Examining the chin and upper and lower abdomen is a reliable, minimally invasive way to screen for excessive hair growth in women, a key indicator of too much male hormone, researchers report.
The researchers wanted to find a way to identify this problem in women that was as non-intrusive and accurate as possible. They believe this approach is approximately 80 percent accurate and will be less traumatic for women in many situations than the full body assessments currently used.
In addition to cosmetic concerns, women with excessive hair growth, or hirsutism, are often overweight with menstrual dysfunction and diminished fertility related to problems with ovulation. Symptoms can begin in childhood. Hirsutism also is highly correlated with polycystic ovary syndrome, or PCOS, a major cause of infertility as well as a significant risk factor for diabetes and heart disease. PCOS is a subcategory of androgen excess or excess male hormone, the most common hormone disorder, which affects about 10 percent of women.
So, at least half the women with excess hair growth will be at increased risk for insulin resistance, metabolic dysfunction, diabetes and heart disease. That is why this is such an important marker, the authors note.
Hirsutism the single most defining feature of androgen excess disorder, such as PCOS. Excessive hair growth strikes at the femininity of women. We are talking about terminal hairs that are harder, more pigmented and thicker than the usual soft hairs you see, the researchers explain; they have previously published studies indicating hirsutism is second to obesity in negatively impacting a woman's quality of life.
Diagnosis is a complex process that can include a history and physical exam, quantifying hair growth, measuring male hormone levels as well as an oral glucose tolerance test to determine the degree of insulin excess and diabetes risk, said the researchers. It also requires ruling out syndromes or disorders with similar symptoms such as non-classic congenital adrenal hyperplasia, which the team helped differentiate.
Current therapies, such as birth control pills to prevent androgen synthesis and the blood pressure medicine, spironolactone, a diuretic that also blocks androgen receptors, treat symptoms rather than causes, the researchers said.
The team is also examining signaling abnormalities in fat - a determinant of insulin resistance - in PCOS patients. Clearly fat in PCOS behaves differently than fat in healthy women of the same weight. Abnormal signals are partially to blame for the abnormal response to insulin, and it is also suspected that the signaling abnormalities are good treatment targets, say the authors.
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