This study was to determine if there exists a difference in the rate of hirsutism in genetically similar women in two different environments. 112 Nigerian women living in the U.S.A and 70 women living in Nigeria were surveyed. All women completed a pictorial survey scoring peripheral hair growth in 6 body areas from 0 (no significant hair growth) to 4 (severe hair growth). Total hirsutism score was calculated as a sum of individual scores. The survey also included demographic data, menstrual history, and data regarding use of hormonal treatments. Statistical comparisons between groups included t-test, nonparametric tests and chi-square test. Multiple regression analysis was carried out to identify independent predictors of peripheral hair growth. Women residing in U.S.A had a 31% higher total hirsutism score than those residing in Nigeria. This difference was not related to irregular menstrual cycle. To account for possible effects of age, B.M.I and differences in tribal origin, multiple regression analysis was performed. Location (living in U.S.A vs. Nigeria) remained the strongest predictor of total hirsutism score (P=0.02); tribal origin was also significant (P=0.04), while age and B.M.I had no independent predictive value (P>0.1). It was concluded that this difference, is not explained by factors such as age, obesity and ethnic origin. We propose that this difference may be due to differences in environmental or lifestyle factors of the women.

Yes / Hair follicles (HFs) are immersed within dermal white adipose tissue (dWAT), yet human adipocyte-HF communication remains unexplored. Therefore, we investigated how perifollicular adipocytes affect the physiology of organ-cultured human anagen scalp HFs. Quantitative (immuno-)histomorphometry, microCT and transmission electron microscopy showed that the number and size of perifollicular adipocytes declined during anagen-catagen transition, whilst fluorescence lifetime imaging revealed increased lipid oxidation in adipocytes surrounding the bulge/sub-bulge region. Ex vivo, dWAT significantly stimulated hair matrix keratinocyte proliferation and HF pigmentation. Both dWAT pericytes and PREF1/DLK1+ adipocyte progenitors secreted hepatocyte growth factor (HGF) during human HF-dWAT co-culture, for which the c-Met receptor is expressed in the hair matrix and dermal papilla. These effects were abrogated by an HGF-neutralising antibody, and reproduced using recombinant HGF. Laser capture microdissection-based microarray analysis of the hair matrix showed that dWAT-derived HGF up-regulated KRT27, KRT73, KRT75, KRT84, KRT86 and TCHH. Mechanistically, HGF stimulated Wnt/β-catenin activity in the HM by inhibiting SFRP1 in the dermal papilla, up-regulating matrix AXIN2, LEF1, WNT6 and WNT10B expression. Our study demonstrates that dWAT regulates human hair growth and pigmentation via HGF secretion, and thus identifies important, molecular and cellular targets for therapeutic intervention in disorders of human hair growth and pigmentation.

Hirsutism is excessive hair growth in women. The prevalence is estimated at 5%. The aim of this thesis was to describe different aspects of how life is affected for women suffering from hirsutism. Both qualitative and quantitative methods were used. Study I showed that hirsutism deeply affects women’s experiences of their bodies in a negative way and was experienced as a life sorrow. In Study II the patient-physician relationship was described. The patient-physician relationship from the patient’s perspective was suboptimal, as most meetings included feelings of being rejected and even humiliation. In Study III the aim was to translate and psychometrically evaluate an instrument that measures perceived social support, “The Multidimensional Scale of Perceived Social Support” (MSPSS). The translation was performed according to WHO:s official process, and validation was performed in a sample that consisted of 281 participants, 127 women with hirsutism (main sample) and 154 nursing students. MSPSS had good psychometric properties with regard to factor structure, construct validity, internal consistency and reproducibility. Study IV described different aspects of HRQoL in the main sample, the correlation of anxiety, depression, level of hairiness, age and BMI. The F-G scores were dichotomized into minor (F-G ≤14) and major (F-G≥15) hair growth. Higher levels of hair growth were significantly correlated to a lower level of QoL measured by DLQI, EQ-5D and symptoms of both anxiety and depression measured by HADS. Study V investigated if social support was associated with quality of life and outcome of HRQoL compared to a reference group of women (n=1115). SF-36, the MSPSS and the F-G scale were used. Compared to the reference group, women with hirsutism reported lower quality of life in all dimensions of SF-36 (p<0.01) The dimension most affected was vitality (VT=41.2), which had a lower value than has been reported for patients with MS and myasthenia gravis. A Multiple Regression Analysis showed a significant relation between quality of life and social support, indicating its importance for the ability to adapt, in spite of low quality of life.

