause hirsutism.
- Medications. Some medications can cause hirsutism. One such drug is danazol, which is used to treat women with endometriosis.
Sometimes, hirsutism can occur with no identifiable cause. This happens more frequently in certain populations, such as women of Mediterranean, Middle Eastern and South Asian ancestry.
Several factors may influence your likelihood of developing hirsutism. These include:
- Family history. Several conditions that cause hirsutism, including congenital adrenal hyperplasia and polycystic ovary syndrome, run in families.
- Ancestry. Women of Mediterranean, Middle Eastern and South Asian ancestry are more likely to develop hirsutism with no identifiable cause than are other women.
Hirsutism can sometimes be emotionally distressing. Some women feel self-conscious about having unwanted body hair. Also, although hirsutism doesn't cause physical complications, the underlying cause of a hormonal imbalance can.
If you have hirsutism and irregular periods, you may have a condition called polycystic ovary syndrome, which can inhibit fertility. Women who are taking certain medications to treat hirsutism should avoid pregnancy because of the risk of birth defects.
Hirsutism generally isn't preventable. But if you have polycystic ovary syndrome, controlling obesity may help reduce hirsutism.