Hirsutism is excessive hair growth on the body and face, women have male(androgennomu) type. Is characterized by the appearance of hair on the upper lip, Chin, chest, back and abdomen. If HIRSUTISM often observed violation of the regularity of the menstrual cycle, uterine bleeding, infertility, anemia. Light degree of hormone changes may not require treatment. Hirsutism expressed need for long term care (from 6 to 12 months)and eliminating the causes (polycystic ovarian tumor or tumor of the adrenal gland, the pituitary gland, the syndrome itsenko-kushinga) to stop hair growth. To get rid of the junk inthe patients with girsutizmom help various cosmetology techniques.
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Hirsutism
Causes of HIRSUTISM
Classification of HIRSUTISM
Symptoms of HIRSUTISM
Complications of HIRSUTISM
Diagnosis of HIRSUTISM
Treatment of HIRSUTISM
Forecast for HIRSUTISM
Hirsutism treatment in Moscow
Hirsutism is excessive hair growth on the body and face, women have male(androgennomu) type. Is characterized by the appearance of hair on the upper lip, Chin, chest, back and abdomen. If HIRSUTISM often observed violation of the regularity of the menstrual cycle, uterine bleeding, infertility, anemia. Requires prolonged treatment (from 6to 12 months) and the removal of the cause (or polycystic ovarian tumors, tumors of theadrenal, pituitary, syndrome itsenko-kushinga) to stop hair growth.
Hirsutism is observed in approximately 2-10% of women and can be so pronounced that forces women to resort to various methods of mechanical removal of excessive hair. With the growth of gross, HIRSUTISM pigmented hair pinned in androgen-dependent areas that have a heightened sensitivity to the male sex hormones-androgen: on the face, chest,around the areola of the nipple on the abdomen, back, thighs. Hirsutism is not only acosmetic problem, but evidence of the serious pathological processes in the body that require correction by the gynecologist and endocrinologist.
Hirsutism should be distinguished from Hypertrichosis, where hair growth occurs inandrogen-independent zones.
Causes of HIRSUTISM
If Hirsutism is thin, soft vellus hair is clear, under the influence of a number of factors are inTerminal-the long, hard and pigmented. Among the causes of HIRSUTISM, the mostfrequently encountered giperandrogeniâ, the family factor, side effects of medications and idiopathic excess androgens.
Giperandrogeniâ, or increased production of androgens (male sex hormones) can developunder the following conditions:
disorders of ovarian function in the syndrome polikistozhnykh ovaries, ovarian tumors,ovarian gipertekoze, chronic Anovulation, gipotalamicescoy amenoree and others. Hirsutismovarian origin characterized by disorders of menstruation, infertility, ovarian hypertrophy.
disorders of adrenal function in congenital or acquired adrenal hyperplasia of adrenaltumors, etc. Hirsutism nadpočečnikovogo Genesis develops due to increased production of adrenal steroid hormones, including androgens.
disorders of pituitary functions of the syndrome Itsenko-Kushinga, akromegalia,prolaktinome, etc. Hirsutism pituitarnogo origin is due to a primary pituitary lesion with the further involvement of the adrenal glands and is characterized by increased secretion of cortisol and androgen.
The development of the family (or genetic) Hirsutism is a result of genetic and chromosomal characteristics, experienced over several generations in some families orethnic groups. Most often observed in HIRSUTISM of Caucasian-Mediterranean women, rarely in Northern European and Asian.
Reception of a number of medicines has the side-effect of the development of HIRSUTISM.This is hormones (hydrocortisone, cortisol, etc.), anabolic drugs, progestogens, androgens,streptomycin, acetazolamide, interferon, Cyclosporine, minoxidil, diazoxid, carbamazepine, etc.
Hirsutism due to unknown causes, is called idiopathic syndrome of excess androgens. Whenidiopatičeskom had sensitivity to HIRSUTISM androgen receptors of the skin and hair follicles. Manifestations of idiopathic HIRSUTISM less pronounced hormonal abnormalitiesare minor, the menstrual cycle and reproductive function usually is not violated.
Causes of HIRSUTISM can also serve as a physiological age and condition of the womanduring which there has been a shift in the balance of estrogen and androgen (pregnancy,postmenopauza).
In 90% of cases of HIRSUTISM due to polycystic ovarian syndrome or idiopathic syndrome.
Classification of HIRSUTISM
In accordance with the reasons of excess owolosenie, in Endocrinology, there are severalclinical forms of HIRSUTISM:
nejroèndokrinnyj: nadpočečnikovyj, pituitarnyj, ovarian HIRSUTISM;
dermatological or constitutional: family, idiopathic HIRSUTISM;
iatrogenic or exogenous-drug-dependent HIRSUTISM.
According to the degree of association with other disabilities are hormone changes:
actually HIRSUTISM;
Hirsutism, weighed down by a hyperactive piloseborejnym complex (acne, acne, etc.);
Hirsutism with ovulation;
Hirsutism combined with signs of virilization.
Symptoms of HIRSUTISM
The main manifestation of Hirsutism is male type of body hair growth in women, i.e. growthof short, tight, Pigmented hair on the face, chest, around the areola of breast, back,abdomen, inner thighs, buttocks.
Other symptoms of HIRSUTISM are increasing acceptance of the skin and hair, acne, alopecia, as a consequence of increased Androgen levels. Often, Hirsutism is accompanied by disordered menstrual function (irregular menstrual periods, amenorrhea) and infertility.
