May 29, 2012


When I saw a tiny cover image of this book on the soon-to-be-released graphic novels list last year, I was skeptical.  I figured the little bearded girl with the spotted knickers and plump little belly was just a gimmick, but eventually I looked up a blurb and learned this wasn’t the case. 

Her name is Lula, and the book is all about what happens after she trades a lock of her beard to a witch for a rock that turns out to be an egg... which turns out to contain a hulking monster.  Now, despite knowing this much, I really didn’t know what to expect, but I was curious enough to buy it.  Lula, of course, lives and works in her grandpa’s circus, where all the other cast members (some authentic oddities and others pretty average) are quick to judge the beast Lula brings home.  Meanwhile, what the witch does with the lock of Lula’s facial hair brings even bigger troubles to the circus.

Although the story itself is simple and accessible to a much younger crowd, I enjoyed the commentary on being happy with who you are and not compromising for anyone or anything.  The exploration of inner beauty is none-too-subtle, but I was charmed by the fact that Lula really believed in it.  It never crosses her mind that she’s not beautiful for a moment, and her attitude is, to me, what makes this book.

And how often does a girl with a beard get to be a heroine, really?  Who knows why Powell thought of a story about a bearded girl, but it’s nice to see them out there in the entertainment industry a little more--and as characters, not props.

May 23, 2012

7 Things You Can Do to Deal With Hirsutism

Because there is often no way for modern medicine to “fix” hirsutism for good, you should not be afraid to start contemplating living with this forever.  I promise it gets easier.  I have spent this month outlining how hirsutism is investigated and what could be causing it. 

So, regardless of the outcome of your tests, here’s what helped me, and therefore is my prescription:

  • Understand what is causing the hirsutism.  It gives you peace of mind, and helps you see that it is a bodily quirk, a genetic lottery, and has always been beyond your control.
  • Don’t be afraid to try the different treatments out there.  Even if you don’t plan to be taking medications forever, being able to say you’ve tried everything also helps you to realize this is not your fault; it is out of your hands.
  • Family support is wonderful if you have it, but often they cannot fully understand what you’re going through, so find a place to interact with other women with similar challenges, and listen to their experiences.  And if you can’t find one or feel intimidated by the ones out there, do what I did and create your own place.  There are other girls and women looking for those like them all the time.  They’ll find you.
  • Similar to the above, talk about your hirsutism, even if only to yourself.  It helped me to have this blog, and women like me that I could share with.  A diary is another good option if you’re more comfortable with it.  Sometimes I imagine myself making a defense in front of a mirror, the same way people fantasize about receiving an Oscar.  You really can talk yourself into acceptance over time, and might even make you want to talk about it with others.
  • Spend your energy helping others.  This could be returning the support of other hirsute women you meet.  Maybe you could volunteer for the less fortunate.  Maybe you know of a friend who is going through a tough time.  Focusing on making them feel better takes your attention off your own problems.  There is nothing quite so rewarding as relieving the burden of someone else.
  • Nurture and take care of yourself.  Be proud of your achievements.  Pursue new experiences.  Challenge yourself.  You may never be able to celebrate your hirsutism or wear it with pride as some women do.  And that is okay.  You are not obligated to show off your beard, just as other women are not obligated to shave theirs.  Body positivity goes both ways.  Feeling good about yourself as a whole helps you to see that being hirsute is just another tiny detail about what makes you you, the same way your height or the color of your eyes is just a tiny detail unique to you.
  • Cultivate spirituality.  Not wanting to make anyone uncomfortable or risk alienating anyone, I try to avoid turning this blog into a platform for my beliefs, but I am also helped to cope by trying to foster a relationship with God and an appreciation for why things are the way they are now, as well as the hope for the future.  Regardless of what you believe, looking at “the bigger picture” helps keep your own problems in perspective.

I hope that this month's series of posts have covered the main points.  I tried to think of what would have benefited me when I was searching for answers, and what I could have liked to have known then. 

And please, if you have any questions, do not hesitate to ask me!  I allow anonymous comments, and I won’t publish them if you tell me not to.

