Many people wonder if birth control causes facial hair. This article explains how hormones influence hair growth and how different birth control methods can affect these levels.
Understanding Hormones and Hair Growth
Hair growth is linked to hormones, especially androgens like testosterone. Androgens are present in both men and women, regulating hair follicles. They transform fine “vellus” hairs into thicker, darker “terminal” hairs in specific body areas. Hair follicles on the upper lip, chin, chest, and back are particularly sensitive to androgens.
Excessive growth of dark, coarse hair in androgen-sensitive areas in women is medically termed hirsutism. This occurs when hair follicles are exposed to higher-than-normal androgen levels or become more sensitive to typical levels. Hirsutism can vary from mild to pronounced, visibly manifesting androgen influence.
How Birth Control Influences Hair Growth
Birth control’s impact on facial hair depends on its hormonal composition. Combined Oral Contraceptives (COCs) contain estrogen and progestin. Estrogen in COCs increases Sex Hormone-Binding Globulin (SHBG) production in the liver. SHBG binds to androgens like testosterone, effectively reducing “free” or active testosterone in the bloodstream. This reduction can decrease unwanted hair growth or prevent new growth, making COCs a common hirsutism treatment.
Conversely, progestin-only birth control methods (pills, implants, injections) do not contain estrogen and rely solely on progestin. Some progestins possess androgenic properties. If a progestin-only method contains a progestin with higher androgenic activity, it could potentially worsen facial hair growth. For instance, levonorgestrel has more androgenic effects than drospirenone, which can be anti-androgenic. Effects vary significantly by individual and specific formulation.
Common Causes of Facial Hair Beyond Birth Control
While birth control can influence hair growth, it is not the sole or most frequent cause of unwanted facial hair. Polycystic Ovary Syndrome (PCOS) is the leading cause of hirsutism in women. PCOS is a hormonal imbalance with elevated androgen levels, often accompanied by insulin resistance. With insulin resistance, the body’s cells do not respond effectively to insulin, leading the pancreas to produce more. This excess insulin can stimulate the ovaries to produce excess androgens, contributing to coarse, dark hair growth in male-pattern areas.
Beyond PCOS, other less common conditions can also lead to hirsutism. Adrenal gland disorders, such as congenital adrenal hyperplasia, can result in androgen overproduction. Rarely, tumors on the ovaries or adrenal glands can secrete high androgen levels, causing rapid, severe hair growth, often with other masculinizing symptoms (e.g., deepening voice, increased muscle mass). Certain medications, such as minoxidil, danazol, or anabolic steroids, can also induce or worsen hirsutism.
Seeking Medical Advice and Management
Consult a healthcare provider for sudden or rapid increases in facial hair growth, or if accompanied by other symptoms like irregular periods, acne, or unexplained weight gain. These signs might indicate an underlying medical condition requiring diagnosis and treatment. A doctor may conduct hormone level tests, particularly for androgens, and perform a physical examination to determine the cause of hirsutism.
Management options for unwanted hair range from cosmetic approaches to medical treatments. Temporary hair removal methods like shaving, waxing, plucking, or depilatory creams can manage visible hair. Longer-term solutions include laser therapy and electrolysis.
Medically, combined oral contraceptives are frequently prescribed to lower androgen levels and reduce hair growth. Anti-androgen medications, such as spironolactone, may also block androgen effects on hair follicles, often with birth control due to side effects and contraception needs. Topical creams like eflornithine can also slow facial hair growth.