This occurs in patients without any evidence of hormone imbalances, underlying disease, or a family history of hirsutism. Most of these individuals probably have enzyme systems in the hair follicle which make their hair cells more sensitive to normal levels of circulating androgens. Drug induced hirsutism is not common, but some prescription drugs can cause hirsutism in women. Some of the anti-seizure medications used to treat epilepsy, anabolic steroids, and some immunosuppressant drugs are also associated with excess hair growth in women. A careful medical history should be able to determine if drug-induced hirsutism may be a consideration for any individual patient.
Androgen excess represents the most common cause of hirsutism.
Androgen excess may be due to a number of conditions including polycystic ovary syndrome. This is the most common cause of androgen excess in otherwise healthy reproductive age women. PCOS may also lead to irregular or absent menstrual periods, high blood pressure, acne, increased body weight, and infertility. In vary rare cases, excess androgen production may be caused by ovarian or adrenal tumors. Other adrenal disorders such as adrenal hyperplasia or Cushing s syndrome can also cause hirsutism.