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Hirsuitism and Homeopathy
Homeopathic Journal :: Volume: 2, Issue: 11, Sep, 2009 (General Theme) - from Homeorizon.com

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Author : Dr. Rajneesh K. Sharma, M.D. (Hom), B.H.M.S., CMD of Homoeo Cure & Research Institute View Profile

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Definition Excessive growth of facial or body hair in women is called hirsutism (Psora- Sycosis). It is defined as the presence of excessive terminal hair in androgen-dependent areas of a woman´s body. It has to be differentiated from hypertrichosis, which is usually familial in nature and associated with an endocrine dysfunction - such as thyroid dysfunction - or with medications such as phenytoin or minoxidil (Psora). Types of hirsutism It may be

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Primary or idiopathic hirsutism- Idiopathic hirsutism is defined as hirsutism with no other clinical abnormalities, particularly no menstrual irregularity; and using the Rotterdam criteria, no evidence of a multifollicular ovary. It may well be a mild variant of PCOS. It is probably hereditary, because there is usually a family history of the disorder (Psora). Secondary hirsutism- It is most often associated with polycystic ovary syndrome. This type of hirsutism may also be caused by: malfunctions of the pituitary or adrenal glands (Psora) use of male hormones or minoxidil (Loniten), a drug used to widen blood vessels (Causa occassionalis) adrenal or ovarian tumors. (Pseudopsora- Sycosis)

g.Sycosis) Causes of Hirsutism Hirsutism is a sign of increased androgen action on hair follicles (Psora). minoxidil. metabolic disorders –e.Syphilis) Androgen-dependent hirsutism– Increased terminal hair over androgenic regions of the face and upper chest. 90% of cases) 3 13-hydroxysteroid dehydrogenase 11-hydroxylase c. porphyria cutanea tarda. (Psora. Cornelia de Lange and Seckel syndromes. Any condition that increases the blood level of testosterone. phenytoin and progesterone analogues. male sex hormone or androgens (Sycosis) or decreases the sex hormone binding globulin (SHBG) levels (Psora. It is caused by Congenital diseases –e.Sycosis.ACTH overproduction      Pituitary adenomas Tumors that may secrete ACTH.PITUITARY/ADRENAL a. the most common areSmall-cell carcinoma of the lung Tumors of the thymus Pancreatic islet-cell carcinoma b. androgen analogues. anorexia nervosa.Androgen-producing adrenal tumors . drugs –e. deficiencies of:    21-hydroxylase (most common.Syphilis) results in hirsutism.(Psora.g. cyclosporine.Other classification of hirsutism may be as below  Androgen-independent hirsutism– entire body is covered with vellous hair evenly distributed over androgen-dependent and androgen-independent regions. from increased circulating levels of androgens (Sycosis) or increased sensitivity of hair follicles to normal levels of circulating androgens (Psora).g. Causes of Hirsutism 1. anticonvulsants. corticosteroids.Congenital adrenal hyperplasia.

Polycystic ovarian syndrome secondary to adrenal hyperandrogenism 4.Leydig cell tumors c.Polycystic ovarian syndrome b.OVARIAN a.Medications that cause hyperprolactinemia         Metoclopramide high-dose phenothiazines butyrophenones such as haloperidol thioxanthines such as thiothixene methyldopa reserpine estrogens opiates Some of the main conditions causing hirsutism are- .Virilizing ovarian tumors   Granulosa.Idiopathic hirsutism (mostly ovarian) b.Insulin resistance 3.EXOGENOUS MEDICATIONS a.  Adrenal adenomas Adrenal carcinomas 2.Oral contraceptives (uncommon) c.COMBINED OVARIAN AND ADRENAL a.stromal cell tumors Sertoli.Androgens or anabolic steroids b.

