Hair on my face, hormones on my mind
Dear Dr Mitchell,
I am 28 years old. I believe I have a hormonal imbalance. I have hair on my face just like a man would, some in more places more than others. I get really moody everyday. My period is painful and my flow changes from heavy to light depending on each month. I get yeast infections at times and every three to six months I get bacterial vaginosis. Is this because of my hormonal imbalance? I only have one male sex partner. I change my underwear a lot and wipe properly. What should I do? Do products like Enzara and Femanol work?
The excessive hair growth on your face and the mood changes are suggestive of excessive male hormones in your system. This hormone is testosterone and excessive production causes hair growth on the face, chest and abdomen. This is usually seen in polycystic ovarian disease.
This is a condition which results in infrequent menstrual period, excessive weight gain with a tendency to the development of diabetes mellitus and infertility. This may be confirmed on doing a hormone profile and a pelvic ultrasound. The pelvic ultrasound will show the presence of multiple small cysts around the ovaries.
The absence of this finding on ultrasound, however, does not rule out polycystic ovarian disease and the clinical manifestations and the hormone profile may be diagnostic.
The frequent occurrence of yeast infection and bacterial vaginosis is significant. This may be due to an underlying diabetic tendency or may be due to repeated exposure and re-infection from your partner. He will need treatment simultaneously to reduce the risk of recurrence. You should also get a HIV test done since a decrease in your immune system may also present itself with recurrent infections.
Polycystic ovarian disease may be treated with good outcome. Weight loss is always advised especially if you are overweight. You should go on an appropriate diet with decreased carbohydrate and fats and start an exercise programme. The aim is to lose at least 10 per cent of your current body weight. This usually results in regular predictable cycles and decreases your testosterone levels.
The use of a hormonal preparation which contains an anti-androgen such as DIANE 35 will also help with decreasing the excessive hair growth and giving good cycle control. Electrolysis and the use of a hair removing cream will offer some temporary relief of the excessive facial hair growth.
Femanol is an over the counter preparation which is formulated for bacterial vaginosis and it is recommended that it should be taken on a regular basis to stop the recurrence of bacterial vaginosis and also yeast infection. It is thought that the ingredients in Femanol can assist in re-establishing the natural lactobacilli in the vagina and boost the immune system to fight the current infection and reduce recurrence.
Enzara is a mixture of chlorophyll and other natural herbs. It contains green tea extract, Bromelain, sunflower extract, Kosher gelatin, glycerin and parsley seed extract. The recommended dose is one pill twice daily.
The problem with self medication is that you just never know exactly what you are treating. Other infections, such as trichomonas vaginalis causes vaginal itching and an odour and you will need specific treatment for this. This is also sexually transmitted and your partner will need treatment. You should consult your gynaecologist for proper evaluation and a pap smear.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025. We regret that we cannot supply personal answers.