May 18, 2012

I’m a girl and I’m growing hair on my face. Please just tell me why!

The third and final post in this series directed at young women beginning to develop hirsutism.  The first article dealt with what to expect in the doctor’s office and the second article dealt with some of the main tests you will likely undergo.  Now we will talk about what those test results may tell the doctor, and what can be done about them.

I’m a girl and I’m growing hair on my face.  Please just tell me why!

The “why?” and the “what can be done?” are too intertwined to separate.  And I’m afraid the bad news is, unless the cause is a tumor or organ that can be removed, or a medications that can be stopped, there is no current “cure.”

And no, laser hair removal is not a cure, despite what laymen, some laser hair removal companies, and even some doctors will tell you.  Especially if you are hirsute, your hormones will be able to coax your laser-burned hair follicles right back to life.  This happened to meIf you wish to try laser hair removal, ensure you know the cause of your hirsutism first and have that under control.  I have both read and been told by my own specialist medications combined with supposedly “permanent” methods like laser hair removal are much more successful, and for a longer period of time.

Regardless, learning to love and accept yourself as a whole (not as a “bearded lady” or a “hirsute woman”, but as a woman) seems to be the best treatment available.  But I have a whole blog to talk about that.  Let’s move on to the immediate topic of concern:

What could the diagnosis be? 

Medications or steroid use - Sometimes the answer could be as simple as something you are putting in your body yourself that is causing the hormone imbalance.  Certain treatments for asthma, epilepsy, and endometriosis can do this, to name a few.  If the medication is not essential or can be changed, your doctor can discuss with you the safe way to taper them off.

Polycystic Ovarian Syndrome (PCOS) - The most common diagnosis.  In PCOS, the ovaries are producing excessive amounts of androgens, for a few possible reasons.  The high androgen levels are what cause the hirsutism, as well as other symptoms relating to too much “male” hormone like:
  • acne
  • thinning of scalp hair
  • irregular (and otherwise abnormal and uncomfortable) periods
  • lack of ovulation (and thus difficulty becoming pregnant)
  • a series of small cysts like a “necklace” on the ovaries,
  • issues with metabolism like weight gain and insulin resistance
And these are just the most obvious symptoms.  Although this is the most common diagnosis, you should know that some doctors immediately jump to this conclusion without ruling out the other possibilities.  The tricky thing about PCOS is that it has such a wide range of symptoms, and not all of them will appear in every woman.  Many women won’t get cysts on their ovaries at all, some women never have weight issues, some don’t grow unwanted hair. 

This is usually a syndrome that, depending on how it presents in you personally, will need to be treated, because it can put women at higher risk for many other conditions such as diabetes and cardiovascular disease.  Treatment of PCOS can include:
  • Diet and medications to bring insulin sensitivity under control, which can in turn help the other symptoms. 
  • Oral contraceptives to help regulate your cycle, if starting a family is not your immediate goal. 
  • If hirsutism is the primary concern, you can also be prescribed the same anti-androgen medications as other women with hirsutism, as long as you are not planning to conceive. 
  • If conception is your main goal, there are ovulation-inducing medications, and assisted reproductive technology is an option.
And the nice thing is, there is a lot of support out there for you at places like SoulCysters.

Obesity - Similar to PCOS, hirsutism can be caused by hormonal imbalances from obesity.  And considering obesity can be a symptom of things like PCOS, Cushing’s syndrome or hypothyroidism (discussed later), it may all be related anyway, but I thought it was worth mentioning.

Cushing’s Syndrome - Too much cortisol in the body.  This can be caused by certain drugs, or disorders like Cushing’s disease, wherein the pituitary creates too much ACTH (telling the adrenal glands to make lots of cortisol) or the adrenal glands themselves secrete too much cortisol (or, rarely, a tumor not related to the endocrine system is secreting the ACTH itself).  Aside from hirsutism, other symptoms include:
  • acne
  • weight gain
  • excessive sweating
  • easy bruising and skin dryness
  • high blood pressure,
  • insulin resistance
  • gastrointestinal problems
  • irregular periods or lack of ovulation
  • changes in libido
  • insomnia
Often, Cushing’s syndrome is caused by other medications, which you can gradually stop taking, if possible.  If you have Cushing’s disease and it is caused by a benign tumor on the pituitary or adrenals, treatment usually involves surgically removing it.  Either way, it takes some time for the endocrine system to recover, and usually some hormone therapy will be required. 

