The cause of hirsutism can be either an increased level of androgens (male hormones) or an oversensitivity of hair follicles to androgens, and the most common cause is polycystic ovary syndrome. Male hormones such as testosterone stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass. Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• There are no known life threatening causes of hirsutism.

• Androgen secreting tumors ^[1]
• Congenital adrenal hyperplasia
• Cushing’s syndrome
• Idiopathic hirsutism
• Polycystic ovary syndrome ^[2]