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21 years
Its always like this .. frim childhood ..
Aug 23, 2014

Dr. Zakia Dimassi Pediatrics
Three possible explanations of excess hair or hirsutism in your case:
1- Polycystic Ovaries Syndrome (PCOS): characterized by numerous bag-like structures (cysts) in the ovaries, associated with irregular menstrual period, hairiness, acne, obesity, and insulin resistance (your organs don't respond to insulin; you sometimes get velvety black areas under your armpits, on the back of your neck). This is because of hormonal imbalances (you have more made than female hormones, or your male hormones are simply more active though not elevated). These physical changes usually appear during puberty. In order to diagnose PCOS, hormonal levels (female and male hormones "estrogen, testosterone, testosterone derivatives" plus the hormones that are selected by a special gland in the brain to stimulate the ovaries "LH, FSH" , insulin level (if there's insulin resistance then it will be elevated), and an ultrasound of the ovaries are needed. Treatment is usually with oral contraceptive pills (which give you female hormones and thus will decrease excess hairiness).
2- Congenital Adrenal Hyperplasia (CAH) : a disorder where the adrenal gland (a small gland seated above the kidney; it secretes cortisol "the stress hormone" and adrenaline among other substances) grows in size (hence the term Hyperplasia) because of a certain genetic mutation. Symptoms include hairiness, and early signs of puberty (you develop hair in the armpits and on the genitals too early, and you grown tall at a sooner than expected ttime). Diagnosis is made by doing a special test (the ACTH suppression test; ACTH is the hormone produced by a part of the brain and stimulates the adrenal gland to work) and detection of the mutation. CAH is actually a family of defects in 1 of 5 enzymes that are responsible for the synthesis of cortisol. The resulting cortisol deficiency heightens the secretion of ACTH and thereby leads to adrenal cell proliferation. However, only 3 of these defects can produce hirsutism—21-hydroxylase (most frequent), 3β-hydroxysteroid dehydrogenase (less frequent), and 11-β-hydroxylase deficiency (least frequent).
If CAH is considered, an ACTH-stimulation test is indicated, which is a search for exaggerated quantities of the precursors of cortisol. Treatmen is with ccortisol rreplacement
3- Idiopathic hirsutism is a ddiagnosis of exclusion, that isto say, we think of itafter having ruled out ppossible oorganic causes. This entity has no clear cause and thus the most eeffective ttreatment is ccosmetic iintervention (laser body hhair rremova).
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