Yes / Male sex hormones-androgens-regulate male physique development. Without androgen signaling, genetic males appear female. During puberty, increasing androgens harness the hair follicle's unique regenerative ability to replace many tiny vellus hairs with larger, darker terminal hairs (e.g., beard). Follicle response is epigenetically varied: some remain unaffected (e.g., eyelashes) or are inhibited, causing balding. How sex steroid hormones alter such developmental processes is unclear, despite high incidences of hormone-driven cancer, hirsutism, and alopecia. Unfortunately, existing development models are not androgen sensitive. Here, we use hair follicles to establish an androgen-responsive human organ culture model. We show that women's intermediate facial follicles respond to men's higher androgen levels by synthesizing more hair over several days, unlike donor-matched, androgen-insensitive, terminal follicles. We demonstrate that androgen receptors-androgen-activated gene transcription regulators-are required and are present in vivo within these follicles. This is the first human organ that involves multiple cell types that responds appropriately to hormones in prolonged culture, in a way which mirrors its natural behavior. Thus, intermediate hair follicles offer a hormone-switchable human model with exceptional, unique availability of genetically identical, but epigenetically hormone-insensitive, terminal follicles. This should enable advances in understanding sex steroid hormone signaling, gene regulation, and developmental and regenerative systems and facilitate better therapies for hormone-dependent disorders.

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Polycystic Ovarian Syndrome (PCOS) is the most frequent metabolic disorder in the female population. It affects 10% of women of childbearing age, and its pathophysiology, although not completely known, is associated with insulin resistance, hyperandrogenism and gonadotropin alteration. The diagnosis is of exclusion and is difficult due to the multiple phenotypes found, being fundamental the presence of menstrual dysfunction and alteration of the levels of androgens. Hirsutism, increased pilification in androgen-dependent areas, is a frequent complaint and correlates with PCOS in up to 95% of cases. Women with PCOS are at greater risk for developing metabolic syndrome and cardiovascular disease. These comorbidities usually manifest with aging and there are no guidelines for diagnosing PCOS after menopause. Because of this, we have attempted to prove the hypothesis that the history of self-reported hirsutism and / or oligomenorrhea influences the calculation of risk for comorbidities after menopause (type 2 diabetes mellitus, asthma, chronic bronchitis or emphysema, osteoarthritis, stroke, Heart failure, angina or myocardial infarction, multiple sclerosis, neoplasia, and Parkinson's disease). This cross-sectional study investigated women (1057) with at least 55 years of age, post-menopausal, with no cognitive deficit and / or communication difficulty who were seen in primary care services in a municipality in the south of Brazil during the 24-month period, Through a structured questionnaire that collected self-reported data on the presence of comorbidities, reproductive history and complaint of hirsutism in menacme. A significantly higher prevalence of comorbidities was found in women with a history of hirsutism and / or oligomenorrhea [OR = 1.6 (95% CI 1.1-2.4), or = hirsutism [OR 2.0 95% CI 1.3-3.2), P = 0.004]. As well as the prevalence of stroke, angina or myocardial infarction, heart failure, chronic obstructive pulmonary disease and osteoarthritis were significantly higher (p <0.03). Therefore, the presence of hirsutism and oligomenorrhea in menacing are risk factors for comorbidities, mainly cardiovascular, these alterations are possibly associated with the presence of PCOS, so its correct diagnosis in the menacme could avoid the reduction of quality of life in senectude. / Síndrome dos Ovários Policísticos (SOP) é a desordem metabólica mais frequente na população feminina, acomete 10% das mulheres em idade fértil e cuja fisiopatologia, apesar de não ser completamente conhecida, associa-se a resistência à insulina, hiperandrogenismo e alteração das gonadotropinas. O diagnóstico é de exclusão e dificultado devido aos múltiplos fenótipos encontrados, sendo fundamental a presença de disfunção menstrual e alteração dos níveis de androgênios. O hirsutismo, pilificação aumentada em áreas andrógeno-dependentes, é queixa frequente e correlaciona-se a SOP em até 95% dos casos. Mulheres portadoras de SOP tem maior risco para desenvolver síndrome metabólica e doenças cardiovasculares. Essas comorbidades costumam manifestar-se com o envelhecimento e inexistem diretrizes para diagnosticar SOP após a menopausa. Devido a isso, tentamos comprovar a hipótese de que a história de hirsutismo e/ou oligomenorreia autorrelatada na menacme influencia no cálculo do risco para comorbidades após a menopausa (diabetes mellitus tipo 2, asma, bronquite crônica ou enfisema, osteoartrite, acidente vascular cerebral, insuficiência cardíaca, angina ou infarto do miocárdio, esclerose múltipla, neoplasia e doença de Parkinson). Esse estudo transversal investigou mulheres (1057) com pelo menos 55 anos, na pós-menopausa, sem déficit cognitivo e/ou dificuldade de comunicação que foram atendidas em serviços de atenção primária de um município do sul de Brasil durante o período de 24 meses, através de um questionário estruturado que coletou dados autorrelatados da presença de comorbidades, história reprodutiva e queixa de hirsutismo na menacme. Identificou-se prevalência de comorbidades significativamente maior nas mulheres com história de hirsutismo e/ou oligomenorreia [OR = 1,6 (95% IC 1,1-2,4), p = 0,002] ou hirsutismo isolado [OR 2,0 (IC 95% 1,3-3,2), P = 0,004]. Assim como a prevalência de acidente vascular cerebral, angina ou infarto do miocárdio, insuficiência cardíaca, doença pulmonar obstrutiva crônica e osteoartrite foram significativamente maiores (p <0,03). Portanto, a presença de hirsutismo e oligomenorreia na menacme são fatores de risco para comorbidades, principalmente cardiovasculares, essas alterações são possivelmente associadas a presença de SOP, por isso seu correto diagnóstico na menacme poderia evitar a redução da qualidade de vida na senectude.

