Hirsutism causes
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Overview
Causes
The cause of hirsutism can be either an increased level of androgens (male hormones) or an oversensitivity of hair follicles to androgens. Male hormones such as testosterone stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass.
Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.
It is speculated that insulin, at high enough concentration, stimulates the ovarian theca cells to produce androgens. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Again, the result is increased androgen production.
The following may be some of the conditions that may increase a woman's normally low level of male hormones:
- Polycystic ovary syndrome
- Cushing's disease
- Tumors in the ovaries or adrenal gland (cancer)
- Congenital adrenal hyperplasia
- Insulin resistance
- Drugs like Ciclosporin, conjugated estrogens, Desogestrel and Ethinyl Estradiol, Dexamethasone, ethynodiol diacetate and ethinyl estradiol, Ethosuximide, Fluoxymesterone, Methyltestosterone, Oxandrolone, Oxymetholone, prednisolone, Tiagabine