Know about Hirsutism & Virilization

Hirsutism is growth of excess hairs in females in a male pattern, e.g. growth of beard, mustache, excess hairs in chest and some other parts of the body. Virilization is a type of extreme form of hirsutism where there is also other characters that only males possess, like deepening of voice (male type of voice), clitoris becomes enlarged (clitoris is homologous organ of penis in females), breast becomes small or atrophied, there is increased muscle mass like males etc. In general hirsutism is rarely due to serious underlying pathology, but virilization commonly indicates serious underlying pathology like tumor of adrenal gland or ovary.

The common reason of hirsutism and virilization is excess androgens. And tumors of androgen secreting organs can cause serious form of hirsutism i.e. virilization. Androgens are secreted by adrenal gland and ovaries and neoplasm (benign or malignant) of these organs cause virilization and excess secretion of androgens due to some benign (less serious) cause produces hirsutism.

There are nine areas in humans, that are sensitive to raised level of androgens in blood and when there is increased androgen, the excess hair growth takes place in some or all of these nine areas. The nine areas are upper lip, lower jaw, upper back, lower back, upper arms, chest, abdomen, pelvis and thighs. Some of these areas are highly sensitive to even minor increase in androgen level and some are less sensitive to androgens. This explains why different females with hirsutism have excess hair growth in different androgen sensitive areas.

The important androgens which are mainly responsible for hirsutism are testosterone, androstenedione, and dehydroepiandrosterone (DHEA) and its sulfated form of dehydroepiandrosterone (DHEAS).

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