Hirsutism

Overview of Hirsutism

Hypertrichosis: Hypertrichosis connotes excessive growth of non-sexual (fetal lanugo type) hair.

Hyperandrogenism: Hyperandrogenism is a state of increased serum androgen level with or without any biological effect of hyperandrogenemia.

Virilism: Virilism is defined as the presence of any one or more of the following features—deepening of the voice, temporal balding, amenorrhea, enlargement of clitoris (clitoromegaly) and breast atrophy. It is a more severe form of androgen excess. Virilism may be due to adrenal hyperplasia or tumors of adrenal or ovary.

Indian epidemiology then other

Causes of Hirsutism

• Hirsutism may be associated with excess androgen production either from the ovaries or adrenals or excess stimulation of the endorgan, i.e., hair follicles.
• It represents one of the early manifestations in the spectrum of virilism. Whereas, virilism is almost always associated with hirsutism (except at birth) but hirsutism may not be associated with virilism.
• There may be racial or familial link. Increased hair growth is observed during puberty, pregnancy and following menopause.
• Obesity (android)—Insulin resistance and androgen excess. Obesity (BMI > 25) associated with distribution of fat primarily in the gluteal and femoral region is called gynoid obesity.

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Risk factors are things that make you more likely to develop a disease in the first place.

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Pathophysiology of Hirsutism

• It involves combination of the following: Increased concentration of serum androgens especially of testosterone.
• Decreased level of SHBG resulting in increased free testosterone (testosterone itself reduces SHBG level).
• Increased responsiveness of the target organ (skin) to the normal circulating androgens. This may be related to ethnic background. Oriental women have less number of hair follicles per unit area of skin compared to a Caucasian woman.
• Increased activity of 5α-reductase which converts testosterone to DHT in the skin and hair follicles Thus, the hair follicle becomes a secondary site of androgen metabolism at the expense of hair follicle stimulation and hirsutism.[1]

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Sign & Symptoms of Hirsutism

Hirsutism is stiff or dark body hair, appearing on the body where women don’t commonly have hair — primarily the face, chest, lower abdomen, inner thighs and back. People have widely varying opinions on what’s considered excessive.

When high androgen levels cause hirsutism, other signs might develop over time, a process called virilization.

Signs of virilization might include:

• Deepening voice
• Balding
• Acne
• Decreased breast size
• Increased muscle mass
• Enlargement of the clitoris.[1]

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Diagnosis of Hirsutism

• Tests that measure the number of certain hormones in your blood, including testosterone or testosterone-like hormones, might help determine whether elevated androgen levels are causing your hirsutism.
• Your doctor might also examine your abdomen and do a pelvic exam to look for masses that could indicate a tumor. [1]

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

Investigation of Hirsutism

The following guidelines prescribe in an attempt to pinpoint the diagnosis.

• History of intake of an offending drug producing androgen city is to exclude first.
• Family history of excess hair growth too often correlate.
• Mild hirsutism are not infrequently find during puberty, pregnancy and post menopause.

During postmenopausal period, there decrease SHBG, more amongst obese patients, resulting in elevate testosterone.

Physical examination includes:

• BMI calculation
• Modified Ferriman – Gallway score for grading hirsutism.
• Others for: acne, acanthosis nigricans galactorrhea and clitoral size.
• Hirsutism of rapid onset and progressive in nature or symptoms of virilization, needs exclusion of a tumor (adrenal or ovarian). Serum DHEA-S > 700 μg/dl may rarely be seen with adrenal tumors.
• High serum level of testosterone (> 150 ng/ml) is mostly associated with an androgen producing tumor. Serum level of DHEA-S correlate well with daily urinary 17–KS secretion. Further evaluation should be done with ultrasonography, CT or MRI.

Treatment of Hirsutism

• Treatment of hirsutism with no sign of endocrine disorder is not necessary.
• For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications.[1]

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Homeopathic Treatment of Hirsutism

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines for Hirsutism:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.

Medicine:

1. Oleum Jecoris Aselli:

• Useful for abnormal growth of hair on the face of a woman, particularly on the chin and upper lips. The hair on the face could be short, dark also thick.
• It is used to treat amenorrhea and oligomenorrhoea, both of which develop as a result of hormonal imbalance in a female’s body.
• There can be soreness of both ovaries along with dysmenorrhea.

