Introducing the bearded lady...

February 22, 2007 12:02 PM

I'm a hairy woman. What is the criteria for being "hirsute" on a woman? How can I tell if I have PCOS?

I'm a hairy woman.

This is troubling enough. I want to have an idea of whether or not I'm medically "hirsute" before I approach my doctor about this. I'm really embarrassed. I've already seen him for my horrible razor burn on my legs; I have a referral to a dermotologist (though most have been unhelpful about my razor burn). Should I ask the derm about my hairiness?

For the record: I have hairy thighs and dark hair below the knee. I have dark hairs on my breasts, a few on my chin, a mild 'stach, and a dark happy trail. My arms are hairy enough to warrant comment and my back and butt are fuzzy. I even had a rogue hair on my neck this morning, which broke the straw on the camel's back and urged me to post here.

My mom is a bit hairy, but only on her arms. My dad's not outrageously hairy. I asked my mom whether I had a hairy aunt or something, but none's to be found. I have heavy, painful periods and high-normal blood glucose. I'm about ten pounds overweight.

Does this sound like PCOS? Does it sound like a freak mutant gene and I should just deal with it? Is this hairiness benign or is something more sinister going on behind the scenes?

Summer's coming, and I have to wear shorts eventually...

posted by anonymous to Health & Fitness (19 answers total)

As a non-hirsute woman with PCOS, I'd have to say it's possible. Are your periods regular?

If you're going to the dermatologist, also ask him/her if you have any ""acanthosis nigricans", which is another indicator (since you'll be at a derm anyway.)

You also might want to get a referral to a reproductive endocrinologist, who can help control your possible elevated androgen (male hormone) levels.
posted by nekton at 12:25 PM on February 22, 2007

A friend of mine with PCOS says that it caused her to be extra hairy. She had laser treatment and is now fairly hair free. I can't tell you if it what you have, but sounds like it could be... On the other hand I know some girls that are just naturally hairier but thats a combo of having a bit of extra hair, and having that hair be naturally dark. It's hard to notice on people that are really blond, but even a little bit can stand out on girls with dark body hair.
posted by magikker at 12:38 PM on February 22, 2007

Should I ask the derm about my hairiness?

Yes. Chances are that your doctor will say that it's normal, especially if you don't have any other symptoms that point to PCOS. But there's no reason not to ask. It's possible that it's a sign of something, and it's also possible that your dermatologist will have some ideas about what to do about it even if it's not medically significant. Acne isn't going to kill you, and dermatologists still treat that. If this is causing you angst, you should do something about it.

This isn't anything to be embarrassed about. There are tons of hairy women wandering around. You just don't realize it because most of them shave and wax and bleach and pluck and never, ever talk about it. We'd all be better off if we could overcome our embarrassment and talk about this stuff a bit more. I think that on this and a bunch of other issues, women have such weird conceptions of what's normal that we all think we're ugly freaks.
posted by craichead at 12:53 PM on February 22, 2007

I have no idea on the PCOS thing, but I recommend laser treatment. You can have it done almost anywhere and even though it can be quite expensive, it really does work. I'm having it done myself. Right now I have no more hair left in my underarms, and halfway through the treatment on my legs and bikini line.
posted by CrazyLemonade at 12:57 PM on February 22, 2007

I would suggest getting the referral to the endocrinologist for the heavy periods and, while there, bringing up the hirsutism. You may have hirsutism and PCOS, but many girls I know have approximately the level of hairiness you describe. Even among endos, the standards can differ. I went to one (who was Pakistani) and he thought my hairiness levels looked normal; then I went to an Anglo woman and she immediately diagnosed me with hirsutism and PCOS.

Even if you're diagnosed with and treated for PCOS, chances are good you'll still have issues with excess hair. From personal experience, I can say that laser treatments, though somewhat painful, were quite effective for long term hair clearance. I haven't had the permanent clearance some people get, but definitely lightening/thinning of the growth. With or without diagnosis/treatment for PCOS, you'd probably be happier if you can find an acceptable treatment for the hair situation, be it bleaching, waxing, laser, shaving, or some combination of all of the above.

