Doctors figured out yet finally with the induction of hirsutism. It is known that the appearance of excess hair due to excessive production of male hormones (androgens) in the female body, usually in the ovaries or adrenal cortex. But not all forms of hirsutism associated with endocrine disorders, for example, such as:
- constitutional (family, genetic) hirsutism, associated with heredity. Genetic form of hirsutism includes, partically, excessive hair growth in women in some ethnic groups (in the East and the Mediterranean). Some increase in the growth of facial hair in women during menopause related hormonal changes, too, is considered as a variant of the norm;
- exogenous hirsutism - excess hair appearance, caused by taking drugs (steroid hormones, glucocorticoids, contraceptives, some heart medications and antibiotics). For example, is not safe in this respect, prolonged use of minoxidil, cyclosporine, cortisone, hydrocortisone, diazoxide, streptomycin, interferon, acetazolamide;
- idiopathic hirsutism. This is a case when endocrine pathology is not found and no possibility of exogenous and constitutional forms. In short, the cause of the disease has not been established. Possible causes of excess hair growth, there may be increased sensitivity of hair follicles to androgens, increased amount of male hormone receptors in the skin, increased activity of the enzyme responsible for the transfer of testosterone to dihydrotestosterone (active fraction).
However, all these forms are somehow related to the endocrine field, although not always of a pathological character. Not for nothing that statistics brings together polycystic ovary and idiopathic hirsutism - in statistics, they accounting for about 90 percent of all diseases of hirsutism.
This also should include stress factors as well as the appearance of excess hair on a woman's body can also be triggered by chronic stress and debilitating hunger strike. Still, these factors act indirectly, through the endocrine imbalance. And in general, hirsutism is a marker for increased production of androgens in women (hyperandrogenism).
That is why, before prescribe treatment, it will be offered you to be tested for testosterone, DHEA-s and other hormones in blood serum, including androstenedione, which, they say, in women moves of testosterone. And rightly so. But it would be wrong to restrict only the analysis of hormonal levels.
This is because hirsutism is often caused by disease of the ovaries, which increases the secretion of androgens (polycystic, tumors and their metastases to the ovaries). The most frequent cause of excessive androgen production is polycystic ovaries.
And now look: According to scientists, polycystic ovaries detected in 92% of women with hirsutism. But elevated levels of androgens in the blood - only 50%. So often with hyperandrogenism in women, androgen levels in the blood are normal. Paradox?
No any paradox! Hyperandrogenism - this is not only the excess production of testosterone and other androgens by ovaries and adrenal glands, but also increased the conversion of androgens to more active forms directly into the tissues (e.g., the skin turns testosterone into dihydrotestosterone (DHT). If you have an idea about chemical kinetics, then you realize that even with increased androgen production, their rapid exhaustion into skin receptors (the same hair follicles) may lead to the fact that the levels of hormones in the blood remain within normal limits.
Uniquely elevated levels of androgens in the blood is observated mainly in the case of androgen-producing ovarian tumors (as luteome, tecome).
Cause of excess hair growth may also be adrenal disease (enhancement of the functions of the cortex, benign and malignant tumors) and other endocrine disorders, mainly in the thyroid gland. Here, too, restriction of only one laboratory test for the maintenance of hormones may play a doctor (and hence the patient), a cruel joke.
Such confusion with the tests due to the fact that many doctors mistakenly equate the term "hyperandrogenism" with hyperandrogenemia - rising levels of androgens in the blood. For this reason, patients in the presence of hyperandrogenism, which is not accompanied by increased levels of androgens in the blood, are often not granted the necessary treatment in time, resulting the manifestations of hyperandrogenism are progressing and getting worse.
And I'll add that, if we take the figures quoted by scientists, it turns out that this is, probably, in every second patient (92% and 50%!) Although professional should read not only the high school textbooks.
I used to wonder why on sites devoted to treatment of hirsutism authors often writte that with proper therapy, prognosis is always favorable, but at the same time on the forums, women screaming shouting that the treatment they did not work? And now I understand: so that with proper ...
And it becomes clear statistics cited by scientists, the frequency of diagnoses among women with hirsutism: polycystic ovaries - 40%, idiopathic hirsutism - 50%! In fact, the diagnosis of "idiopathic hirsutism" means that the doctor you wrote: "I why you have excess hair!" But if he does not knows he going to treat, then the treatment will be not know what.