Elevated androgens (e.g., testosterone, DHEA-S) may stimulate terminal hair growth in androgen-sensitive areas. Contributing factors include:
Polycystic Ovary Syndrome (PCOS): Affects ~10% of reproductive-aged individuals; often presents with irregular cycles, acne, scalp hair thinning, and insulin resistance.
Menopause/Perimenopause: Declining estrogen creates relative androgen dominance.
Thyroid Dysfunction: Hypothyroidism may lower sex hormone-binding globulin (SHBG), increasing bioavailable androgens.
Insulin Resistance: Hyperinsulinemia can stimulate ovarian androgen production.
Adrenal Disorders or Medications: Certain steroids, hormone therapies, or rare tumors may alter androgen levels.
Genetic and Ethnic Factors
Hair growth patterns vary significantly across ethnicities. Individuals of Mediterranean, Middle Eastern, South Asian, or Latin American descent may experience naturally denser facial hair without pathology. Family history is a relevant consideration.
