Hirsutism

Hirsutism is the growth of excess coarse, dark hair in a male-pattern distribution—typically on the face, chin, chest, abdomen, and back—affecting 65-75% of women with PCOS and often causing significant emotional distress. This symptom results from elevated androgens, particularly testosterone and its more potent form DHT, which transform fine vellus hairs into thicker terminal hairs in androgen-sensitive areas. PCOS is the most common cause of hirsutism in women, and treatment typically involves anti-androgen medications like spironolactone, combined oral contraceptives, and cosmetic approaches like laser hair removal. Unlike many PCOS symptoms, hormonal treatment takes approximately 6-12 months to produce visible improvement in hair growth patterns.