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The PCOS Newsletter is a weekly publication answering one PCOS question at the time so we can be empowered by knowledge.

An issue will land in your inbox each Sunday

PCOS and Excess Hair

This week’s question:

Why do I have excess hair in unwanted places?

The answer:


This is a common symptom of PCOS that can leave women feeling self-conscious and confused.


Approximately 65-75% of women experience this symptom to varying degrees. The excess hair is often referred to as hirsutism, which is defined as the growth of coarse, dark hair in areas where women typically have fine or no hair.


It can be measured using a scoring system called the modified Ferriman-Gallwey (mFG) system, which measures the severity of hair growth across nine different areas of the body.


But, who is to blame?


The main culprits behind this symptom are high levels of androgen hormones, such as testosterone, dehydroepiandrosterone (DHEA), and androstenedione, as well as individual sensitivity to these hormones.


Certain areas of the body, such as the chin or upper lip, are more sensitive to androgen hormones, which is why these areas may have more hair growth. You will notice, man have a lot of hair in these area. The reason for that are the raised levels of testosterone in men. We get hairy faces and they get sexy beard (the inequalities 🙄). Only joking.


So, how do these hormones influence the hair growth?


There are a few ways in which they operate.


1. It makes your hair grow thicker

In humans, there are three types of hair: lanugo, vellus, and terminal hair.

  • Lanugo is the hair babies are born with

  • Vellus hair is the fine hair you may have over your body but it’s hardly visible and lightly pigmented

  • Terminal hair are your eyelashes, scalp hair and eyebrowns.

Androgens transform the fine, minimally pigmented vellus hair in androgen-sensitive areas into coarse, pigmented, terminal hair.


2. It increases the growth phase of your hair

The hair follicle cycles through three phases:

  • anagen, a period of rapid growth;

  • catagen, a period of slow down

  • telogen, a period of rest and shedding of hair

Androgens tend to lengthen the anagen phase. Successive hair cycles and longer anagen duration promotes an increase in follicle size. These larger follicles produce longer, thicker hair.


3. There could be an issue with some enzymes


Hair follicules contain enzymes that can break down these androgens, when in excess. An altered function of these enzymes may be associated with a greater or lesser androgenic activity in the hair follicle.


The result often leads us with hair in unwanted places.


To address this symptom, it is important to speak with your healthcare provider to check your androgen levels. Addressing the underlying cause of the excess hair growth may save you money and time at the beauty salon.

But not all is doom, androgen levels lead to a good libido, better bone density and improved muscle mass. We don’t want to aim for increasing them, but everything in our body is also made to be our friend.


Lots of love,


Fracesca


Sources

1. Matheson, E., & Bain, J. (2019). Hirsutism in Women. American Family Physician, 100(3), 168–175. https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

2. Metwally, M. (2020). Obesity and hirsutism. In Obesity and Gynecology (pp. 77–82). Elsevier.

3. Spritzer, P., Barone, C., & Oliveira, F. (2016). Hirsutism in Polycystic Ovary Syndrome: Pathophysiology and Management. Current Pharmaceutical Design, 22(36), 5603–5613. https://doi.org/10.2174/1381612822666160720151243

4. Spritzer, P. M., Marchesan, L. B., Santos, B. R., & Fighera, T. M. (2022). Hirsutism, normal androgens and diagnosis of PCOS. Diagnostics (Basel, Switzerland), 12(8), 1922. https://doi.org/10.3390/diagnostics12081922


Disclaimer: We are all so unique in our own ways so this information is for education purposes only. Please further consult your healthcare provider about your health needs.

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