Excessive hair growth issues
Dear Dr Mitchell,
As I have excessive hair growth on my chin, breasts and lower abdomen, I decided to consult an endocrinologist. The doctor prescribed Aldactone and Diane35 for three months, and also advised me to lose some weight. Could you say whether this course of treatment will reduce the hair growth on my chin, or will I have to use some other method?
The problem that you have seems to be polycystic ovarian syndrome. This is a condition that is associated with excessive weight gain, irregular menstrual periods, and excessive hair growth on the face, chest and abdomen. There is also an increased chance of acne and a male pattern type of hair distribution, with baldness around the temples. Women with polycystic ovaries also have difficulty becoming pregnant, since ovulation tends to occur infrequently. The increased tendency to gain weight resulting in obesity is also associated with an increased risk of diabetes mellitus.
The condition can be confirmed by doing a pelvic ultrasound where the ovaries will be found to be bulky and to contain multiple cysts. A blood test to check the level of luteinising hormone (LH), follicle-stimulating hormone (FSH), testosterone, and also the blood glucose level should be done. The baseline testosterone level is increased in women with polycystic ovarian syndrome, and this is the cause of the excessive hair growth, acne, increased size of the clitoris, and even hoarseness of the voice noticed in some women.
The problem can be controlled by losing weight and achieving your ideal weight for your height. This can be accomplished by a regular exercise programme at least three to four times per week, and also going on a diet that restricts your caloric intake and your intake of fats and carbohydrates. Weight loss can be challenging, and you will definitely benefit from the professional help of a dietician. Achieving the ideal weight for your height will help in establishing normal menstrual cycles and control the excessive male hormone (testosterone) in your system. The use of Diane35 and Androcur will help to establish regular cycles and control the excessive hair growth and acne.
You might also need to use creams to remove some of the excessive hair growth. Electrolysis or laser hair removal are also beneficial. Polycystic ovarian disease tends to be chronic, and once you stop the treatment and regain weight the problem may return. It requires discipline and a change in lifestyle, especially with diet and exercise. You can actually take breaks from the drug therapy, but the symptoms may return and you may be required to go back on the treatment intermittently.
Metformin is a drug that is commonly used to help in reversing some of the problems caused by the polycystic ovaries and helps in reducing the blood sugar level, weight loss, and improving fertility in the long run. When you are ready to become pregnant, then the Diane35 will be discontinued and Clomid introduced to help boost ovulation and improve your chance of becoming pregnant. Weight loss and exercise will also help to reduce your risk of diabetes mellitus and hypertension, thus improving your outcome when you decide to become pregnant.
Aldactone (Spironolactone) is a drug used to treat high blood pressure and heart failure, but it is also used to treat swelling (oedema) caused by certain conditions such as heart failure and liver disease by removing excess fluid and improving symptoms such as breathing problems. The medication is also used to treat low potassium levels and conditions in which the body is making too much of the natural chemical aldosterone. It is also known as a “water pill”.
Consult your doctor who will advise you further.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER:
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
