Hirsutism
Hirsutism is the growth of dark, coarse terminal hair in women in a male-distribution pattern — face, chest, abdomen, upper back, and inner thighs. It results from elevated androgen levels or increased sensitivity of hair follicles to androgens. Most cases are benign (PCOS or idiopathic), but rapid onset or virilization warrants evaluation for rare androgen-secreting tumors.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
Unwanted coarse dark hair on the face (upper lip, chin, jaw, sideburns), chest, areolae, linea alba, inner thighs, and upper back. Associated symptoms may include acne, scalp hair thinning, clitoral enlargement, or deepened voice if androgen levels are very high.
Causes & Risk Factors
PCOS accounts for approximately 75% of cases. Other causes include idiopathic hirsutism (normal androgens with increased follicular sensitivity), non-classic congenital adrenal hyperplasia, androgen-secreting ovarian or adrenal tumors, Cushing's syndrome, hyperprolactinemia, and androgenic medications.
How We Evaluate
Total and free testosterone, DHEAS, LH, FSH, 17-hydroxyprogesterone (fasting, morning, early follicular phase for CAH screening), and prolactin are the core lab panel. Cortisol testing and adrenal imaging are added if Cushing's syndrome is suspected. Pelvic ultrasound evaluates ovarian morphology.
Treatment Options
Weight loss in PCOS improves androgen levels. Oral contraceptives (preferably with anti-androgenic progestins like drospirenone) suppress ovarian androgen production. Spironolactone blocks androgen receptors at the hair follicle. Eflornithine cream slows facial hair growth. Clinical response takes six to twelve months since hair cycle is slow.
When It Is Urgent
Seek prompt evaluation for rapid-onset hirsutism developing over weeks to months with virilization (clitoral enlargement, voice deepening, muscle bulk increase) — this pattern raises concern for an androgen-secreting tumor.
Frequently Asked Questions
Do I need a referral to see an endocrinology provider?
No referral is needed at Nomi Beach Health. You can book directly with our team for hormone, thyroid, metabolic, or weight-management concerns.
How long does it take to see results from treatment?
Timeline depends on the condition. Thyroid medication often improves symptoms within four to eight weeks. Weight-loss interventions show measurable changes in four to twelve weeks. Hormone therapy timelines vary by the specific condition and individual response.
Will I need labs before my first visit?
You can come in without prior labs — we order whatever is appropriate during or after your visit. If you have recent results, bring them so we can start the conversation right away.
Are these conditions managed long-term or treated once?
Most endocrine and metabolic conditions require ongoing management rather than a single treatment. We build a follow-up schedule around your specific diagnosis and goals.
Can I be seen for weight loss even if I do not have a hormone diagnosis?
Yes. We evaluate weight holistically — including metabolic markers, lifestyle factors, and, when appropriate, medication options such as GLP-1 agonists.
Get a Clear Plan for Hirsutism
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.