Excessive hair growth in a young female

Patient

Q: I heard this could be linked to a thyroid prooblem. I am a 19 year old female with facial and body hair. I began menstrating at age 11. My periods now are HEAVY and irregular. I had always had a little bit of thicker hair, but nothing worth worrying about. I noticed around age 13-14 that my facial and body hair were becoming thicker. All I had done to that point was bleach my upper lip hair. However, the quantity of hair in my sideburns started to increase then eventually thick, darker hairs came. Around that time, thick, dark hairs on my chin came too. I tweezed just those hairs but nothing helped. Things became so bad and frustrating that I eventually just started shaving and have been doing so for the past 4 or so years. At this time, almost my whole chin, my sideburns and some cheek, some of my neck and under my jaw and now beginning on my back all have very thick, coarse, dark hair. Is this a hormone imbalance or something worse?

Doctor

A:   The symptoms you describe are medically known as hirsutism, defined as excessive male-pattern hair growth, and this may affect between 5 and 10% of women of reproductive age. There are several different causes for hirsutism, usually related to hormone imbalances of the sex hormones (androgens) including; polycystic ovarian syndrome (PCOS), congenital adrenal hyperplasia (CAH), an abnormal growth of the adrenal gland or ovary, and insulin resistance syndromes. Coupled with your symptoms of heavy and irregular periods, this could be a manifestation of PCOS. I would advise attending your family doctor for a detailed history of your symptoms and clinical examination. He may perform blood tests to exclude some of the above causes including hormone profiles (including LH:FSH ratio), refer you for an abdominal ultrasound scan or refer you to a specialist for treatment e.g. OBGYN, or endocrinologist.

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