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Abstract Oligomenorrhea (menstrual disturbances) and hirsutism (excessive growth of body hair) are typical symptoms of polycystic ovary syndrome, a common endocrine disorder with long-term health risks among fertile-age women. Associations between body size development and polycystic ovary syndrome symptoms in a cohort design (528 symptomatic and 1479 asymptomatic women) and endocrine, metabolic and clinical characteristics of women with self-reported symptoms of oligomenorrhea or hirsutism in a nested case-control design (518 cases and 1036 controls) were investigated in this general population-based study. Gynecologic ultrasonographic examinations were performed in 196 cases and 67 controls to assess the morphology of the ovaries and its relationship to biochemical and clinical parameters. The study population was derived from the Northern Finland Birth Cohort 1966, which included all births with expected birth dates in 1966 in Northern Finland and is well representative of the general female population. Polycystic ovary syndrome symptoms in adulthood were associated with obesity, particularly abdominal obesity, in adolescence and in adulthood, but not with birth weight or being small for gestational age. Hormonal changes typical of polycystic ovary syndrome, i.e. higher circulating concentrations of testosterone, luteinizing hormone (LH) and insulin and lower levels of sex hormone-binding globulin (SHBG), were detected in women with self-reported symptoms of oligomenorrhea and/or hirsutism compared with the controls. Less favorable metabolic cardiovascular disease risk factor profiles, higher body mass index (BMI), waist-hip ratio (WHR), and triglyceride and C-reactive protein (CRP) concentrations and lower high density lipoprotein cholesterol (HDL-C) levels, were detected in women with symptoms, being the most severe among women who reported both hirsutism and oligomenorrhea. Unfavorable characteristics were pronounced in the presence of overweight or obesity. Women with symptoms more often had features characteristic of polycystic ovarian morphology associated with an endocrine and clinical profile reflecting polycystic ovary syndrome. This study shows that questioning in regard to symptoms of oligomenorrhea and hirsutism is useful in detecting women at risk of polycystic ovary syndrome and associated health risks. Avoidance of being overweight is important among young women to prevent the development of insulin resistance. Systematic follow-up of women with symptoms of oligomenorrhea and hirsutism is justified for prevention and early detection of long-term health risks.

Bakgrund: Polycystiskt ovariesyndrom (PCO) är ett vanligt syndrom som många kvinnor lider av. PCO innebär att äggstockarna bildar fler folliklar (cystor) än vad som anses vara normalt samt att en hormonell obalans föreligger. PCO har en prevalens på 5-10 procent och är en vanlig endokrin avvikelse hos kvinnor i fertil ålder. Då dessa kvinnor befinner sig i hela vårdkedjan är det viktigt att som allmänsjuksköterska känna till hur denna patientgrupp upplever sin livssituation. Syfte: Syftet med denna litteraturstudie var att undersöka kvinnors upplevelser av att leva med PCO och hur det påverkade deras livskvalitet. Metod: Analys av tio vetenskapliga artiklar, varav sex av artiklarna hade en kvalitativ ansats och fyra av dem hade en kvantitativ ansats. Resultat: Analysen resulterade i fyra huvudteman: Avvikande yttre, sex och relationer, sjukvården samt självuppfattning. Bristande vård samt en generellt lägre livskvalitet sågs hos dessa kvinnor. Slutsats: Implikationer för vården blir att utveckla sin kunskap inom detta område för att på så sätt förbättra livskvaliteten för kvinnor med PCO. / Bakground: Polycystic ovary syndrome (PCO) is a common syndrome that many women suffer from. PCO means that the ovary produces multiple follicles (cysts) than what is considered normal, and that a hormonal imbalance can be seen. PCO means that the ovary produces multiple follicles (cysts) than what is considered to be normal. PCO has a prevalence of 5-10 percent and is a common endocrine differential in women of childbearing age. These women are in the continuum of care, why it is important for a general nurse to know how these patients perceive their life situation. Aim: The aim of this study is to explore women's experiences of living with PCO and how it affects their quality of life. Method: Analysis of ten scientific papers, there six of the items had a qualitative approach, and four of them had a quantitative approach. Result: The analysis resulted in four main themes: Deviant exterior, sex and relationships, health and self-perception. Lack of care and a generally lower quality of life were observed in these women. Conclusion: Implications for health care will be to develop their knowledge in this area in order to improve the quality of life for women with PCO.