Hirsutism (hairiness)
This is usually due to above average levels of androgens, the male hormones that are normally present in women at low concentration. Some women do not find the excess hair a problem, particularly if it does not affect their face, or it is blonde in colour. Sometimes excess hairiness is not abnormal and is a racial or genetic variation. Initial treatments include bleaching, plucking, shaving and electrolysis. Some women fear that by removing or shaving the hairs that they will grow back even thicker or there will be more. This is actually not true. Although new hairs may feel coarser when short, the number and texture is no different. If these treatments do not produce an acceptable result, drugs may be used to reduce the high androgen levels, if that is the cause.
The contraceptive pill contains oestrogen, which can lower androgen levels and will improve hirsutism. A formulation is available which includes a specific drug to reduce these further, known as 'Estelle'. The other component of Estelle is called cyproterone acetate, and this may be used in a higher dose if hirsutism persists. It must be combined with adequate contraception, as it can cause fetal abnormality if taken during early pregnancy. Spironolactone is another alternative, and is often given with a low dose contraceptive pill to regulate the menstrual cycle. A newer drug is called finasteride, which appears promising. Side effects of the anti-androgens can include tiredness, mood changes and reduced libido.
All hirsutism treatments must be continued for between 8 and 18 months before a response can be expected, due to the slow rate of hair growth. At that time, electrolysis can be performed to remove the unwanted hairs already present, and less return growth can be expected.
Go to Treatment: newer insulin-sensitising agents
Back to PCOS main page