Congenital Adrenal Hyperplasia (CAH) - A genetic disorder that is present at birth.  It has several different forms, but in the forms relevant to hirsutism the adrenal glands produce excessive amounts of androgens.  This can cause symptoms in girls and women besides hirsutism, including:
  • irregular cycles
  • lack of ovulation and infertility
  • early or delayed puberty
  • ambiguous genitalia
  • mineral imbalances
There are hormones that can be applied to reduce the hyperplasia, and in young ones hormone therapy of testosterone or estrogen can be applied at puberty.  And, as in PCOS, there are anti-androgen medications that can reduce the effect of the angrogens on your skin and hair, though these will not reduce the excessive production.

In many countries, newborns are screened for CAH, but it is a good idea to be tested for this again simply for family planning.  As a recessive gene, if you and your partner both carry it, there is a greater chance this disorder will present in your children, and with greater severity.

Hypothyroidism - The thyroid is not making enough thyroid hormone.  This can be thanks to the thyroid gland itself, the pituitary gland not communicating properly with the thyroid, or the hypothalamus is not talking enough to the pituitary gland.

Some sources will cite hirsutism as a symptom of hypothyroidism, and others do not.  It seems to be a rare occurrence, but happens often enough to be connected.  And considering hypothyroidism’s other symptoms include affects on the menstrual cycle, libido, scalp hair loss, and weight gain, like in the previously mentioned conditions, it is worth putting on the list. 

I won’t go into it much more than that, but this can be treated by medications containing synthetic thyroid hormones.

Tumor - I must emphasize again that this is quite rare, and remind that tumor does not equal cancer.  Aside from the tumors mentioned in Cushing’s syndrome, it is possible that a tumor, frequently on an ovary, is secreting the androgens right into your system, and its removal will help restore balance to your body.

Idiopathic Hirsutism - Just as tricky as PCOS, if not more-so because different doctors use the term in different ways.  To many, “idiopathic hirsutism” means “I don’t know what it is, or why it is.”  And maybe that’s party true.  But if all the other possibilities have been excluded, and your only symptom is hirsutism with no evident cause (not even high androgen levels), there is still an explanation. 

Doctors may not be able to explain yet why this happens, but some women are just more sensitive to the normal levels of hormones in their body.  These normal hormones are just tootling along, minding their own business, and the androgen receptors completely misunderstand and tell the woman’s skin to do things like get oil and sprout dark, coarse hair where a light, vellus filament once grew before.

Since there is no known underlying cause to treat, you can choose to manage your hair with the previously mentioned anti-androgen medications if you wish.  As I said, these don’t lower your androgen levels, but they interfere with the way they interact with your androgen receptors.  This will reduce, but not always erase, your excess body hair.  But as mentioned in the outset, once you have determined which medication (if any) works best, you might find some more aggressive hair removal methods (such as electrolysis or laser hair removal) are more effective.

There is a lot of information out there that is more detailed about each of these conditions and their treatment, including what the medications are like and how they help, as well as their side-effects.  Since I have idiopathic hirsutism, I mainly talk about the anti-androgen medications here.  I have tried Spironolactone with and without oral contraceptives (Alesse and Diane-35) and Finasteride, which you can read about by following the links.

I also talk about methods of hiding body hair, from plucking and trimming to bleaching and chemical depilatories to shaving and more.  I personally endorse shaving as the least invasive and easiest method.  And I sometimes review products that I feel others might be curious about or that have been helpful to me.

Because this post is so full of information, most of which you will not need, I will post next week the summary of how I have learned to deal emotionally with hirsutism.  Your thoughts and feelings will be the most important part of your treatment.

May 15, 2012

200th Post!

This September will mark the 5th year I've been blogging, but today marks another milestone: Post # 200.

