Excessive facial or body hair in females, known as hirsutism, can be a source of concern. Prolactin, a hormone primarily recognized for its role in milk production, sometimes appears at elevated levels in women. This article explores whether high prolactin levels directly contribute to facial hair growth in females.
What Is Prolactin?
Prolactin is a protein hormone produced mainly by the pituitary gland, a small organ located at the base of the brain. While best known for initiating and maintaining milk production (lactation) and supporting breast development during pregnancy, prolactin has over three hundred functions in the body. These roles extend to metabolic regulation, immune system modulation, fluid balance, and various reproductive and behavioral functions.
When prolactin levels in the blood become abnormally high outside of pregnancy or breastfeeding, the condition is termed hyperprolactinemia. Common causes include benign pituitary tumors called prolactinomas, certain medications like antipsychotics, some antidepressants, and high blood pressure drugs, as well as hypothyroidism. Symptoms of hyperprolactinemia often involve irregular or absent menstrual periods, infertility, milky nipple discharge unrelated to pregnancy (galactorrhea), reduced sexual interest, and vaginal dryness.
Understanding Hirsutism in Females
Hirsutism is characterized by the growth of coarse, dark hair in areas typically associated with male hair patterns, such as the upper lip, chin, chest, abdomen, and back. This contrasts with the fine, light “peach fuzz” found in these regions. Hirsutism is a common endocrine disorder affecting approximately 10% of women in the United States.
The primary cause of hirsutism is almost always an excess of androgens, which are male hormones, or an increased sensitivity of hair follicles to normal androgen levels. Polycystic Ovary Syndrome (PCOS) is the most frequent cause, accounting for 70% to 85% of cases, and involves an imbalance of sex hormones. Other conditions contributing to androgen excess include adrenal gland disorders like congenital adrenal hyperplasia or Cushing’s syndrome, and, rarely, androgen-secreting tumors in the ovaries or adrenal glands. Certain medications, such as anabolic steroids, testosterone, or minoxidil, can also induce hirsutism.
The Relationship Between Prolactin and Facial Hair
While elevated prolactin levels themselves do not directly stimulate the growth of coarse facial hair, there can be an indirect or associated relationship with hirsutism. Prolactin’s main influence is not on hair follicles but on reproductive hormone regulation. High prolactin can disrupt the normal hormonal balance by inhibiting the release of gonadotropin-releasing hormone (GnRH), which in turn reduces the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
This disruption can indirectly affect androgen production or metabolism within the body. For instance, some conditions that cause hyperprolactinemia, such as PCOS, are also primary drivers of androgen excess and, consequently, hirsutism. In such cases, the hirsutism is mainly a result of the androgen excess stemming from the underlying condition rather than directly from the high prolactin.
It is important to recognize that hyperprolactinemia is rarely the sole or primary cause of significant hirsutism. When hyperprolactinemia is present alongside hirsutism, the excessive hair growth is usually attributed to other, more direct causes of androgen overproduction. If hirsutism is observed, it is typically mild and secondary to other hormonal imbalances that may coincidentally elevate prolactin.
When to Seek Medical Guidance
If you notice significant or rapid growth of coarse, dark hair in male-like patterns, particularly on your face or body, consulting a healthcare professional is advisable. A proper diagnosis is important to identify the underlying cause of both hyperprolactinemia and hirsutism, as their origins can vary and require specific treatment approaches.
Diagnostic evaluation often involves blood tests to measure hormone levels, including prolactin, testosterone, and other androgens. Imaging studies, such as an ultrasound of the ovaries or an MRI of the pituitary or adrenal glands, may also be recommended to rule out tumors or other structural abnormalities. Treatment for hyperprolactinemia commonly involves medications called dopamine agonists, which help lower prolactin levels and can shrink pituitary tumors. For hirsutism, treatment focuses on addressing the root cause, which might include anti-androgen medications, oral contraceptives, or specific creams to slow hair growth.