What is Hirsutism and why is it related to PCOS?
Hirsutism is the medical term that refers to the presence of excessive terminal hair in androgen sensitive areas of female body ( upper lip, chin, chest, back, abdomen, arms …).
It is a clinical sign and not a disease in itself; ITS PRESENCE DOES NOT THEREFORE NECESSARILY REQUIRE treatment and that is why you might find difficult to feel supported by doctors.
In fact, the physicians should decide if hirsutism should be treated taking 2 things into account:
1- The severity of the phenomenon by doing some tests we will talk about later
2- The subjective perception of the patient. It is to say, how does the woman feel about it, how does it affect her daily life, how does it repercute in her emotions and, consequently, in her health ( metal or physical).
However, the majority of the time this second criteria is not taken into account and we have to deal with it alone.
Furthermore, when obesity is present, hirsutism is normally more severe, specially in the abdominal phenotype. Another thing we need to take into account is that the diagnosis is right and it is not something called virilisation or Hypertricosis.
There are 3 main kinds of Hirsutism:
idiopathic hirsutism and PCOS hirsutism.
¿Why does hirsutism occurs to me?
You might want to know also that Hirsutism is an alteration in the hair follicle cycle. Normally the hair follicle growth cycle is made up of three major phases: anagen ( a stage of rapid growth), telogen (a stage of relative quiescence), and a catagen (apoptosis-madiated regression) and Hirsutism interfere in a prolongation of the anagen phase with a consequent transformation of vellus into terminal hairs.
This alteration appears under the effect of ANDROGENS that are triggered and involved in the regulation of hair follicles (TESTOSTERONE and DIHYDROTESTOSTERONE or DHT). These hormones are present in both men and women blood, but it is sensitively higher in women with PCOS.
In addition, there is also cutaneous testosterone, which may come from circulation, principally synthesized in the adrenal and ovaries or even it can be lovally generated ( hair follicles are equipped with all necessary enzymes for the biosynthesis and metabolism of androgens)
So if your hirsutism is spreaded for example all over your face, neck, chest… it might be due to the testosterone, generated via a de novo syntethic pathway from cholesterol/ and/or via shortcut pathway from circulating Dihydrotestosterone. That is WHY there are better solutions than taking pills or spending hours and hour shaving yourself. It is possible to reduce cholesteron and testosterone level by following 3 IMPORTANT THINGS:
– Diet low in hormones, low in choresterol and rich in Omega 3 or food that help to balance your hormones.
– Exercise routines that releases testosterone ( there are some kind of sports that actually reases testosterone so we should be careful)
– Emotonal Management Routines since Emotions can surely modify the components of our body ( stress, lack of sleep, sadness, happiness… they all have consequencs in our biochemical components).
All in all, there are also things we can do by ourselves.
First of all, you should know that there are very effective tests such as photo analysis, weight of shaved hair analysis, microscopy evaluation… in order to determine if it must be treated or not. However, all these OBJETIVE method are very expensive and Doctors reuse to carry out the procidement.
That is why they end up using SUBJECTIVE methods. The difference between OBJECTIVE and SUBJECTIVE is that OBJECTIVE doesn´t give space for interpretations or opinions, like mathematics, 2+ 2 = 4 bt, in the other hand, SUBJECTIVE depends on the interpretation of one or more humans. Consequently, depending on the doctor, his or her experience, opinion, mood, education, etc… they will consider it severe enough or not (that is what happen also with hair loss, weight, and any other PCOS symptom).
One of this SUBJETIVE tests they use is the Ferriman-Gallwey test. You migh know it already:
In that test they ask you with of the figures from 1 to 4 do you identify with, they also check your body and point their own professional but SUBJETIVE opinion, which may differ between professionals.
Now that we have some information about what exactly is Hirsutism, why it is related to PCOS , how Doctor determine if it needs to be treated or not and some details we need to take into account when dealing with Hirsutism, should we start SPEAKING ABOUT WHAT TO DO?
First of all, you have options. You can decide to accept your body with hair or without hair. Both ways it is your body, it deserves love and it is beautiful in any way.
For example, I love and admire people who does not let society take part in decisions about their lives but the only IMPORTANT thing is that you deeply believe in your own voice, your own definition of beauty and your freedome. If you really consider you look better without hair, that is perfectly okay! That is your voice, listen to it.
Second, you are able to choose how to feel about it and about the process. That is emotional management and there are hundred of techniques that can help you. For example, you might find more interesting women that don´t care that much about being a bit hairy but you find difficult to be that kind of person. If you would like to become a women that doesn´t care about people´s opinion when it comes to your physical appearance then you should work on EMOTIONAL and BEHAVIOURAL Therapy.
easyPCOSlife believes in you and WILL ALWAYS helo you with the best techniques to feel happy whatever your goals as a woman with PCOS are.
Third, if you decide to have a live without hirsutism because you feel better that way you need to combine Therapy during the process and Physical treatment.
There are cosmetics that help with mild hirsutism, epilotory systems ( laser, intense pulse light, electrolysis, thermolysis), topical medication, Oestrogen and progestin Compounds ( Eps, antiandrogens, Metformin…), lifestyle intervention, weight loss, etc.
It will always depend on your CHARACTERISTICS as an individual and your OWN goals.
There are not 2 identical persons, so there are not 2 women diagnosed with PCOS that need exactly the same.