Excessive Hair Growth in Women – Symptoms, Causes, and Treatment Methods

Excessive terminal hair growth following a male-pattern distribution in women—clinically termed hirsutism—may arise from a spectrum of endocrine disorders and metabolic derangements. The predominant etiologic factor is polycystic ovary syndrome (PCOS), a condition characterized by chronic hyperandrogenism (elevated androgen secretion) and ovulatory dysfunction. During puberty, a transient physiological increase in androgen levels facilitates phenotypic maturation: pubic and axillary hair emerges, and secondary sexual characteristics develop. In healthy adolescents, this hormonal surge resolves spontaneously upon completion of pubertal development. However, persistence of hyperandrogenism leads to the clinical manifestation of PCOS, with hirsutism serving as a cardinal feature. Pathological androgen overproduction may also originate from hormone-secreting neoplasms, such as ovarian or adrenal cortical tumors. While the adrenal glands physiologically synthesize androgens in both sexes, circulating levels in women remain substantially lower than in men. A less common but significant cause is congenital adrenal hyperplasia (CAH), which disrupts steroidogenesis pathways. Additional contributing factors include visceral obesity, hypothyroidism, eating disorders such as anorexia nervosa, and chronic psychological stress. Hirsutism is frequently accompanied by comorbid conditions that further impair quality of life: acne vulgaris, androgenetic alopecia, insulin resistance, and menstrual irregularities ranging from oligomenorrhea to amenorrhea. Fortunately, contemporary endocrinological interventions offer effective management strategies to mitigate symptoms and enhance patient well-being.

As with any disorder, the most important thing here is to identify the cause of the disorder. Depending on the cause, surgical procedures are used. If a tumor is responsible for excess androgen secretion, or pharmacological therapy to balance the hormonal economy (there may also be oral contraceptives). As the cause is discovered earlier, the more easily and effectively a defect can be cured. In addition to self-treating, women also try to remove the cause by cosmetic means, which is not always possible.