Good luck!
posted by katemonster at 1:05 PM on February 22, 2007

You are definitely hirsute, and should ask the dermatologist. When we learned about PCOS (pharmacy school) we were told that hair on the thighs is always considered abnormal. This made me laugh b/c I am greek and hair on the thighs is just a fact of life. For people not fortunate enough to be of mediterranian extraction, though, hair on the thighs is a sign that something isn't right. PCOS is extremely common, and hirsutism is an extremely common sign. It's often treated by giving you birth control pills to counter the excess androgen production, so not a big deal. The earlier it's treated the better, because it puts you at risk for developing diabetes, which puts you at risk for all sorts of things you don't want (like cardiovascular trouble).
posted by selfmedicating at 1:19 PM on February 22, 2007

It sounds like you are hirsute. I would consider a hairy back, stomach, chin, and mustache to make it worth mentioning to your doctor.

What's the worst he can say, "You're not that hairy!" If you have other symptoms that also seem to correspond with PCOS, then I'd say you have a good case to bring it up to your doctor without sounding like a hypochondriac. Why let yourself suffer wondering if you have something that you can treat/control?
posted by tastybrains at 1:27 PM on February 22, 2007

Since you are concerned about your hairiness, and it's making you uncomfortable, it's worth a trip to the dermatologist to talk about different options. Be sure to make a list in advance of your appointment of questions to ask; reading them to your dr. off a sheet will be easier than coming up with them on the spot. Ask about hair removal possibilities, likelyhood of PCOS, different products you can try, etc.

Also, for the razor burn, try Tend Skin. I've heard great reviews by several users.
posted by Sprout the Vulgarian at 1:40 PM on February 22, 2007

You might find this article of interest:

Women with hirsutism grow hair on their faces, breasts and stomachs. This can cause great distress. The hair grows because they have abnormally high levels of the 'masculinising' androgen hormones. Androgens travel around the body in the blood stream, and a key way of treating hirsutism is to reduce the level of these androgens.

Data just published in Phytotherapy Research shows that drinking two cups of spearmint tea a day for five days could reduce the level of androgens in women with hirsutism.

"Current therapies use either oral contraceptives to suppress androgen production, or medications such as spironolactone that prevent the body responding to androgen -- but this study shows that spearmint could be a good natural alternative for women who have mild symptoms," says researcher Mehmet Numan Tamer who acts as spokesperson for the research team. The research was carried out at the Suleyman Demirel University, Isparta, Turkey.

In the trials the herbal tea was made by pouring a cup (250ml) of boiling water over 1 heaped teaspoon (5g) of dried leaves, and leaving it for 5 to 10 mins.

The team decided to study the effects of spearmint on hirsutism because of previous reports that extracts of the spearmint plant (Mentha spicata Labiatae) could reduce libido in men. A possible reason for this reduced libido could have been that spearmint was reducing their androgen level. Other research had shown that these extracts reduced androgen levels in rats.

"We now need to do further studies to test the reliability of this finding, and to see the extent to which the reduced androgens do help women with mild hirsutism," says Professor Tamer.
posted by LeisureGuy at 2:31 PM on February 22, 2007 [2 favorites]

I have mild PCOS. A list of other symptoms I've been told to watch for:

- longer menstrual cycle (e.g. 5 weeks instead of 4)
- extra weight, especially in the belly area
- extra hair
- acne-like blemishes on your jawline or upper back/base of your neck

The initial test for PCOS is quite simple. They take a urine sample and test for elevated androgen levels. If that comes out positive, they might do more testing to make sure (an ultrasound or something?), but I never bothered with that because my symptoms are so mild.
posted by heatherann at 2:56 PM on February 22, 2007

My girlfriend has PCOS, and what you describe sounds pretty similar to me. (she also complains of abnormal periods, both extra heavy and then long gaps with no period at all) She has also had some difficulty getting some doctors to recognize this condition. Several have apparently told her that she should just shave more (she plucks her chin steadily) increase her exercise (she goes to the gym three or four nights a week) and watch her diet (she works at a health food store, and makes good use of her discount). Clearly, there have been soem difficulties! But she has been having good results with a female ob-gyn, and is seeing some improvements. She takes birth-control to regulate some of her horomone levels and Metformin, which is actually a diabetes medication, but has proven to be quite helpful in some cases of PCOS.

