Other Conditions

1. Hirsutism
2. Hormone Replacement Therapy Q&A
3. Lipedema

1. Hirsutism

1. If you're a woman and you have a lot of hair growing in places where it normally does just for men, like your upper lip, chin, chest, stomach, or back, that’s a condition called hirsutism.

   The hair is often dark and coarse, instead of the light, fine “peach fuzz” that covers most of the body.

   About 5% of women in the U.S. have hirsutism.

   
   
   
   
   

   Causes

   
   

   It's often caused by genes, hormones, or medication.

   Genes. Sometimes, hirsutism runs in families. If your mother or sisters have it, you're more likely to get it. It's also more common in people from the Middle East, South Asia, and the Mediterranean.

   Hormones. Many times, the condition is linked to high levels of male hormones (called androgens). It's normal for women's bodies to make these, and low levels don't cause excess hair growth. But when these amounts are too high, they can cause hirsutism and other things, like acne, a deep voice, and small breasts.

   High levels of male hormones and hirsutism are common in women who have:

   • Polycystic ovary syndrome, which causes small cysts, or fluid-filled sacs, to form on your ovaries.
   • Cushing's syndrome, which you get when you have high levels of the stress hormone cortisol for long periods of time.
   • Tumors in your adrenal glands (which make hormones like cortisol) or your ovaries.

   Medication. Some drugs can change the hormone levels in your system, so you grow unwanted hair on your face or body. This can happen with:

   • Drugs that have hormones, like anabolic steroids
   • Drugs that spur hair growth, like Rogaine (minoxidil)
   • A drug called Danocrine (danazol) that can help with endometriosis, when the tissue that lines the uterus grows outside of the womb

   
   
   

   Treatments

   
   

   If you have more facial or body hair than you want, there are a number of ways you can remove it.

   Weight loss. If you’re overweight and drop pounds, your body should make fewer male hormones, so you should grow less hair on your face or body.

   Shaving. You can remove unwanted hair easily with a razor or electric shaver. You may need to shave daily to avoid stubble growth. Some people get razor burn from shaving too often, but a soothing cream may help.
   
   
   
   
   

   
   
   
   
   

   Tweezing or threading. There are different ways to pluck the hair out at the root. You can use tweezers. Or you can hire someone to “thread” -- use a long, tight strand to loop around and remove each unwanted hair. These methods can cause pain and redness.

   Waxing. A quick way to remove lots of unwanted hair by the root is with melted wax. Often you get this done in a salon. Wax is applied to the skin, then removed quickly. It can cause pain and redness.

   Creams. Some creams have strong chemicals called depilatories. You apply the cream, let it sit for a while, and when you wipe it off, the hair goes with it. They can irritate sensitive skin, so test a small spot before you use one on a large area.
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1. Hormone Replacement Therapy Q&A
4. Hormone Replacement Therapy Q&A
5. 1. Should I stop taking hormone replacement therapy (HRT)?
   It depends on how long you’ve been taking it and why. Here are some facts to help you decide:
   You may be taking HRT to relieve menopause symptoms. At one time, doctors also used to prescribe HRT to manage diseases like osteoporosis and heart disease in women past menopause. But in 2002, a Women’s Health Initiative study found that women who took the most common form of HRT, a combined estrogen and progesterone pill, had a higher risk of heart disease, stroke, and blood clots.
   HRT and Menopause Symptoms: Research shows that a small dose of HRT is still the best way to reduce uncomfortable symptoms in early menopause. Women younger than 60 have the lowest risks, especially if they use the estrogen-only formula for a short time, applying it to their skin instead of taking by mouth.
   Several years of treatment is usually enough to relieve symptoms. So if you’ve been on HRT for more than 5 years, talk with your doctor about tapering off. But you should remember that after stopping, you can expect the hot flushes to return.

HRT and Heart Disease: Doctors no longer prescribe hormones to manage heart disease or other chronic conditions like osteoporosis. If you’re taking HRT to reduce the risk of heart disease, ask your doctor about gradually stopping it.

Before the WHI study, doctors prescribed HRT for heart problems. Some earlier studies showed that women who took hormones had lower rates of heart disease and other chronic diseases. The women may have just been healthier and had better access to medical care.

The WHI study and follow-ups confirmed that HRT didn’t reduce the risk of heart disease; it increased it in healthy, postmenopausal women.

HRT and Osteoporosis: As with heart disease, you should weigh the benefits of using hormones with other risks. To reduce osteoporosis, doctors often suggest lifestyle changes such as regular weight-bearing exercise. You can also try a medicine like Fosamax and Evista, or calcium and vitamin D supplements.