It kind of snuck up on me--in fact, it probably would have flown right by me had I not been poking through the new Blogger updates and noticed the post count.  I just wanted to mark the occasion somehow, and thank you all for reading and interacting and showing me I really am not alone.  You've all taught me so much about how to live with hirsutism and be happy, and you're making me think all the time! 

So let's all pause and take a minute to contemplate how far we've come in our own personal journeys (and please share your thoughts on your own progress in the comments if you want!)  I'm a tea drinker, so I'll be contemplating mine with a nice mug of orange pekoe and the sounds of neighbors mowing their lawns on this muggy (heh, no pun intended) afternoon.

(By the way, you can buy mugs like this all over the place.  This one was brought back from the States.)

201st post will be later this week, continuing the current "newly hirsute" topics of concern.

May 11, 2012

I’m a girl and I’m growing hair on my face. What will happen?

 This post is a continuation of a series of little articles for girls with hirsutism who have just started looking for answers.  Read the previous post here.

I’m a girl and I’m growing hair on my face.  What will happen?

 Last week I talked about what it means to have hirsutism and what your initial doctor's visit will probably be like.  After they do their physical exam (you'd be surprised how much this can tell a dcotor--I can barely comprehend it myself!) and ask for more information about your symptoms, they will either give you an order for some tests, or refer you to a specialist who will give you an order for some tests.

What kind of tests will I undergo?

You are growing coarse dark hair in these odd places because male hormones called androgens are telling those hair follicles to grow it (including testosterone--and forgive me for using the term “male hormones”, which is misleading; it’s a hormone women need too). This can be caused by too much of that hormone or a sensitivity to that hormone.  There are many different parts of the endocrine system that can affect this change in you.

This list is not exhaustive, but it gives you some of the main tests the doctor will likely order:

  • Tests to measure the amount of androgens in your blood like Testosterone, SHBG (Sex Hormone Binding Globulin), and/or Free Androgen Index
  • Tests to measure your thyroid activity such as TSH (Thyroid Stimulating Hormone) and sometimes Free T4 (Free Thyroxine)
  • Tests to measure pituitary function like FSH (Follicle Stimulating Hormone)
  • Tests to measure adrenal function including Testosterone, DHEAS (DHEA-SO4, DHEA Sulfate, Dehydroepiandrosterone Sulfate) and 17H (17-hydroxy-progesterone)
  • A fasting glucose test will also tell them a lot about how your endocrine system is working

They may not order all of these tests if you aren’t presenting symptoms besides the hair that call for concern in these areas.  Or they may order others besides these, like estrogen, cortisol or insulin, which are relevant for certain conditions that cause unwanted hair growth.

Don’t stress over these tests.  They can only reveal so much.  Every woman is supposed to have some level of "male" hormones in her body, and I was shocked to learn that it is actually very difficult to determine what amount is “normal.”  Hormone levels fluctuate throughout your cycle; even throughout the day.  (Some tests even have to be taken at a certain phase of your cycle for pertinent results, and the doctor will tell you about that if it is necessary.) 

The labs are given a range to judge by.  The computer might rank you as "high" but you might simply fall on the high side of normal, which is completely normal for you.  This was what happened in my case.  My family doctor told me I had too much testosterone, while my endocrinologist blinked with surprise and said that my levels were fine.  It comes down to this: What might be average for one woman could be an extreme for another.  That is why it is so good to have an endocrinologist on your side--they have experience interpreting these tricky tests.

Depending on the results of these tests, the doctor may order more tests.

Some of the afore-listed tests can be ordered as follow-ups to other tests.  For example, a doctor may order only a TSH test at first, then ask you to get your Free T4 evaluated afterward.  And keep in mind that once you decide on a treatment path, the doctor may want to test you periodically for side-effects.  Be prepared for multiple trips to the clinic or lab.  For example:

  • If your 17H test comes back with results in certain range, they will want you to take an ACTH stimulation or "CAH" test.  This is a test that involves an injection of ACTH, and then subsequent blood tests to monitor how your adrenal glands react.  (I have done this test, it’s a lot better than it sounds.  You can read about it here.)
  • Your DHEAS and corstisol levels might also point to requiring a closer look at the pituitary and/or adrenal glands by CT scan or ultrasound.
  • Several results might indicate a pelvic ultrasound would be useful.  Testosterone, DHEAS, FSH, Glucose could all point the finger at your ovaries for the source of the elevated hormones or sensitivity that is causing your hair. 
  • TSH or T4 results may show the need to check out the thyroid in detail, by ultrasound or sometimes using radioactive iodine in a scan.

