WOMEN’S BODIES: MEDICAL TREATMENT FOR HIRSUTISM
If an overactive gland or a hormone-producing tumour is discovered, it will be treated by surgery or drugs so that excess hormone production stops.
Two types of drugs are used to treat hirsutism:
• drugs that reduce hormone production such as the contraceptive Pill and similar hormone combinations. These reduce ovarian production of hormones (including androgens) but supply oestrogen and progesterone. They are sometimes used to treat simple hirsutism, with good results. The Pill that contains the anti-androgenic progestogen cyproterone acetate in low dose is most useful (also for acne).
• drugs such as spironolactone and higher-dose cyproterone acetate, which reduce the effect of androgens in the body. These drugs can cause some side-effects such as breast tenderness, lethargy, irregular periods and occasionally depression, though these are rarely serious and are often minimized if either oestrogen or the Pill is added to the treatment. Anti-androgens can’t be used if there is any possibility of pregnancy because of the risk of interfering with the sexual differentiation of a male’ foetus.
It is important for women having these treatments to realise that the life cycle of terminal hairs is measured in months (from when the hair begins to grow until when it falls out), so no apparent improvement may be seen until up to six months after starting. Treatment curbs androgen-stimulated growth of hair in ‘male’ sites, and prevents the conversion of more vellus hairs to terminal hairs. But once hair follicles have been stimulated to grow terminal hairs, they resume this growth when anti-androgen treatment is stopped. Those terminal hairs that develop before treatment can be removed by permanent cosmetic methods; then no new terminal hairs will form when excess male hormones have been eliminated.
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