Hirsutism is a condition where women have excess unwanted hair on their faces and bodies. The hair is dark and coarse and usually appears where men typically grow hair, on the chest, face, and back.
Body and facial hair is normal. The amount of hair varies among women. But about half of women with hirsutism may have high levels of male sex hormones called androgens.
Most cases of hirsutism are not severe, and are not caused by any underlying condition. However, sometimes there is a more serious underlying condition, such as Cushing syndrome. About 8% of adult women in the United States have hirsutism. Sometimes no cause can be found.
The main symptom of hirsutism is hair growing on the abdomen, breasts, and upper lip (male-pattern hair growth in women). If hirsutism is caused by high levels of male hormones, symptoms may also include:
If hirsutism is caused by Cushing syndrome, signs and symptoms can include:
About half of women with hirsutism have high levels of male sex hormones, called androgens. Those high levels can be caused by:
Sometimes, women with hirsutism may have normal levels of male hormones. If there is no underlying condition, doctors may not be able to determine what causes hirsutism.
The following factors may increase your risk of hirsutism:
Your doctor will examine you and take a medical history. You may be asked about your menstrual cycle, what medications you take, and your family history. Your doctor will check you for hair growth and also may do a pelvic examination to check for tumors or cysts on the ovaries. After doing the physical exam, your doctor may order one of the following tests:
Preventing hirsutism depends on the cause. For women with polycystic ovary syndrome (PCOS), for example, losing weight through diet and exercise may help. Studies suggest that obese women with PCOS may be less likely to develop hirsutism if they eat a low-calorie diet.
Treatment for hirsutism depends on whether there is an underlying cause, and how severe the hair growth is. For example, if medications are making it worse, you can ask your doctor if you can switch medications. A tumor on the ovaries or adrenal glands can be removed surgically. Overweight women with hirsutism may want to lose weight so their bodies will make less testosterone.
If your doctor cannot find a cause, you can try a combination of self care and hair-removal techniques. Psychological support may also help because hirsutism is often a frustrating and embarrassing condition.
Being overweight may contribute to hirsutism. Eating a balanced diet and getting enough exercise can help control weight.
The U.S. Food and Drug Administration (FDA) has not approved any medications to treat hirsutism. However, some drugs may lower androgen production and reduce hair growth. It can take 6 months or longer for the medications to produce noticeable changes in hair growth. They must be taken long term to keep symptoms under control. These medications include:
If a tumor on the ovaries or adrenal glands is causing hirsutism, you may need surgery to remove it.
Laser therapy can remove unwanted hair for some women. The laser destroys hair follicles and stops hair from growing. You will need several sessions to reduce hair growth in specific areas, and you may need touch-ups afterward. Laser therapy works best on women with dark hair and light skin.
Ask your health care provider how to use complementary and alternative therapies (CAM) in your overall treatment plan. Always tell your provider about the herbs and supplements you are using or considering using.
These nutritional tips may help women stay at a good weight, which may help lower androgens in the body:
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting treatment. You may use herbs as dried extracts (capsules, powders, or 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 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.
These herbs are sometimes suggested to treat hirsutism, but most have not been studied by scientists. Always talk to your doctor before taking any herb that can affect hormones. DO NOT take these supplements if you are pregnant or breast feeding, or planning to become pregnant. Women who have a history of breast, uterine, or ovarian cancer, or other hormone-related conditions, should not take these supplements except under their doctor's supervision.
One small study of women with hirsutism found that acupuncture reduced both hair density and hair length. It also reduced levels of the male hormone testosterone. More research is needed.
If you are pregnant, you should not take medications, herbs, or supplements that change hormone levels. Talk to your doctor if you are pregnant, breastfeeding, or plan to become pregnant.
Pregnant women may notice more hair growth during the third trimester, especially on the face, arms and legs, and breasts. This is normal and is not a sign of hirsutism.
Treating the underlying cause of hirsutism can improve your symptoms. Long-term medication may slow hair growth, but it usually will not get rid of existing hair on the face and body. Some cosmetic techniques, laser hair removal and waxing, can reduce unwanted hair. Women who are embarrassed by their condition might consider seeing a trained counselor.
Akdogan M, Tamer MN, Cure E, et al. Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism. Phytother Res. 2007 May;21(5):444-7.
Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Human Psychopharmacol. 2003;18(3):191-5.
Bode D, Seehusen DA, Baird D. Hirsutism in women. Am Fam Physician. 2012 Feb 15;85(4):373-80. Review.
Domino FJ, ed. Griffith's 5 Minute Clinical Consult. Baltimore, MD: Lippincott Williams & Wilkins, Inc.; 2007.
Ekback MP, Lindberg M, Benzein E, Arestedt K. Health-related quality of life, depression and anxiety correlate with the degree of hirsutism. Dermatology. 2013;227(3):278-84.
Fauci AS, Braunwald E, Hauser SL, et al, eds. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw-Hill; 2008.
Franks S. The investigation and management of hirsutism. J Fam Plann Reprod Health Care. 2012 Jul;38(3):182-6. doi: 10.1136/jfprhc-2011-100175.
Goldman L, Ausiello DA, et al, eds. Goldman's Cecil Medicine. 23rd ed. Philadelphia, PA: Elsevier Saunders; 2007.
Grant P. Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytother Res. 2010 Feb;24(2):186-8.
Larsen PR, Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Elsevier Saunders; 2008.
Liepa GU, Sengupta A, Karsies D. Polycystic ovary syndrome (PCOS) and other androgen excess-related conditions: can changes in dietary intake make a difference? Nutr Clin Pract. 2008 Feb;23(1):63-71. Review.
Middlekauff HR, Yu JL, Kui K. Acupuncture effects on reflex responses to mental stress in humans. Am J Physiol Regulat Integrat Comp Physiol. 2001;280:R1462-R1468.
Oner G, Muderris II. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gynaecol. 2013;33(3):289-91.
Panidis D, Tziomalos K, Papadakis E, et al. The clinical significance and primary determinants of hirsuitism in patients with polycystic ovary syndrome. Eur J Endocrinol. 2013;168(6):871-7.
Somani N, Turvy D. Hirsutism: an evidence-based treatment update. Am J Clin Dermatol. 2014;15(3):247-66.
Tirabassi G, Giovannini L, Paggi F, et al. Possible efficacy of Lavender and Tea tree oils in the treatment of young women affected by mild idiopathic hirsuitism. J Endocrinol Invest. 2013;36(1):50-4.
Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Menopause. 2006;13(2):185-96.
Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlove-Wuttke D. Chaste tree (Vitex agnus-castus) -- pharmacology and clinical indications. Phytomedicine. 2003;10(4):348-57.
Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2020 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.