What You Should Know about Beard in Women

By Dr. Okechukwu Amako, MBBS (Ibadan)
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During puberty, both boys and girls develop what are known as secondary sexual characteristics. Boys start growing hair in the armpits and private part area and on their face (beard); their body becomes more muscular and their voices become deeper. Girls grow hair in the armpits and the private part, and their breasts start budding out; their voices become lighter, and they start seeing their menstrual period.

The secondary sexual characteristics in boys are majorly due to the action of male sex hormones called androgens. In girls, the female sex hormone, oestrogen secreted by their ovaries, is majorly responsible for the development of secondary sexual characteristics; the ovaries also produce low quantities of androgens, which cause hair growth in the armpits and the private part in girls.

While boys naturally grow facial hair (beard) and hair on the chest and the back due to the action of androgens, girls don't because their ovaries produce majorly oestrogen and very little of the androgens. Male-pattern of facial hair (beard) in a woman signifies that her body is producing a higher than normal level of androgens. Overproduction of androgens in a woman is usually due to certain medical conditions with several physical manifestations of which a male-pattern of facial hair is one.

Male-pattern of hair growth on the face (involving the jaw and upper lip), the chest and the back (known by doctors as hirsutism) in a teenage girl or a young woman results from the action of a higher than normal level of the male sex hormones, the androgens, which can be caused by any of the following medical conditions:

1. Polycystic ovarian syndrome (PCOS)

This is a gynaecological condition in which the woman experiences irregular menstrual periods or doesn't see her period for several months. She may also be overweight or obese; an ultrasound scan of her ovaries usually reveals multiple cysts; a blood hormone test shows that she has a higher than normal level of androgens which are responsible for the male-pattern of facial hair. Polycystic ovarian syndrome is usually associated with infertility which is the main reason that brings the woman to the hospital.

2. The adrenal glands located on top of the kidneys produce many hormones such as adrenaline, cortisol (a natural steroid) in both men and women. This pair of organs also produces very small amounts of androgens.

The hormone-producing function of the adrenal glands is under the control of another hormone produced by a structure in the brain called pituitary gland; the pituitary gland also produces other hormones that control the production of hormones in different parts of the body.

A tumour affecting this pituitary gland can cause excessive secretion of its hormone that controls the adrenal glands. The result is excessive production and secretion of the adrenal hormones, including cortisol and the androgens. This condition is called Cushing disease and when it occurs in a woman, male-pattern of facial hair can be one of its physical features.

This condition, this time called Cushing syndrome, can also be due to a tumour in the adrenal glands which results in excessive production of cortisol and androgens.

3. Male-pattern of facial hair in a woman is a feature in a condition in which the adrenal glands produce an abnormal version of the hormone, cortisol. Production of a faulty hormone by the adrenal glands forces the pituitary gland in the brain to keep secreting its own hormone in a bid to make the adrenal glands to produce the right hormone. However, this leads to overproduction of androgens and causes beard-like facial hair growth in a woman.

4. Medications used in treating women with a condition called endometriosis and conditions like depression can cause a male-pattern of facial hair growth in women as one of their side effects.

Male-pattern of hair growth in women (hirsutism) can also be genetic (runs in some families), meaning some of the medical condition responsible for it may run in some families.

Women with a male-pattern of facial hair, depending on its severity, can have other features associated with overproduction of the male sex hormones (androgens).

-the woman's voice can start deepening like that of a man
-her skin may become oily and she may have acne on her face
-her body may become more masculine (well-developed muscular physique)
-her breasts may decrease in size
-her hairline may start receding (baldness)
-her clitoris (the tissue structure above the urethral opening in the private part area) may become enlarged
-the woman may also experience psychological changes such as feeling aggressive or having a high libido

Besides the underlying medical conditions behind beard-like facial hair in women, the major cause of worry for most women is the appearance it gives them and how they feel the society perceives them.

Treatment usually relies on identifying the specific medical condition in the woman responsible for the male-pattern of facial hair. Hence, women in this situation are advised to visit a good specialist hospital or a teaching hospital where different medical specialists (including endocrinologists, gynaecologists, dermatologists and plastic surgeons) can evaluate them to find the exact cause of the condition for appropriate treatment.

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For more advice and help, feel free to consult a doctor.
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Published Friday, June 2nd 2017

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