Or you may look at other choices, such as statins, which reduce cholesterol in the blood but also treat osteoporosis and heart disease.

2. Is any type of hormone therapy safer than others?

Experts are still not sure. You and your doctor should talk about which form of HRT might be right for you.

Low-dose hormone replacement therapy: Studies show that lower doses of hormone replacement therapy offer the same benefits without as many risks. In a new study by the Fred Hutchinson Cancer Research Center, where the WHI research took place, women who took low-dose estrogen had 53% fewer hot flashes and night sweats.

Estrogen alone: This is the suggested treatment for women who’ve had a hysterectomy to remove their uterus. Women who take estrogen alone have fewer risks of breast cancer and other disorders. Still, doctors caution that taking estrogen alone can increase your risk of stroke and uterine cancer.

Bio-identical estrogen patches, creams, or vaginal rings: These forms of estrogen are similar to what the body makes. Unlike a pill, they enter the body through the skin or walls of the vagina. In this way, they bypass the liver, reducing the risk of serious blood clots or gallbladder disease. There is still a risk of both, but it will be less than if you were taking the equivalent dose of oral hormones.

3. What else can I do to prevent menopause symptoms?

Soy or black cohosh: Soy and black cohosh supplements contain phytoestrogens, plant materials that may act like estrogen in the body. Some studies haven’t found any proof that these “natural” therapies reduce menopause symptoms. Supplements aren’t regulated or approved by the FDA, and phytoestrogens may increase risks for certain diseases.

Antidepressants: Studies show antidepressants like Prozac and Effexorreduce hot flashes. One study found that venlafaxine, the main ingredient in Effexor, reduced hot flashes and night sweats by 48%. The results were similar to those for low-dose estrogen but without the risks.

Lifestyle changes: Here are some other ways to cope with menopause symptoms:

• Dress in layers so you can remove clothes as needed.
• Avoid hot and spicy foods and beverages.
• Use cotton sheets, and wear clothes that allow your skin to breathe.
• Limit caffeine and alcohol.
• Use relaxation techniques such as yoga.
• Don’t smoke.
• Get regular exercise.

Don’t forget to check with your doctor. The best plan for you might be to do nothing at all.

1. Lipedema

Lipedema affects up to 11% of women. It happens when fat is distributed in an irregular way beneath your skin, usually in the buttocks and legs. Although it begins as a cosmetic concern, it can eventually cause pain and other problems.  Lipedema can be mistaken for regular obesity or lymphedema.

Symptoms of Lipedema

The typical symptoms are a large lower half and column-like legs, which are often tender and bruise easily. For example, the top half of your body may be a size 8, but the bottom half may be a size 16.

As the condition progresses, fat continues to build up, and your lower body grows heavier. The lipedemic fat can later collect in the arms. 

Over time, fat cells block the vessels of your lymphatic system, which normally helps balance body fluid levels and protect against infection. This blockage prevents the proper drainage of lymph fluid, leading to a buildup of fluid called lymphedema.

If not treated, lymphedema can lead to problems such as infections, delayed wound healing, development of scar-like tissue called fibrosis, and hardened skin in the legs.

Causes of Lipedema

The cause is not known, but doctors suspect female hormones play a role. That's because the condition affects mostly women, and it often begins or worsens at puberty, during pregnancy, following gynecologic surgery, and around the time of menopause.

Scientists also believe genes are involved, because many women with the condition have family members with the condition.

Lipedema Treatments

Dieting and exercising will not reduce the fat involved in lipedema. But it's still important to do those things because they can help you lose weight from lipedema fat and reduce inflammation.  

A treatment called complete decongestive therapy can ease painful symptoms. Complete decongestive therapy involves:

Manual lymphatic drainage. A form of massage that uses gentle, rhythmic pumping movements to stimulate the flow of lymph around blocked areas to healthy vessels, where it can drain into the venous system. This helps relieve pain and prevent fibrosis.

Compression. The use of stretch bandages or custom-fitted pantyhose, panties, or spandex shorts to increase tissue pressure in the swollen legs and lessen the odds of fluid building up again.

Exercise. Helps to reduce fluid buildup, boost mobility, and maintain or improve how well your legs work.

Thorough skin and nail care. Helps lower the risk of wounds and infection if you have lipedema associated with swelling.

Liposuction, specifically water-assisted liposuction and tumescent liposuction, can remove the lipedema fat. The procedure uses a hollow tube that is placed under the skin to suction the fat tissue. Several sessions may be needed depending on the amount of abnormal fat.