This is certainly not a comprehensive list of tests, but it gives you an idea of how much work it can be to pinpoint the underlying cause of your hirsutism.  That’s why it’s good to start now.  Knowing the reason provides a huge amount of peace of mind, I can tell you, even if you don’t like the reason.  And while some reasons do not require treatment unless you want to manage the hair growth, your hirsutism may be a sign of a condition that could cause complications later on in your life.

Combining your description of all your symptoms, a physical exam and these tests, a specialist can then come to a conclusion and advise treatment.  We’ll talk about some of the possible conclusions next week.

To read about all my tests (read: me whining about needles and full bladders) go here.

A really good site about lab tests, what they’re used for and why: Lab Tests Online (Not intended to replace a doctor’s advice!)

Read the next post in this series here.

May 8, 2012

Follow-Up to My Lonely Weekend

For those who were wondering about my weekend last week following this post--it was a successful failure.  But what I reenforced to myself was that it is more painful to live with not trying than it is to try and fail.  Here’s why:

My practice hair-do bombed.  I had to go out as I normally look, but I was out like I promised myself I would be, so I felt good anyway.  Sort of powerful.  A hair-do might have helped, but not that much.

Traffic was so terrible that I had to give up on going to the festival, and instead headed right down to that party.  I am out of my element in a pub, and no one I knew ended up showing up.  Talk about awkward!  But people were friendly and curious, and when the attention was thankfully not on me I sat by the window sipping a rum and coke and smiling in what I hoped would be an inviting way as I let people move around me.  I met a lot of people that way.  And you know how you meet someone and you both say, “We should do this again sometime” but neither of you even bother to exchange phone numbers?  Well I met people I actually want to keep in touch with, and I have actually done so.  (I also maintain one of the bar staff was checking me out repeatedly throughout the night.  I have terrible self esteem so if I got that impression, there must have been something to notice about his behavior, right?)

I did try to get to the festival the next day.  Had to pep-talk at myself all over again.  I actually arrived on the grounds, and feeling horribly intimated, walked double-time towards what I hoped were the ticket booths with my head down pretending to text on my phone.  I felt like everyone was staring.  “Oh look at her, she’s all alone...”  And when I got to the booth, they told me tickets were sold out for the day.  Shocked and disappointed, I took a very long way back to the car, a path that included a shady street in order to avoid passing those same staring people a second time.  They would know I was stupid enough not to pre-order.  However, not being able to go in allowed me the day to get so much work done that really did need to get done, and I had a lovely lunch at a restaurant I've wanted to try for years, so that was a bonus. 

By Sunday I was exhausted.  There was no way I was going to be able to pluck up the courage to make a third attempt!  It was time to cut my losses.  One of my favorite events of the year, missed.  I opted to give priority to my family, and then if I had time, maybe I’d go down and catch the tail end of everything.  I found out they sold out of tickets for that day, too, but I ended up not having time at all, so it was rather moot.  There was actually quite a bit of outrage at the number of people who did get turned away this year, and watching all that ugly rage allowed me to look at my disappointment and shrug.  There was always next year.  And next year I’d learn from my mistake and pre-order.  Or maybe I’d look at helping out the function by volunteering instead, since they really seemed to have needed it this year.  Good way to meet people with whom I have things in common.  So I was able to let go of my own feelings.  I had tried, and it might not have worked out but dealing with negative emotions is an opportunity to grow.  You learn more from failure than success, right?

I guess I’m more resilient than I think.

The series of posts geared toward young girls with hirsutism continues later this week!

May 1, 2012

I’m a girl and I’m growing hair on my face. What do I do?

Did you know, I recently realized I never did articles like this, as was my intention from the very start?

