Polycystic Ovary Syndrome and Facial Hair

Q:  My 22-year-old granddaughter was recently diagnosed with Polycystic Ovary Syndrome (PCOS). Most books just describe the symptoms, such as obesity, facial hair and missed periods, but PCOS automatically puts women at a high risk for eventually developing diabetes, heart disease and cancer. She presently is on birth control pills to adjust her periods.

What advice do you have for diet and facial hair?

A:  In addition to female hormones like estrogen and progesterone, women also secrete a small amount of androgens, the hormones that cause masculine characteristics. Girls and women with Polycystic Ovary Syndrome (PCOS) have irregular periods and excess facial hair because their ovaries secrete a bit too much of the "male" hormones. This imbalance can cause mild or severe symptoms such as those you've mentioned. Obesity exacerbates the hormone imbalance and is also a risk factor for diabetes. A diet that promotes weight reduction is important for preventing diabetes and decreasing the hormones in the body (they are stored in the fat).

Spironolactone is a prescription diuretic that blocks androgen and may decrease facial hair. Birth control pills help slow the rate of hair growth, but existing hair has to be dealt with by chemical methods like bleaching or depilatories; mechanical removal such as shaving, waxing or plucking; or newer laser techniques.

A word of caution about the laser treatments - the technique is not permanent (the roots generally grow back in 8-12 months), does not work as well on blond hairs, and can be quite expensive (over $500 last time I checked).

For more information on this topic, see the HealthLink article The Facts About Polycystic Ovary Syndrome.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.