Hirsutism is a condition where a woman has male-pattern hair growth. It results in excessive coarse dark hair where women don't generally have hair, such as the face, chest and back. It can happen due to high androgen levels or increased skin sensitivity to androgens caused due to certain medical conditions. Else it could be traced to ethnicity and genes.
Excessively high androgen levels are most often the cause for Hirsutism. Some signs of virilization might be noticed along with Hirsutism such as acne, balding, deepening voice, enlarged clitoris and reduced breast size. Other causes include:
Anti-androgens are often prescribed to block the androgen effect thereby reducing the excessive hair growth. The effect is slow as the hair takes about 6 months to get thinner and less noticeable. Oral contraceptives, Finasteride, Spironolactone and Cyproterone are commonly prescribed anti-androgens.
Women resort to waxing and shaving to get rid of unwanted hair. Depilatories and eflornithine cream are also self-care options. Laser treatment or IPL (Intense Pulsed Treatment) are undertaken to destroy the hair root permanently. They are done over several sittings and must be done under qualified practitioners.
Luteinizing Hormone LH is another important hormone for reproduction. In men, LH promotes secretion of testosterone. In women, LH surge in the second part of the menstrual cycle triggers ovulation. LH is released when a woman is ovulating, and causes the ovaries to release an egg. LH and FSH are closely linked. At the beginning of the menstrual cycle, FSH and LH are secreted to stimulate ovarian follicles. Mid-cycle, the growing follicle will inhibit FSH secretion and increase estrogen. This is a trigger for sudden release of LH that leads to release of the mature egg.
The LH Surge is vital for pregnancy - as it causes the matured egg to be released. The next 24 - 36 hours are the fertile window when a woman can get pregnant. Ovulation Predictor Kits that are available measure LH level in the urine - identifying the best time to conceive. Reduced levels of LH in females indicate ovarian hyperfunction.
LH and PCOS
In females suffering from PCOS - Polycystic Ovarian Syndrome, the LH levels are already elevated when compared to FSH. Since there is no LH surge, ovulation does not take place. Elevated LH levels cause release of androgens from the ovaries leading to acne and Hirsutism. Infertility and miscarriage are common. Studies have shown that there is a direct relation between insulin resistance and elevated LH levels.
In females, the LH levels in the blood can vary based on stage of menstrual cycle, age, pregnancy and other pituitary gland disorders. It can be measured by a blood test or urine test. Usually this test is prescribed for women with irregular periods trying to get pregnant or assessing if a woman has entered menopause. Men with low testosterone levels or having very late puberty are asked to take the LH test.
High levels of Luteinizing hormone are most often caused by ovarian tumors or improperly-developed ovaries. Thyroid or Adrenal disease can elevate LH levels. PCOS and Autoimmune disorders also cause the levels of Luteinizing hormone to rise. Low levels of Luteinizing hormone indicate ovarian failure or primary testicular failure. This can happen due to viral infections such as mumps, autoimmune disorders, radiation exposure and tumors.
Early phase of menstrual cycle: 0.5 to 16.9 IU/L
Peak of menstrual cycle: 8.7 to 76.3 IU/L
Using contraceptives: 0.7 to 5.6 IU/L
Pregnant: less than 1.5 IU/L
Menopause: 15.9 to 54.0 IU/L
Between 20 years and 70 years: 0.7 to 7.9 IU/L
Over 70 years: 3.1 to 34.0 IU/L
Anovulation indicates a situation where a woman is unable to get pregnant as there is no release of ripened egg from the ovaries. While often a woman might have her menstrual periods, ovulation may not be taking place. Often anovulation is a major cause for infertility in women. Anovulation can occur due to stress, reaction from drugs, over-exercising or problems in endocrine system such as progesterone imbalance, congenital adrenal hyperplasia or ovarian failure. Other causes include excessive weight gain, anorexia or bulimia. A woman suffering from PCOS is also likely to suffer to anovulation. Symptoms of anovulation include amenorrhea, absence of PMS symptoms and hirsutism.
Various tests such as Thyroidfunction test, Adrenal function test, LH and FSH tests and prolactin test are conducted to check for possible causes of anovulation. It may be accompanied by pelvic ultrasound, CAT scan and MRI. Treatment with fertility drugs usually solves the problem of anovulation. These include Clomiphene, Gonadotropin and Pergonal. The woman is required to maintain good body weight with right diet and exercise.
Bibliography / Reference
Collection of Pages - Last revised Date: March 23, 2019