PCOS and hirsutism 

Polycystic ovary syndrome (PCOS) or Polycystic ovarian disease (PCOD) is a condition that affects millions of women of reproductive age around the world. It is a hormonal disorder characterized by an imbalance of reproductive hormones and the presence of multiple cysts on the ovaries.

Hirsutism is the most common symptom of PCOS. It is the excessive growth of thick, dark hair in areas where it usually does not grow in women, such as the face, chest, and back (male pattern hair growth).

Understanding the underlying causes and treatment options for hirsutism associated with PCOS is important to manage the condition. There are both medical and lifestyle options available to help treat hirsutism.

 Causes of PCOS

The exact cause of PCOS is unknown; however, lifestyle factors and genetic predisposition often play a role. 

It is believed to be also connected to insulin resistance and inflammation. 

Also, abnormal hormone levels are a major concern. Especially higher levels of the male sex hormone androgen prevent the ovaries from releasing eggs, thus leading to irregular menstrual cycles.

Symptoms of PCOS

The symptoms usually begin at menarche, i.e. around the time of the first menstrual cycle. Sometimes, the symptoms develop after patients have had a few periods. The symptoms are varied. 

• Irregular periods: Patients have fewer, irregular, or long-lasting menstrual cycles.
• Infertility: PCOS is the number one cause of infertility, and this is the result of not being able to conceive due to irregular ovulation or the lack of regular and frequent ovulation.
• Excess of androgen: High levels of this hormone might lead to excess hair on the face and the body, also called hirsutism. It can also cause severe acne and male pattern baldness.
• Polycystic ovaries: The ovaries might get bigger due to several follicles containing immature eggs developing around the edges of the ovaries. These larger ovaries can be seen upon ultrasound examination.
• Obesity: About 40-50% of patients with PCOS are obese and find maintaining an ideal weight troublesome.
• Skin tags: These are flaps of extra skin found in the neck or armpits.
• Skin darkening: Patients may develop dark patches of skin, especially in the neck, armpit, below the breasts, and groins. This condition is known as acanthosis nigricans.
• Hair thinning: Patients with PCOS may start losing lots of hair and develop even baldness.
• Psychological problems like mood changes, depression, etc., are common.
• Sleep problems and fatigue

PCOS treatment

• Birth control using hormones: There are several options, like birth control pills, vaginal rings or intrauterine devices (IUDs), etc. All these help regulate the menstrual cycle; some help control acne and reduce excess hair growth.
• Insulin-sensitizing medicine: A drug for treating diabetes, metformin helps process insulin. Once the diabetes is under control, patients with PCOS have regular menstrual cycles.
• Anti-androgens: These drugs block androgens from attaching to their receptors in the body. After patients have been on oral contraceptives for six months and if these are not effective enough, anti-androgens are sometimes prescribed.
• Lifestyle changes: Regular exercise, healthy eating, and weight management.
• Surgery: This is less employed by surgeons as newer and better medicines are present for correcting androgen hormone abnormalities. Previously, doctors performed surgeries to remove the ovarian tissues producing androgen hormones.
• Complementary & Alternative Medicine (CAM): CAM, especially homoeopathy, has good remedies for treating PCOS. Homoeopathy works by attacking the root cause of the disease. And for this, a detailed case is taken by the homoeopathic physician where all the symptoms of the patient (termed 'totality of symptoms') are taken into account to arrive at something called the 'constitutional similimum' that will help in alleviating the symptoms of the patients.

It is important to note that there is no cure for PCOS, and treatment focuses on managing the symptoms. 

Treatment of hirsutism

One of the most important to remember is that the United States Food and Drug Administration (FDA) has not approved any medicines to treat hirsutism. But some helpful drugs are listed below:

• Oral contraceptives: Birth control pills or other hormonal contraceptives containing estrogen and progestin are helpful in the treatment of hirsutism caused by androgen production.
• Lifestyle changes: Regular exercise and healthy eating
• Laser treatments: These will help reduce hair growth by up to 95%. Diode lasers are the most effective laser option, irrespective of hormonal levels.
• Natural solutions: A study showed that PCOS-afflicted women who drank spearmint tea (Mentha spicata) had lower androgen levels. Lavender and tea tree oils may lessen moderate hirsutism. According to a pilot study, treating the skin locally with lavender and tea tree oils could improve the condition. These oils should only be applied topically.
• Herbs: Saw palmetto (Serenoa repens), Chaste tree (Vitex agnus castus), Black cohosh (Actea racemosa), etc. These should not be taken unless prescribed by a doctor.
• Topical cream: Eflornithine is a cream available on prescription and useful for hirsutism in women. This is directly applied to the affected area of the face. Though this helps slow the growth of new hair, it does not get rid of existing hair. This can be used in conjunction with laser therapy for an enhanced response.

Can hirsutism caused by PCOS be cured?

OCPs and non-pharmacological treatments are typically used to treat mild hirsutism. However, antiandrogens and OCPs, plus a safe contraceptive method, may be necessary to treat moderate or severe hirsutism.

Does PCOS facial hair go away?

Excess facial hair can be reduced with PCOS treatment. However, due to the lengthy growth cycle of hair follicles, this may take anywhere between six and nine months. Fortunately, PCOS and hirsutism are treatable. Most of the time, treatment aims to promote fertility or alleviate symptoms of hyperandrogenism.

Nutritional tips for maintaining an ideal weight and controlling hirsutism

• Women should consume plenty of fruits and vegetables containing antioxidants. Examples are blueberries, cherries, tomatoes, squash, bell peppers, etc. 
• Women should avoid refined foods like white bread, pasta, and sugar.
• One must avoid rice, oils, and sugar.
• Red meat consumption should be reduced. Instead, lean meats, fish, especially cold-water ones, tofu, and beans should be consumed.
• The consumption of trans fats should be decreased or eliminated. Examples of foods containing trans fats are commercially-baked goods like cookies, crackers, cakes, French fries, onion rings, doughnuts, processed foods, and a few kinds of margarine.
• Total avoidance of alcohol and tobacco
• Six to eight glasses of pure, filtered water should be consumed daily.
• Regular exercise of at least 30 minutes daily for five days a week

What if hirsutism remains after trying everything?

UnCover has the best options for hair removal using a laser. Laser hair reduction is permanent since it removes hair from the roots. After the treatment ends, there is a 70-80% reduction in hair growth density and thickness.

The number of sessions recommended is about six to eight. However, certain areas of the body, like the face and softer regions of the arm, might necessitate more sessions. Suppose a patient has other conditions like PCOS and hirsutism resulting from this. In that case, the sessions can increase to 12 to 15.

Some post-treatment redness might be present after laser hair removal. Sunlight should be avoided for two weeks before and one week after the treatment procedure. Laser hair removal is not painful. Although, each short-duration pulse of the laser produces a faint tingling sensation. Patients may feel like a rubber band is snapping on the skin in sensitive areas like the top lip.

The cost of laser hair removal treatment starts at Rs. 1,800. It may go up to Rs. 15,000 and more depending upon the part involved and the number of sessions required.

UnCover combines laser equipment with cutting-edge technology to reduce the heat sensation produced on the skin and minimize any sort of discomfort. A panel of professional doctors will guide patients to undergo the right procedure.

UnCover’s counsellors and an excellent panel of professional dermatologists will gladly answer all queries related to PCOS/PCOD and the accompanying hirsutism. Their state-of-the-art and latest equipment and procedures will help treat conditions safely. Book a free consultation today. Call now for all your hair removal solutions.