Polycystic ovary syndrome (PCOS) is a condition where the female body produces excessive amounts of male sex hormones. These male hormones, called androgens, affect a number of body systems in the female body.
One of the most common symptoms of PCOS is excessive hair growth on the face, especially in the area above the upper lip. This condition is called hirsutism. It affects about 50% of women with PCOS and 25% of women without PCOS. In women with PCOS, hirsutism often becomes worse during pregnancy and is usually temporary after delivery.
While hirsutism often improves during pregnancy for some women, for others it does not resolve entirely. Therefore, you may continue to have some type of facial hair after delivery if you have had it before pregnancy or are pregnant again (recurrent hirsutism). To learn more about this condition and treatment options for it visit our site: Hirsute Hair Loss Treatment.
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What are the causes of hirsutism?
Hirsutism can be caused by two main conditions: acne and hormonal changes caused by certain medicines or medical conditions like diabetes mellitus or thyroid dysfunction. Hormonal therapy can also cause hirsutism in some individuals. This typically occurs when the prescribed medication causes a sudden rise in testosterone levels.
People with acne also often have hirsutism. This is because the follicles that produce excessive hair are the same ones that cause acne breakouts (see page Acne). When you have a hormonal imbalance caused by your thyroid function or when you are using certain medications, these same follicles also grow rapidly and sometimes in an abnormal way. This results in more sebum being produced than the follicle can handle, causing it to enlarge and produce more hair than normal. These enlarged follicles are called polycystic ovaries.
As long as you have this polycystic ovary syndrome, you will continue to be affected by hirsutism. Even if you do not develop acne, your body still produces too much androgen hormone leading to excessive facial hair growth (hirsutism). As we mentioned above – if there is no acne at all – this may indicate an underlying disorder such as anovulation, hyperprolactinemia, or hyperandrogenemia. See Treatment Options for Hirsutism in Pregnancy.
Thyroid Dysfunction / Hyperthyroidism / Hypothyroidism / Diabetes Mellitus
Hyperthyroidism: This is when the thyroid gland produces too much hormone. The symptoms include a hot feeling in the face, hands, and feet, nervousness, increased appetite, and weight gain. Sometimes this can be accompanied by excessive hair growth (hirsutism).
Hypothyroidism: In hypothyroidism, the thyroid gland does not produce enough hormones. This can also cause excessive hair growth (hirsutism) as well as poor memory, confusion, and depression. Sometimes you may also get cold intolerance during this condition. As you may expect, women with hypothyroidism often have a goitre (swelling of the thyroid). The cause of a goitre is not known but it is thought to be related to high levels of estrogen [. This occurs more often in menopausal women. You will be more likely to have an enlarged thyroid if your mother had hyperthyroidism or hypothyroidism or if you are female herself. Some people also notice that they have an enlarged thyroid when their body doesn’t make enough iodine after having been exposed to radioactive iodine such as during the Chernobyl nuclear disaster (see page Radiation). If you were born before 1950 you are likely to have a low iodine intake, and you can read about this on page Iodine Deficiency.
This is when the pancreas cannot produce enough insulin to regulate blood sugar levels. This will lead to high blood sugar levels (hyperglycaemia) as well as a change in the way the body uses insulin (insulin resistance). As a result, people with diabetes often have increased hair growth or hirsutism. You may also get swollen feet and hands. Sometimes this is accompanied by a goitre (swelling of the thyroid). This condition will be managed by your doctor. He may advise you not to use topical treatments like minoxidil which is sold over-the-counter for treating hair loss but only under his professional supervision (see page diabetes mellitus).
In addition, there are other medical conditions that can cause hirsutism including polycystic ovary syndrome (see page Acne), Cushing’s disease, Addison’s disease, hyperprolactinemia, and premature menopause, and Turner’s syndrome . In women who have had breast cancer or those with Paget’s disease of the breast, they are more likely than others to develop hirsutism.
Treatment Options for Hirsutism in Pregnancy
You can’t just stop using the treatment that you’ve been using and expect the problem to go away. The only option is to reduce your hair growth by changing your skincare routine and stopping using hair growth products. This will not get rid of all the hairs or make them fall out, but it will be noticed that they are thinning out (thinning hair). For advice on how to manage your condition, talk to a healthcare professional who is experienced with hypertrichosis (excessive hair growth) such as a dermatologist or a plastic surgeon who has experience treating women with hypertrichosis. If you were born before 1950 you may be more likely to have thyroid problems and in this case, speak to your doctor about getting a check-up at least once a year. You can read about other forms of hirsutism including male hirsutism in ‘Hair Loss’ page.
Hormonal Imbalance and Menstrual Problems During Pregnancy / The Menstrual Cycle During Pregnancy / Progesterone Therapy in the Third Trimester of Pregnancy / Progesterone Therapy and Breastfeeding / Hormonal Therapy During Pregnancy
In the normal menstrual cycle, levels of the female sex hormones oestrogen and progesterone rise at the start of menstruation, causing a surge in hair growth. Once ovulation has occurred (the egg is released from the ovary), levels of oestrogen fall while progesterone rises (see page Oestrogens). At this point, you should start to see thinning hair and then some shedding. After menstruation, there is a further drop in hormone levels. By this stage, more hairs are falling out but your hair is now on its way down. If you have anovulatory cycles then your cycle will be irregular, which could affect how much you shed during pregnancy.
Women who have polycystic ovary syndrome often have irregular cycles as well. If you have a premenstrual syndrome or mood swings or if your partner’s period starts earlier than usual you may also notice that these symptoms occur before your period begins (see page PMS). The good news is that most of these conditions don’t usually persist after birth or cause any problems for the baby.
Hormones can be affected by many things during pregnancy such as the use of certain medications, having a poor diet, not being physically active, or having an eating disorder. If you have these conditions, talk to your healthcare professional to see what you can do to improve them.
If you’re in your first trimester and notice that your period has stopped or started early then speak to your doctor about it as soon as possible. Early spotting is common and if it persists for more than seven days then it’s usually nothing to worry about. However, if it lasts for longer than four weeks then you should talk to a healthcare professional because it could be a sign of one of the problems described above.
Your doctor will also want to make sure that everything is OK in terms of your weight and blood pressure so ask them about this too (see page Blood pressure). If these are all normal then there is no need for an immediate ultrasound scan; however, if they are not normal, particularly if you have already been pregnant before or are overweight or have high blood pressure, then get yourself checked out by a healthcare professional.