In the future, if HIRSUTISM due giperandrogeniej, women often develop signs of virilization,i.e. men features: increasing muscle mass, the voice coarsens, a hair at the temples,increases libido, decreased breast size, male body fat localization changes on the body.Giperandrogeniâ causes changes on the part of the female genitalia: clitoris increasing,decreasing the labia, vaginal lubricants education ceases.
To assess the severity of HIRSUTISM used different quantitative metrics. The only person is scored on a scale from "0" to "+4" where "+1" is the presence of hair on the upper lip orChin, and "+4"-a well developed beard.
On another level of HIRSUTISM counting scale determined by calculating:
"hormonal number (sum of points defining the quantitative and qualitative growth of hair onthe upper lip, Chin, chest and mammary glands, upper and lower back, upper and lowerabdomen, shoulders and hips);
"indifferent number (sum of points defining the quantitative and qualitative growth of hairon the forearm and lower leg);
"girsutnogo number" (the amount of "indifferent" and "hormonal" numbers at a rate less than 12 points, on average, 4.5 -4.6 points).
However, these estimates are largely subjective and important only to assess the dynamics of enlargement or reduction of hair growth, with the ongoing treatment or with the progression of the disease.
Complications of HIRSUTISM
The hormone changes may be complicated by violations of menstrual function, infertility,pathological uterine bleeding, anaemia. Hirsutism in cystic ovaries is often combined with diabetes mellitus.
Diagnosis of HIRSUTISM
When history in patients with girsutizmom it is necessary to clarify the following points:
1. the nature of the disease:
the gradual increase in body hair, accompanied by the appearance of acne, increased body mass index, irregular menstruation, often testifies in favor of cystic ovaries.
the dramatic development of HIRSUTISM with virilization symptoms, most commonly seen inandrogen-secreting tumors.
2. Medicinal history.
3. the nature of the menstrual functions. In patients with a regular menstrual cycle is usuallyidiopathic HIRSUTISM or family nature and do not require in-depth examination.
To clarify the nature of HIRSUTISM conduct laboratory tests to determine the content of the following hormones in serum:
total testosterone (testosterone content < 200 ng%, declining when taking prednisone ororal contraceptives, suggests polycystic ovaries; at concentration > 200 NG%-neoplasticovarian lesion);
dehydroepiandrosterone sulfate (DHEAS)-indicator of the activity of secretory function of the adrenal gland (at a concentration of DHEAS > 700 NG%, decreasing withdexamethasone, adrenal hyperplasia; suspect elevated levels of DHEAS, makes one thinkabout tumor in the adrenal glands);
androstenedione (increased concentrations of androstenedione is observed with the pathology of the ovary);
17-hydroxyprogesterone-intermediate metabolite steroid hormones of the adrenal gland(increases in congenital adrenal hyperplasia forms);
cortisol (concentration increases in the syndrome itsenko-kushinga);
gonadotropins (LH concentration increases relative to FSH for ovarian polikistoze).
To determine the causes of Hirsutism is gynecologist, adrenal and ovarian cancerULTRASOUND, CT, MRI of adrenal glands and other organs, MRI of the brain. To excludemalignant processes in the ovaries is performed diagnostic laparoscopy.
Treatment of HIRSUTISM
Light degree of HIRSUTISM, not accompanied by violations of menstrual function, does not require special treatment.
Since Hirsutism is usually an independent disease, and not a manifestation of other pathologies, his treatment is aimed at removing the primary etiological factor (removal oftumors in the pituitary or adrenal glands, ovaries, removal of drugs that cause hair growthtreatment for hypothyroidism, syndrome Itsenko-Kushinga or acromegaly, etc.).
Medicinal therapy with Hirsutism is prescribed after the exclusion of androgen-secretingtumors. Since Hirsutism is a consequence of the giperandrogenii, to the appointmentantiandrogennogo drugs action, suppressing testosterone levels and decreasing androgensensitivity to hair follicles.
In congenital adrenal hyperplasia is form cortisol, prednisone or dexamethasone. To suppress excess androgen during ovarian polikistoze prescribe oral contraceptives (Janine,Diane-35, etc.), al′dalakton (spironlakton), clomiphene. Hormonal drugs treatment cycletakes between 3 to 6 months, sometimes cycles have to be repeated. Be aware of theserious contraindications to treatment of antiandrogenami during pregnancy, as well as the fact that these drugs prevent new hair, but did not reduce the existing.
If HIRSUTISM, overweight, accompanying patients recommended the diet with lowcarbohydrate content.
Cosmetic treatments for HIRSUTISM help remove or make less visible unwanted hair. Theyinclude Dodge, plucking, shaving, waxing bioèpilâciû or special creams, hair removal and so on Moderately expressed manifestations of hormone changes are masked hairdiscoloration hydrogen peroxide. Constant plucking and shaving the hair can cause scarringor skin infections. Chemical depilation is not effective on thick and coarse hair. The mosteffective method of getting rid of hair with Hirsutism is the hair removal or laser hair removal, destroy the hair follicle and stops the growth of new hair.
Forecast for HIRSUTISM
Many women suffering from girsutizmom, developed serious psychological complexes, tofull-fledged family and intimate life, hindering communication in society.
Treatment of HIRSUTISM, the effect of reducing the long-term hair growth becomes evidentonly after 6-12 months. When treating HIRSUTISM new hair growth is halted, but the hair does not disappear. So completely get rid of excess hair growth with Hirsutism is not possible, although slow down their growth is realistic.
