female body hair
Introduction
Introduction Body hair is thick, don't think hirsutism. Medically, female hirsutism refers to an increase in body hair density in any part of a woman's body surface, which becomes longer, thicker, and darker, and the distribution pattern is masculine. It is caused by elevated levels of androgen in the body or increased sensitivity of the target organ to androgens for various reasons. More than 90% of women with hirsutism have elevated androgen, and the rest are mostly idiopathic hairy. The upper part of the back, the chest, the upper abdomen, the upper pubis, and the thick hair on the ears and nose suggest a strong androgenic effect. The Ferriman-Gallway hair scoring standard is helpful in the diagnosis and follow-up of hirsutism. A total score of more than 6 in 9 sites indicates excessive hair.
Cause
Cause
Androgen increase is the most common cause of female hirsutism, of which polycystic ovary is the most common cause.
Second, various diseases that cause an increase in glucocorticoids can also be hairy.
Other causes are hypothyroidism and taking hormonal drugs, genetics, etc.
Examine
an examination
Related inspection
Sex hormones six tests plasma 17-hydroxyprogesterone (17-OHP) gynecological ultrasound examination vaginal gynecological routine examination
Signs:
Often the upper jaw, upper lip, front of the ear, forehead, and posterior neck hair increase, the nipple, the midline of the umbilicus has a relatively long hair, the pubic hair is diamond-shaped.
Women with ovarian disease are not only hairy, but often accompanied by pelvic masses, hemorrhoids, menstrual disorders or abnormal reproductive function.
Such diseases as Cushing's syndrome are often accompanied by obesity of the face and body, and the relative weight loss of the limbs, as well as elevated blood pressure and blood sugar, and purple lines on both sides of the lower abdomen and thighs.
If it is only a simple body surface hair, without masculine performance, menstrual disorders or reproductive dysfunction, the hormone levels are also normal, and the family also has a lot of body hair, most of them are caused by heredity.
If the female body hair is more than one, first go to the gynecological clinic for the relevant hormone level check to exclude the polycystic ovary and other reasons.
Auxiliary inspection:
(1) Serum testosterone and androstenedione may be derived from the ovary or adrenal gland. In patients with hairy hair, free T increased, and the total T increased. If total T and A are significantly elevated, tumors that secrete androgen should be suspected.
(2) Dehydroepiandrosterone sulfate reflects the best indicator of adrenal androgen secretion. >18.2mmol/L makes sense.
(3) elevated 17-hydroxyprogesterone 21 or 11b-hydroxylase deficiency in patients with congenital adrenal hyperplasia, >24.2nmol / L can diagnose the disease; basic value of delayed adrenal hyperplasia Normal, but can be significantly increased after ACTH stimulation.
(4) Dihydrotestosterone and 3a-androstanediol glucuronide (3aAG) The latter is a metabolite of the former. If total T, free T, A, DHEA-S are normal, and DHT and 3aAG are elevated, suggestive of idiopathic hirsutism.
(5) Serum luteinizing hormone (LH) and follicle stimulating hormone (FSH), such as elevated LH, decreased FSH, LH / FSH ratio > 2: 1, suggesting polycystic ovary syndrome.
(6) Dexamethasone inhibition test. Two-day method 2mg dexamethasone inhibition test helps to identify adrenal and ovarian-derived androgen increase; and extended dexamethasone inhibition test (7 days) helps identify adrenal tumors and Congenital adrenal hyperplasia.
(7) ACTH stimulation test, such as excitement, blood 17-hydroxyprogesterone is significantly higher than normal, suggesting late-onset congenital adrenal hyperplasia.
(8) Imaging examination of ultrasound, X-ray, CT, MRI of the adrenal gland, ovary and other suspicious parts contribute to the localization diagnosis of the tumor. The measurement of androgen levels from the adrenal or ovarian veins under CT guidance is also of great interest.
Diagnosis
Differential diagnosis
More calf hair: Infants with more baby hair are usually covered with dense black hair on the back and forehead and ears. Don't worry, the baby's hair will slowly degenerate.
Early development of pubic hair: Under normal circumstances, girls develop pubic hair several months after breast development; boys develop pubic hair only months after penis and testicular development. Early developmental pubic hair can occur at any age, with more girls than boys. The amount of pubic hair is small, sometimes there are manes, but other sexual characteristics develop normally. Most foods are consumed by children's health foods that contain hormones.
No whisker hair and pubic hair: seen in Klinefelter syndrome. Also known as congenital testicular hypoplasia or Klinefelter syndrome. The typical karyotype is 47,XXY. The phenotype is characterized by testicular hypoplasia. The slender figure is caused by the increase in the distance from the heel to the phalanx. Male mammary gland development, pubic hair is female-type distribution, penis and testicles are small. Severe cases are accompanied by mental retardation, cryptorchidism and hypospadias.
Mane and pubic hair shedding: Sheehan's syndrome - anterior pituitary hypofunction (Simon-Siehan syndrome) is a deficiency of pituitary hormone secretion caused by multiple causes, secondary hypogonadal, thyroid, adrenal insufficiency Clinical signs. Adrenal insufficiency - When most of the adrenal glands on both sides are destroyed, there is a manifestation of various corticosteroid dysfunction, called adrenal insufficiency. Both the above-mentioned diseases can cause pubic hair and pubic hair loss. Often the upper jaw, upper lip, front of the ear, forehead, and posterior neck hair increase, the nipple, the midline of the umbilicus has a relatively long hair, the pubic hair is diamond-shaped. Women with ovarian disease are not only hairy, but often accompanied by pelvic masses, hemorrhoids, menstrual disorders or abnormal reproductive function.
Such diseases as Cushing's syndrome are often accompanied by obesity of the face and body, and the relative weight loss of the limbs, as well as elevated blood pressure and blood sugar, and purple lines on both sides of the lower abdomen and thighs.
If it is only a simple body surface hair, without masculine performance, menstrual disorders or reproductive dysfunction, the hormone levels are also normal, and the family also has a lot of body hair, most of them are caused by heredity. If the female body hair is more than one, first go to the gynecological clinic for the relevant hormone level check to exclude the polycystic ovary and other reasons.