and adults. development of male characteristics in women) and rapid progression of hirsutism and cessation of menses. muscle and liver cells.Syphilis. Ovarian tumors. insulin resistance. whereas insulin resistance in liver reduces glucose storage.Sycosis).Sycosis). and is a leading cause of infertility (Psora. Progestins. at high enough concentration..Growing evidence implicates high circulating levels of insulin (sycosis) in women to the development of hirsutism. stimulates the ovarian theca cells to produce androgens (sycosis). Methyldopa. diabetes and obesity are all strongly correlated with PCOS.RA and peripheral androgen metabolism and is involved in evolution of hirsutism in state of hyperprolactinemia (Psora. Most of these conditions involve greater or lesser production of sex steroids and can alter development of primary or secondary sex characteristics in affected infants. lack of regular ovulation and/or menstrual and excessive amounts or effects of androgenic (masculinizing) hormones. treatments that lower insulin levels will lead to a reduction in hirsutism. with both effects serving to elevate blood glucose (Psora. Danazol. High plasma levels of insulin and glucose due to insulin resistance often lead to metabolic syndrome and type.PRL modulates 5. Delayed adrenal hyperplasia. Free testosterone is one of the factors contributing to PCOS symptoms. It is speculated that insulin.Hypothyroidism can lead to a reduction of sex hormone binding globulin (Psora.II diabetes (Sycosis). Metoclopramide. While the causes are unknown. hirsutism. and acne. Pathophysiology of Hirsutism . polycystic ovaries.Also known as hypercortisolism.           Polycystic ovary syndrome (POS or PCOS) –Also known as Stein-Leventhal syndrome. Idiopathic–Most common.Androgen-secreting tumors of the ovary (Psora. There may also be an effect of high levels of insulin to activate the insulin-like growth factor-I (IGF-1) receptor in those same cells. Cushing syndrome. is an endocrine disorder which is the most common hormonal disorder among women of reproductive age. Hyperprolactinemia. Again. Insulin resistance. The symptoms and severity of the syndrome vary greatly between women.It is the condition in which normal amounts of insulin are inadequate (psora) to produce a normal insulin response from fat. Drug induced. Insulin resistance in muscle reduces glucose uptake.Sycosis). Hypothyroidism.infertility. children. the result is increased androgen production (sycosis).Syphilis). Congenital adrenal hyperplasia. The principal features are weight problems. which elevates free fatty acids in the blood plasma.e. Phenothiazines. Further. Insulin resistance in fat cells results in hydrolysis of stored triglycerides.Syphilis) and increase in free testosterone (Sycosis). male pattern hair loss.Syphilis).Anabolic steroids.It refers to any of several autosomal recessive conditions resulting from biochemical paths of the steroidogenesis of cortisol from cholesterol by the adrenal glands (Psora.alpha. Testosterone etc. it is a hormonal disorder caused by an abnormally high circulating level of corticosteroid hormones causing hirsutism (Sycosis). Reserpine.It is due to deficiency of Classical 3ß-hydroxysteroid dehydrogenase (3ß-HSD) (Psora. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute.Sycosis) are usually heralded by virilization (i. Hyperinsulinemia.

in the latter. but the follicle size and type of hair can change in response to numerous factors. androgens transform the vellus hair into a terminal hair. Clinical Picture of Hirsutism . it gets converted into the active form . and pigmented). hormonal regulation plays an important role in the hair growth cycle. Testosterone acts on the hair follicles by converting in to its active form called dihydrotestosterone. and the proportion of time terminal hairs spend in the anagen phase. The role of testosterone Testosterone stimulates hair growth and increases hair size and pigmentation. but also depends upon local factors and variability in end-organ sensitivity to circulating androgens. the sebaceous component proliferates and the hair remains vellus.dihydrotestosterone. In the former case. soft. Hypertrichosis results either from persistence of the lanugo-vellus hairs covering the body of the fetus or from augmented development of hair follicles. in part by reducing the time scalp hairs spend in anagen phase. and not pigmented) or Terminal (long. particularly androgens. Androgens are necessary for terminal hair and sebaceous gland development and mediate differentiation of pilosebaceous units (PSU's) into either a terminal hair follicle or a sebaceous gland. The number of hair follicles does not change over an individual's lifetime. hair fiber diameter. but will manifest with loss of hair in the scalp region.Hair growth cycle The hair growth cycle is comprised of three phases   Anagen (growth phase) Catagen (involution phase) Telogen (rest phase) Depending upon the body site. and is not androgen dependent. Testosterone travels in the blood attached to a protein called sex hormone binding globulin or SHBG. coarse.alpha reductase. Although androgen excess underlies most cases of hirsutism. Androgens increase hair follicle size. Male-pattern hair growth occurs in sites where relatively high levels of androgen are necessary for pilosebaceous unit differentiation. This is thought to result from the fact that stimulation of hair growth from the follicle does not depend solely on circulating androgen concentrations. Androgen excess in women leads to increased hair growth in most androgen sensitive sites. 5. Hair can be categorized as either  Vellus (fine. Hypertrichosis is excessive growth of thin vellus (nonpigmented) hair at any body site. the substance which is responsible for this conversion is found in these hair follicles. there is only a modest correlation between the quantity of hair growth and androgen levels. It is taken to the target areas where the protein releases the hormone. In the target areas.

