Updated Recommendations Provide Guidance for Women Experiencing Unwanted Hair Growth

For the first time since 2008, the Endocrine Society Task Force — which includes representatives from Massachusetts General Hospital — has issued an update to its Clinical Practice Guideline on hirsutism, a condition in which women experience unwanted hair growth in areas men typically grow hair.

Here are five things to know about this condition and the new guidelines, taken from a recent Endocrine Society press release:

  1. Women with hirsutism often experience unwanted dark, course hair on the face, chest or back. The condition affects 5 to 10 percent of women and can cause personal distress, anxiety and depression when it’s not treated. “Excess facial or body hair is not only distressing to women, it is often a symptom of an underlying medical problem,” said Kathryn Martin, MD, an endocrinologist and investigator at Mass General, and a member of the Endocrine Society Task Force responsible for developing the new guidelines. “It is important to see your health care provider to find out what is causing the excess hair growth and treat it.” Mass General researcher R. Rox Anderson, MD, Director of the Wellman Center for Photomedicine, is also on the task force.
  2. One possible cause of hirsutism is polycystic ovary syndrome (PCOS), a condition caused by an imbalance of reproductive hormones. Levels of testosterone and other male sex hormones called androgens tend to be elevated in women with PCOS and other conditions that cause hirsutism. PCOS is a leading cause of female infertility and can also lead to metabolic health problems.
  3. After conducting two systematic reviews and looking at the best available published evidence, the task force revised the guidelines for diagnosing and treating hirsutism. The new guidelines, entitled “Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline,” were published online earlier this month and will appear in the April 2018 print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society.
  4. The updated guidelines now suggest all women with hirsutism undergo blood tests for androgens. The guidelines previously called for testing for women with moderate to severe hirsutism, but the recommendation was broadened to improve diagnosis rates of PCOS and other underlying conditions.
  5. The guidelines suggest medication (oral contraceptives for those not trying to get pregnant) or direct hair removal (e.g. electrolysis) for treating mild cases with no evidence of an endocrine disorder. Additionally, although weight loss itself is not a recommended treatment for hirsutism, some studies have found weight loss was associated with slight improvement in unwanted hair growth. A healthy diet and exercise also can be beneficial for women who have PCOS.


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