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Hirsutism, or excess hair growth, is one of the most common symptoms of Polycystic Ovary Syndrome. What causes it, and — what can you do to free yourself from this PCOS-related hairiness?

Do you suffer from Polycystic Ovary Syndrome and do you have hair in places you'd rather not have hair? You are not alone, but that doesn't mean you want to keep that extra hair. What are your options for treating hirsutism caused by PCOS?

Why Does Polycystic Ovary Syndrome Cause Excess Hair Growth?

Many people think of Polycystic Ovary Syndrome as a "reproductive system disorder", but PCOS is so much more than that. Characterized by polycystic ovaries, hyperandrogenism (excessive androgen levels), irregular periods that are often anovulatory, and frequently insulin resistance, Polycystic Ovary Syndrome is a "life course" disease that impacts patients' hormonal, metabolic, and cardiovascular health. [1]

Hirsutism, or prolific hair growth in women, is a very common manifestation of the high androgen levels that represent one of the main characteristics of PCOS. An estimated 70 percent of women with Polycystic Ovary Syndrome have hirsutism [2]. 

Nine out of 10 women with hirsutism who menstruate normally, and thus don't seek attention for menstrual irregularities, are found to have PCOS once they have an ultrasound of the reproductive organs. [3]

If you have hirsutism, you will notice significant hair growth in places where men, but not women, typically have hair:

  • The upper lip and chin (mustache and beard area)
  • The chest
  • The stomach, around the belly button
  • The back

Not only are you likely to have more hair in these places, the hair is typically darker and coarser than it is in most women as well.

Do you think your hair growth is excessive? If you talk to your doctor about it, he or she will use a special scoring system to assess your hair growth, potentially leading to a diagnosis of hirsutism. [4]

Many women will dislike their excessive hair growth so much that they will seek out treatment to get rid of it. Even if you're otherwise absolutely fine with your hair, however, you should keep in mind that hirsutism is a symptom of a wider problem — high androgen levels. Since these high androgen levels can also lead to much more significant health issues like infertility, type 2 diabetes, and obesity, seeking treatment is recommended. 

Medical Options To Limit PCOS-Related Excess Hair Growth

A very significant portion of women with Polycystic Ovary Syndrome — around 44 percent — is overweight or obese [5]. Since obesity is associated with higher serum androgen levels, being obese will also exacerbate your hirsutism, and losing weight may reduce the proliferation of your hair growth by itself, or it will make other treatments for excess hair growth more effective [6]. 

Those women who are interested in losing weight with PCOS should follow a low glycemic index diet plan for PCOS [7] and exercise regularly. Should diet and lifestyle changes not result in (sufficient) weight loss, the drug Metformin [8] and hormonal contraceptives [9] are common next steps. 

Medications that have been shown to lead to an improvement in hirsutism among women with PCOS include:

  • Flutamide, an anti-androgen drug
  • Spironolactone, a diuretic
  • Oral contraceptives, which help regulate your hormones
  • Cyproterone acetate (Androcur), an anti-androgen and progesterone drug, in combination with birth control pills
  • Thiazolidinediones, medications for type 2 diabetes
  • Finasteride 
  • Metformin [6]
  • Ketoconazole, an anti-fungal drug
  • Danocrine (Danazol), also used to treat endometriosis [10]

You will have noticed that some of the treatment options for PCOS-related excess hair growth are the same as treatment options for weight loss with PCOS. Not all of these medications are suitable for everyone; each has their own set of contraindications, and not all are safe for women who are trying to get pregnant with PCOS. Once you let your doctor know that you would like to take steps to treat your hirsutism, your doctor and you will decide which medication or combination of medications is best for you. 

Cosmetic Hair Removal Options For Hirsutism Caused By Polycystic Ovary Syndrome

Shaving remains the quickest, cheapest, and arguably easiest way to get rid of unwanted body hair. You may, however, get rather fed up with shaving, and your hair will come back as quickly as it was shaved off. 

Other tried-and-tested hair removal methods are:

  • Threading
  • Tweezing 
  • Waxing
  • Hair removal creams

These hair removal methods all have some unpleasant things in common — they have to be repeated periodically, and they can cause redness and irritation of the skin. That is why you may prefer to opt for a permanent hair removal method, and you have two at your disposal. The first is electrolysis, in which the growth center of each individual hair is exposed to an electric current. You may also be considering laser hair removal, which targets the roots of your unwanted hair with concentrated pulses of light. 

Both laser hair removal and electrolysis require several sessions. Research shows that laser hair removal is much more effective than electrolysis, however, and also less painful. [11]

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