What is hirsutism during pregnancy?
Hirsutism is a condition in which women grow body hair and/or facial hair excessively, in more of a male body and facial hair pattern than a female pattern. Such hair tends to be coarser and darker than it is normally in women. The condition results from a presence of higher than normal levels of male hormones, known as androgens, which stimulate hair follicles on the body and face to grow hair more coarsely and vigorously. Hirsutism can occur for various reasons. Most commonly, it happens, due to a range of hormonal conditions, such as polycystic ovary syndrome (PCOS), in which the proportions of different hormones produced in the ovaries are abnormal, excess growth of the cells of the ovary that make androgens, various tumors of the ovaries, adrenal glands, and pituitary gland, excess insulin (as occurs in type 2 diabetes), and the use of anabolic steroids (such as for bodybuilding) and minoxidil (a hair growth drug). Hirsutism also can occur during pregnancy, since pregnancy involves an increase in the levels of several types of hormones, including androgens. At the same time, hirsutism is more often associated with difficulty in getting pregnant, infertility, of which PCOS is one of the major causes, along with the various other hormonal abnormalities mentioned above.
Most commonly, hirsutism occurs on a womans lower abdomen, lower back, inner thighs, breasts, as well as the mustache and beard area of the face. Annie Jones Elliot, the famous bearded lady who toured with the Barnum circus in the late 19th century, may have suffered from a severe case of PCOS or another hormonal condition. Less commonly, hirsutism also can occur on the sternum and the rest of the chest, upper abdomen, and upper back.
How common is hirsutism during pregnancy?
In most areas of the world, hirsutism strikes approximately 5-10 percent of women of reproductive age, mostly in connection with PCOS.
How is hirsutism during pregnancy diagnosed?
Hirsutism is diagnosed based first on the observation of course hair on body parts where it is not usually noticeable in women, then, based on a range of tests to hone in on the cause. Levels of various hormones will be assessed in blood samples, plus imaging procedures may be performed to assess your ovaries, adrenal gland, and pituitary gland for cysts and tumors. The imaging tests may include ultrasonography and magnetic resonance (MRI) imaging. If you are not pregnant, computed tomography scanning may be performed instead of MRI.
Does hirsutism cause problems during pregnancy?
Hirsutism often causes women a great deal of psychosocial distress, whether or not they are pregnant. While hirsutism itself does not have medical consequences, the underlying causes often do. With the most common underlying cause, PCOS, in addition to making it challenging to get pregnant in the first place, pregnant women with PCOS have an increased likelihood of pregnancy complications. These include gestational diabetes, preeclampsia (a dangerous condition featuring high blood pressure and organ dysfunction), venous thromboembolism (blood clots in deep veins, producing traveling clots, called emboli, which cause can cause a pulmonary embolism (a clot in the lungs)), heart attacks, and strokes. Such women also are at risk later for endometrial cancer and type 2 diabetes.
Does hirsutism cause problems for the baby?
Hirsutism itself has no impact on the baby, but the underlying conditions causing the hirsutism can cause maternal complications dangerous to the fetus. These include gestational diabetes (which can enlarge the fetus, making vaginal delivery very difficult), preeclampsia (which requires early delivery, or otherwise can cause fetal growth restriction and cause the placenta to detach from the uterus, killing the fetus), and venous thromboembolism, which can lead to pulmonary embolism, heart attacks, and strokes, all of which can kill the mother and the fetus with her.
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the hirsutism
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat hirsutism during pregnancy?
When hirsutism results from PCOS, the treatment is usually oral contraceptives, which you cannot take during pregnancy. Hirsutism from PCOS and other causes can be treated with anti-androgens, which are medications that block male hormones. However, you cannot take anti-androgens if you are carrying a male fetus, since they can interfere with differentiation of the genitals to their male form, plus they may also cause defects in female fetuses.
Who should NOT stop taking medication for hirsutism during pregnancy?
Generally, medications are not the treatment during pregnancy.
What should I know about choosing a medication for my hirsutism during pregnancy?
It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.
You may find Pregistrys expert reports about the medications to treat this condition in here. Additional information can also be found in the sources listed below.
What should I know about taking a medication for my hirsutism when I am breastfeeding?
Low dose oral contraceptives are approved for use in nursing women. Antiandrogens are not well studied in nursing mothers and generally should be avoided until more is known.
What alternative therapies besides medications can I use to treat my hirsutism during pregnancy?
Unwanted body and facial hair can be removed with a couple of different techniques. There is electrolysis, in which an electrical current is delivered to each follicle. Each treatment session takes a fairly long time because the current is delivered through a special needle that must be inserted into each follicle. There are home devices to do this, but it is a tedious process, and usually, each follicle requires multiple treatments over time for the follicle to be destroyed. Hair also can be removed, effectively with laser treatment, using what are called long-pulsed lasers, meaning lasers that pulse on and off during a period lasting anywhere from 20 nanoseconds to a few hundred nanoseconds. If you have dark skin, there is a risk that the laser may lighten your skin, but lasers are improving, and its possible to select a laser beam of a wavelength that does not discolor skin of a particular shade.
What can I do for myself and my baby when I have hirsutism during pregnancy?
Follow the instructions of your physician. Be assured that the hirsutism itself can be treated with laser therapy and that, after you delive
r, various hormone therapies can address the underlying cause.
Resources for hirsutism in pregnancy:
For more information about hirsutism during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.