Excessive hair growth, also known as hirsutism, can be distressing and may signal underlying medical conditions. While some cases are benign or related to genetics, others may indicate hormonal imbalances or rare medical issues. Here’s what you need to know about evaluating and testing for sudden or excessive hair growth.
1. Common Causes of Excess Hair Growth
- Genetics (Idiopathic Hirsutism): For many women, excess body or facial hair is simply a genetic trait. This is particularly true if there is no change in your menstrual cycle or other health concerns.
- Polycystic Ovary Syndrome (PCOS): One of the most common causes, PCOS, leads to hormonal imbalances, including elevated androgens (male hormones) that can cause excessive hair growth.
2. Rare Causes to Consider
- While PCOS and genetics are common, sudden or severe hirsutism may require investigation into rare causes such as:
- Adrenal Gland Disorders: Conditions like Cushing’s syndrome or congenital adrenal hyperplasia (CAH) can lead to overproduction of androgens.
- Male Hormone-Producing Tumors: Tumors in the ovaries or adrenal glands can produce excess testosterone, contributing to sudden hair growth.
- Genetic Mosaicism: Rare genetic variations, such as Y-chromosome mosaicism, may also contribute to excess hair growth.
3. Key Questions Your Gynecologist Will Ask
Your gynecologist will gather information to determine the potential cause of excess hair:
- Menstrual Cycle and Weight Changes: Irregular periods and weight gain may point to PCOS or hormonal imbalances.
- Timing of Hair Growth: Hair growth that began during puberty is less likely to indicate a serious issue, while sudden hair growth in adulthood warrants investigation.
- Family History: Genetics play a significant role, so understanding family patterns of hair growth is important.
- Medications and Supplements: Certain medications, like steroids or hormonal drugs, can cause excessive hair growth.
4. Testing for Excess Hair Growth
Based on your symptoms and medical history, your doctor may order specific tests:
Hormonal Testing
- Testosterone: Elevated levels can indicate PCOS, adrenal disorders, or androgen-producing tumors.
- DHEA-S (Dehydroepiandrosterone Sulfate): High levels may point to adrenal gland issues.
- 17-Hydroxyprogesterone: Used to diagnose congenital adrenal hyperplasia (CAH).
- Cortisol: To check for Cushing’s syndrome.
Imaging Tests
- Pelvic Ultrasound: To evaluate for ovarian cysts (commonly associated with PCOS).
- CT or MRI of Adrenal Glands: To identify potential adrenal tumors.
Other Tests
- Thyroid Function Tests: Hypothyroidism or hyperthyroidism can sometimes be linked to changes in hair growth.
- Genetic Testing: In rare cases, testing for genetic mosaicism or other chromosomal abnormalities may be indicated.
5. Other Considerations
- Ethnicity and Hair Growth Not a Given, You May Still Need Testing: Hirsutism is equally likely in women of all ethnicities, including Black and White women, and the causes are generally the same.
- Hair Loss vs. Hair Growth: If you’re experiencing hair loss in addition to excess hair growth, the underlying causes differ and require separate evaluation.
- Localized Hair Growth (e.g., Buttocks): Hair growing in unexpected areas may sometimes be due to trauma, infection, hormone use or skin conditions, which can also be evaluated and treated.
6. When to See Your Doctor
If you’ve noticed sudden, excessive hair growth or other accompanying symptoms like irregular periods, significant weight changes, or hair loss, it’s time to consult your doctor. Early evaluation can help determine the cause and guide appropriate treatment.
7. Resources for Further Reading
- American College of Obstetricians and Gynecologists (ACOG): Hirsutism
- Endocrine Society: Hirsutism Evaluation
- Mayo Clinic: Hirsutism Causes and Diagnosis
Sudden or excessive hair growth can be unsettling, but with the right medical evaluation, it’s possible to identify the cause and develop a management plan that works for you. Don’t hesitate to reach out to your healthcare provider if you’re experiencing concerning symptoms.