Briefly, PCOS seems to be another one of those areas that baffles modern medicine, and many doctors don't seem to want to admit this. If you think your regular doctor is giving you the run-around, then go somewhere else. You're the customer!
posted by schwap23 at 2:57 PM on February 22, 2007

For people not fortunate enough to be of mediterranian extraction, though, hair on the thighs is a sign that something isn't right.

?

Doesn't everyone have hair on the thighs? Or do you just mean thick hair?

[/hypochondriac filter]
posted by dilettante at 5:56 PM on February 22, 2007

I'm surprised that a derm hasn't been able to help you with the razor burn. Mine prescribed Clindamycin Gel and it's worked really well. Also, exfoliating before shaving and changing your blade often will help as well.

I don't know much about PCOS but it definitely sounds like something is off. good luck!
posted by radioamy at 6:48 PM on February 22, 2007

Anon, you don't say what area you're in. But if by chance you're in the SF Bay Area, email me at radioamy at gmail dot com and I can recommend an endocrinologist. It sounds like you have some kind of hormonal imbalance whatever it is.
posted by radioamy at 7:11 PM on February 22, 2007

Most hirsutism is physiological, related to genetic make up, not any pathology like PCOS. It's measured on something called the Ferriman & Gallwey scale. It's explained well in this review article.
posted by roofus at 11:47 PM on February 22, 2007 [1 favorite]

...oh and for PCOS your doctor can arrange a hormone blood test, and possibly an ultrasound scan to visualise your ovaries. This doesn't on its own sound like PCOS though, unless you are also having light or infrequent periods.
posted by roofus at 11:49 PM on February 22, 2007

See a gynecologist or endocrinologist, get a blood workup and perhaps a pelvic ultrasound for your concerns. Don't rely on people here for a diagnosis.

The important thing is that you are comfortable with yourself.

Every woman is different. You didn't mention if you have a sister or brother. My sister and I are virtually identical in every way, including the way we grow hair. Well, we both have the same type of hair patterns in the same places which may or may not be considered traditionally "feminine." We've both had the blood tests and neither of us have PCOS or anything out of whack. It's just how we are. And, my brother has a lot of hair on his back. We are just hairy people I suppose. And we're not even of Mediterranean extraction--our heritage is Northern European (light eyes, pale skin).

I wasn't comfortable with my arm hair. To me, it just didn't look right. But no one, including my husband, ever said a word about it. So I had laser treatments and now it's all gone. No big deal. The PA who treats me has been diagnosed with PCOS and gets laser treatments to treat the PCOS symptom of excess hair. I asked my PA once specifically about hair around the female breast and the female happy trail, and she said it is extremely common. Think about it--women in the Western world do everything they can to get rid of hair everywhere except their head. We are not used to seeing hair on women. I'm not saying that that is good or bad, but it can really skew a woman's perspective on her body image. Of course, if you have a medical explanation to your symptoms, you should address a plan of care with your doctor, and part of that should be how you are comfortable with your symptoms. But if there is no medical explanation, don't feel badly. Lots of women have this. Laser treatments are awesome, if you want to get rid of it.
posted by FergieBelle at 8:21 AM on February 23, 2007

I am in a similar situation to you, with hairs sprouting in places I would not expect to have hairs. I second all the advice to go and see a sympathetic doctor, as it sounds like you have a number of symptoms of PCOS and they can check for elevated hormone levels. I turned out not to have PCOS, and while laser treatment is too pricy for me I deal with the hairs by plucking, waxing, and reminding myself that no one but me will care that I have fuzzy arms. Lots of women have hairy bits, try not to look on yourself as a mutant freak.
posted by penguinliz at 10:13 AM on February 23, 2007

See your gyn to rule out PCOS, have a full test on your hormonal activity.

Assuming that all comes back normal, here's some info that may be helpful:

Whether your hairiness is caused by abnormal hormone levels or is just the way you are with normal hormone levels, my gynecologist mentioned birth control can help reduce hairiness. Might want to look into that.

Also, don't feel like you're the only one. There's a reason there is a whole section for hair removal in the "women's care" isle of the pharmacy.

(FYI I stupidly tried Atkins for like a month, and *boom* I went from almost completely hairless to having average hairiness, plus even a bit of facial hair, with my hormone levels coming back totally normal. Unfortunate, but nothing some electrolysis can't permanently reverse.)
posted by lorrer at 5:27 PM on February 23, 2007