Natural body phases and glandular disorders can cause some hair problems.
Some may be endowed with heavy brows, some a shadowy upper lip, chin or sideburns. But it is our hormones and our unique genetic makeup that dictate or influence the patterns of hair growth in most of us.
Hair growth can often be traced to testosterone, a potent male hormone. Both sexes produce testosterone in their bodies, but to different degrees, of course. Testosterone stimulates hair growth on the face and body. Generally, the more testosterone, the faster and coarser body and facial hair will grow.
It can have the opposite effect on male scalp hair, causing it to thin. Estrogen and progesterone are female hormones. Like testosterone, both sexes have these hormones in their bodies. The female hormones stimulate thick hair growth on the scalp while minimizing body and facial hair. An imbalance in any of these hormones — caused by any number of reasons, including puberty, pregnancy and menopause — can alter hair-growth patterns.
Puberty and hair growth
Changes in hair-growth patterns are proceeded by hormonal changes. Hormonal changes are normal in adolescent girls. Hair growth in pubic and under-arm areas is normal. But body and facial hair may also become more prominent — a somewhat more male hair pattern emerges. Once a hair growth pattern becomes established, it usually stays.
Male hair patterns in women
Some women may find that their hair distribution is starting to follow a male hair pattern of increased body and facial hair. It is likely that her testosterone level is increasing. It would be safe to assume that if hair is quite visible in several of the following areas, then there may be an androgen excess: Upper lip, chin; sideburns; throat; cheekbones; neck; chest; breast; abdomen (triangular area extending from pubic area to the belly-button with a possible line continuing upward to the chest); thighs (particularly the inner thighs); buttocks; lower back and forearms (but only if hair is excessively coarse and long).
Menopause and hair growth
Menopause is another natural phase which is characterized by hormonal change. Because of genetic factors, few women respond alike, but the result is often increased facial hair and decreased body hair. One doesn’t actually grow new hairs. Rather, fine hairs grow longer, become darker and coarser. Plucking can accelerate this process, but does not stimulate new hair growth as is commonly believed.
Pregnancy and hair growth
Pregnant? Your body is going through all sorts of hormonal changes, an increase mostly in estrogen but also in androgens. Perhaps you’ve noticed a shadow on your upper lip where none was before? Don’t panic. After the birth of your child, the new hair growth will probably subside.
It is more common during pregnancy to notice that facial and body hair growth is reduced while scalp hair becomes thick and luxurious. After breast feeding has been discontinued, the dormant follicles will quickly produce new hair, and scalp hair often sheds dramatically.
Aging and hair growth
Although spurts of hair growth are common during many phases of a woman’s life, hair may also change “progressively” as you age. This may mean a few more hairs popping up in facial areas while body areas become more hair-free.
Hormone levels and hair growth
A high level of testosterone by itself should not ring any warning bells unless it is excessively high or accompanied by other symptoms. Excessive hair growth (hirsutism) may be accompanied by other symptoms, such as skin problems, obesity and irregular or painful periods.
In any of these cases, a doctor should be consulted. The most commonly diagnosed glandular cause of hirsutism is polycystic ovaries (ovaries having multiple cysts). Although this condition may also result in an abnormal menstrual cycle, acne, obesity and infertility, it may also be asymptomatic. Surgery may be necessary.
Abnormal tissue growth on any endocrine glands, such as tumors, cysts, neoplasms etc., could result in an increased hormone production. If the net result is an increased androgen output, hair growth will increase. Surgery may be necessary to remove the gland or portion of it.
Diagnosing the cause of hair growth
A series of blood tests will give a doctor the first clue as to the source of androgens and the offending gland. Further ultrasound or CT scan, and/or laparoscopy (internal ovarian exam) may also be required. In a rare cases, a glandular tumor is discovered which is spewing out so much male hormone that other male characteristics develop. These are called virilizing tumors and cause changes in muscle development, fat displacement, deepening of the voice and enlargement of genitalia.
The “normal” range of total serum testosterone by the way, is quite broad (20-90 ng/dl), with most women somewhere between 30 and 40. Levels between 60 and100 hint at an underlying problem, while values above 100 are definitely considered abnormal.
Because a majority of hirsute women have serum testosterone levels at the high end of the normal range, other hormonal readings should also be taken. Free testosterone (total testosterone consists of bound and “free” testosterone) should also be measured as it is a more accurate indicator. A variety of other hormones may be checked as well.
Medications and hair growth
If an elevated, but normal level of testosterone is detected, and if the patient is insistent enough, a doctor may prescribe birth control hormones, Prednisone or Dexamethosone (steroids), or other non-hormonal, anti-androgens such as Spironolactone or Cyproterone Acetate. These may provide some improvement. Although existing hairs will not decrease, the problem may stabilize. Patients receiving these drugs should always be aware of the many unpleasant side-effects they can produce. Birth control pills, which are sometimes prescribed to reduce hair growth, can ironically also stimulate hair growth. A very significant number of young women who experience hair growth on breasts, abdomen and facial areas can attribute it to the pill. Most of the growth will appear within the first six months of going on the pill. The amount and type (synthetic or non-synthetic) of male hormone and progesterone that comprises the pill determines whether hair growth will be affected negatively or positively.
Drugs such as cortisone, or any hormone containing medications, as well as some hormone-free medications are well-known for producing hair growth as a side-effect. The side-effects cease upon discontinuation of the medication but hair growth which has become terminal (pigmented and visible) will not be reversed.
Hysterectomies, excess weight & stress
Women who undergo partial or complete hysterectomies may occasionally find facial hair growth increasing due to the hormonal change which occurs.
Many physicians have begun suggesting to patients who are overweight that a loss in weight may reduce facial hair growth. Estrogens can be produced in peripheral fat deposits. These additional hormones, by upsetting the balance, can actually cause the production of more testosterone, resulting in hair growth.
Intense or prolonged stress is another big factor in facial hair growth that is now being recognized. Just as stress and the resulting increase in testosterone can cause acne, so can it stimulate hair growth.