     2. Sepia Succus:

Useful for unwanted facial hair which usually occurs due to a hormonal imbalance.

Useful where PCOS or disturbed menses are the causes for the facial hair to occur.

Usually, the menses are late, scanty with pain in the abdomen.

It also use to treat cases of induration of the ovaries.

   3. Oophorinum:

Generally, Oophorinum is a medicine prepared from the ovarian extract of a sheep or the cow.

This extract contains oestrogen, progesterone, also follicle stimulating hormone and potentize according to the principles of homeopathy.

In detail, Oophorinum use to treat cases of unwanted facial hair that occur due to ovarian cysts or tumors.

Besides this, It primarily acts upon the female genitalia and the skin.

The patient tends to feel worse during menses, which are too early, profuse, clotted also of brief duration.

    4. Natrum Muriaticum:

Useful for unwanted facial hair that grows on the upper lip. Additionally, Acne on the face may also be present.

Moreover, Menses may be too early, too profuse, and the flow is usually observed at night.

The patient can be thin also anemic, with an excessive dryness of the skin and mouth.

All in all, this medicine is also used to treat female sterility also.

     5. Calcarea Carbonica:

• Useful especially for unwanted facial hair in females who have a tendency to grow fat.
• Usually, the patients who require this remedy have a slow metabolism, resulting in deposition of fat over the body.
• Furthermore, There are hormonal irregularities which lead to menstrual disturbances.
• The menses may occur too early, and be profuse. Additionally, they also last for a longer duration.
• These disturbances further initiate the growth of unwanted facial hair.

6. Corticotrophinum:

• Masculinization in women, hair distribution on unwanted area. Timid in company.
• Anxious when alone.
• Forgetful for names, mistakes in spelling also speaking. Absence of menses in young girls.
• Dry skin with heat especially at night.

7. Baryta carb:

• Immaturity, delayed development.
• Slow learning to talk also walk.
• Childishness in old people.
• Silly. Shy, timid, lack of self-confidence.
• Immature development of parts of the body. Additionally, Loss of memory, mental weakness. Irresolute.
• Lost confidence in himself. Senile dementia. Confusion. bashful.
• Aversion especially to strangers. Childish.
• Pain in axillary glands. Cold, clammy feet. Lastly, Fetid foot-sweats.

8. Folliculinum:

• Cycle irregularities Hot flushes.
• All symptoms worse specifically from ovulation to menses.
• All symptoms better after menses except specific menstrual symptoms On the other hand, Worse from heat, noise, touch, resting Prolonged and heavy bleeding with Bright red blood and dark dots.
• She feels she is controlled by another; she is out of sorts with her rhythm, she is living out someone else’s expectations.
• Besides this, She feels she is being fed off emotionally or psychologically, loses her will, over-estimates her energy reserves.
• She becomes drained, she has become a doormat, has forgotten who she is, she has no individuality.
• All in all, Painful periods cantered in ovaries prolonged and heavy bleeding with bright red blood and dark dots, all sorts of cycle problems, either too short, too long or none at all. [3]

Diet & Regimen of Hirsutism

• Leafy Greens
• Fruits
• Beans and Legumes
• Sweet Potatoes
• Tart Cherry Juice
• Cruciferous Vegetables
• Mushrooms
• Garlic [2]

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References use for Article Hirsutism

[1] Obstetrics, Gynaecology and Women’s Health on the move

[2]https://applications.emro.who.int/imemrf/Pak_J_Med_Res/Pak_J_Med_Res_2012_51_4_139_142.pdf

[3] material medica of T.F. Allen

Frequently Asked Questions

What is Hirsutism?

Hirsutism is the excessive growth of androgen dependent sexual hair (terminal hair) in facial and central part of the body that worries the patient.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Hirsutism?

• Sepia
• Oophorinum
• Natrum Mur
• Calcarea Carb
• Corticotrophinum
• Baryta carb
• Folliculinum

What causes Hirsutism?

• Excess androgen production either from the ovaries or adrenals
• Excess stimulation of the endorgan
• During puberty, pregnancy and following menopause
• Obesity

What are the symptoms of Hirsutism?

Stiff or dark body hair, appearing on the body where women don’t commonly have hair — primarily the face, chest, lower abdomen, inner thighs and back.