chest. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass. striae. Main points in evaluating hirsutism are               Abdominal symptoms Family history Breast discharge Extent of hair growth Menstrual. blood pressure (may suggest condition of androgen excess related to adrenal enzyme deficiencies) Documentation of hair amount. and the hairs themselves become larger and darker. acne. fine hairs on her face. the problem is how best to identify the small number of women who have other causes for their hirsutism. A woman whose hirsutism is caused by an increase in male hormones has a pattern of hair growth similar to that of a man. arms. weight. and characteristics Galactorrhea Abdominal and pelvic examination/palpation for masses Physical features of Cushing's syndrome o Striae o Acne o proximal muscle weakness o moon facies o central obesity Signs of virilization o Acne o Clitoromegaly o Deepening of voice o Hirsutism o Increased libido o Increased muscle mass (primarily shoulder girdle) o Infrequent or absent menses o Loss of breast tissue or normal female body contour o Malodorous perspiration o Temporal hair recession and balding Diagnosis Given that most women with hirsutism have idiopathic hirsutism or PCOS. and medication history Skin changes (i.Hair follicles usually become enlarged. distribution. and back.e. acanthosis nigricans) Symptoms of virilization Use of hair removal methods Weight gain Height.. The basic approach to the differential diagnosis should be: . reproductive. A woman whose hirsutism is not hormone-related has long.

Moderately elevated (or higher) serum androgen concentrations. Onset in the third decade of life or later.2 nmol/L) o serum free testosterone values above 2 ng/dL (0.0 U/L 17 OH Progesterone above normalo Follicular <3.6–19.  Documentation of the degree of androgen excess Exclusion of the serious but rare causes of hirsutism such as ovarian and adrenal androgen-secreting tumors There are several clinical findings that suggest one of the rare and more serious causes of hirsutism    Abrupt onset. DHEA-sulfate. or progressive worsening of hirsutism.0–105.18 nmol/L or <1.0 U/L o Luteal phase 0. total & free testosterone. Ferriman-Gallwey score- .6 nmol/L or 3–20 ng/mL Pelvic ultrasonography Testing for Cushing's syndrome Abdominal CT or MRI Laparoscopy or laparotomy Ovarian and adrenal vein sampling Dexamethasone suppression testing Clinical investigation tools GnRH agonist testing Hirsutism profileIt is a battery of tests performed on a female to ID the cause of increased hair growth.0 U/L o Ovulatory phase 22.0 U/L or 2. Symptoms or signs of virilization.0 U/L or 0.07 nmol/L) and o serum dehydroepiandrosterone sulfate (DHEA-S) values above 700 mcg/dL (13.0–15. in young women raise the possibility of an androgen-secreting tumor. short duration (typically less than 1 year). androstenedione. eg.0 U/L or 16.6 µmol/L) Serum prolactin above 20 g/L (0–20 ng/mL) Serum luteinizing hormone (LH) above normal valueso Follicular phase 2.6–19.0–64.0 ng/mL o Midluteal 9.0–64.0–105. 17hydroxyprogesterone. Laboratory Testing             Serum androgens o serum testosterone values above 150 ng/dL (5.0 U/L o Postmenopausal 16.0 U/L or 22. rather than near puberty.54–63. It includes the estimation of 3-alpha-androstanediol.0–15.

Then the grades of all areas are summed. It is the semiquantitative system for the clinical assessment of the presence and severity of hirsutism in the premenopausal woman. A normal hirsutism score is less than 8. Each of nine body areas is graded separately from no hirsutism (grade 0) to minimal hirsutism (grade 1) to marked hirsutism (grade 4). Ferriman-Gallwey scoring Prognosis .One method of evaluating hirsutism is the Ferriman-Gallwey score which gives a score based on the amount and location of hair growth on a woman.

puls. masculine bar-c. ol-j. ol-j. in .growth of hair . but most cases will eventually will respond to a combined approach. phos.growth of hair . thuj. Nat-m. nat-m. Homoeopathic Treatment Repertory of Hirsutism HAIR . mannish looking carb-v. HAIR . HAIR . staph. MANNISH . ign.women. in – Chin ign. calc.women.growth of hair .women. in stram. nat-m.growth of hair – Beard plut-n. bushy med. SULPH. .women. Sep. HAIR . Treatment Management of Hirsutism 1. Mechanical treatment involves bleaching or physically removing unwanted hair by:       cutting electrolysis shaving tweezing waxing using hair-removing creams (depilatories) 2-Secondary hirsutism Treatment of secondary hirsutism is determined by the underlying cause of the condition. HAIR . cortico. HAIR .growth of hair . sabal sep.growth of hair . HAIR . petr. upper cortico. cimic. hydrog. HAIR . lyc. syc.Eyebrows .Lips.growth of hair . thuj. plat. cimic.Primary hirsutism Primary hirsutism can be treated mechanically.Most cases of hirsutism can be treated successfully with medication and cosmetic attention.girls.thick.Eyebrows – Between kali-n. ign. thyr. in – Whiskers calc-s.distribution in women. It may require time and persistent use of these therapies. cortiso.

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