I’m a girl and I’m growing hair on my face.  What do I do?

The words I was too frightened to type into a search engine from the time I was 14 years old, even though it was the question I wanted an answer for more than anything else.  Until my early 20’s, as I was most of the way through college and had already spent what I would have considered a “fortune” on laser hair removal, I didn’t dare look for an explanation.  Now I see them everywhere--Yahoo!Answers, tumblr, forums, in the comments section of beauty articles.  My impression in communicating with some of my readers is that most of you have been living with excessive body hair for a while and already know why you have it.

But what about those girls out there who are in the stage where they cannot yet admit to themselves that they know something is “wrong” with their bodies, or who are just starting to concede to it and aren’t sure what to do next?  (Note, I am about to start addressing girls who can be qualified as ‘hirsute,’ that is, have pronounced male pattern hair growth--not a surplus of soft blond hair, not a thin mustache or darker arm hair accountable to certain ethnicities, not a couple of stray buggers on the chin or nipples.  Hirsute means you have dark and often coarse hair in some or all of the places a man tends to have it--chest, back, stomach, face, etc.)

To you, I would like to start by saying: Don’t panic.

I promise it’s not as bad as it might seem right now, regardless of the reason why you’re growing dark hair in surprising places.

Next, the thing I wish someone had told me before anything else: Abnormalities in hair growth are a symptom, not a sickness.  They indicate a hormonal issue, not a skin issue. 

What you need to do is go to your doctor. 

I know it can be embarrassing talking about it to your parents, never mind someone else.  You’re probably hoping if you ignore it, it will go away.  If you’re a young person whose hormones are in the midst of a change already, perhaps it will.  But most likely, your excessive body hair is a clue to something that doesn’t automatically fix itself. 

Is it serious?  Well, serious compared to what?  If your body hair is robbing you of confidence and changing the way you live your life, is that not serious enough?  You are in control of your own happiness.  Start by taking charge of your health.  If you don’t, you will always be wondering what is going on in your body that you can’t see.  You deserve the peace of mind, and the knowledge that will allow you to make good decisions about how to manage your body hair from day to day.

Three things your doctor will want to know:

When was your last period?/How regular are your cycles?/What are your periods  usually like?  (Heavy flow?  Cramps that last longer than the first few days of your period?)  - Your answers to these is often a very good indicator that something funky is going on with your hormones.  They can even hint at where the hormonal issue might lie in your endocrine system. 

How quickly did the hair appear? - If severe body hair growth has cropped up in a short amount of time, this can direct the doctor’s attention towards certain causes.

What is your family history? - Often you will not find hirsutism in your family history.  Doctors aren't quite sure how or even if hirsutism is passed on, with the exception of one or two disorders that have hirsutism as a symptom.

Any other symptoms? - Some things you may want to mention to the doctor include:
  • changes in mood, energy, appetite, concentration, libido.
  • difficulty losing weight.
  • oily skin and hair, acne, thinning scalp hair.
  • any body pain, changes in breasts, cramps, bloating, headaches.
  • challenges with conceiving.
Aside from this, they will also do a physical examination (checking your blood pressure, feeling your abdomen, etc.)

See all my personal blog entries on visits to doctors.

What next?

Your doctor may order some tests to try to pinpoint abnormalities before doing anything else.  Or, they may refer you to a specialist who will order the tests for you.  Either way, the specialist you will eventually want to be referred to is an endocrinologist.  They are experts in hormones.  Many women have received great care from their gynecologist, but keep in mind that the endocrine system involves so much more than the lady parts.  Indeed, the cause of your hirsutism might have nothing at all to do with the reproductive systems.  That’s not to say OBGYNs can’t be well versed in hirsutism.  Some dermatologists might be familiar with those tests too.  But frankly, they have a lot of other stuff they need to know as well.  Wouldn’t it make sense that an expert in the entire endocrine system is more likely to catch all clues towards your diagnosis, having both the specialization and the experience?

Over the next few weeks I’ll go a little further into the kinds of tests you can expect, possible causes for your unwanted body hair, and what can be done about them.

Read the next post in this series here.