Hormonal Imbalance Can Stimulate Facial Hair Growth In Women

Noticing dark, coarse hairs on your chin, upper lip, or cheeks can trigger feelings of anxiety, embarrassment, and sometimes helplessness, especially if this is a new development. However, you’re not alone: excessive facial hair growth due to hormonal imbalance is an issue that affects 5–10% of women (1). While a light fuzz is considered normal, the appearance of coarse and dark hair in a male-pattern distribution (known as hirsutism) may indicate an underlying hormonal disorder.

This is not merely a cosmetic issue. For many women, unwanted facial hair becomes a significant source of stress, undermining self-confidence and leading them to avoid cameras, mirrors, and even intimacy. But it’s important to understand: hirsutism is not a life sentence. Today, there are effective methods for diagnosing, managing, and removing unwanted facial hair.

In this article, we will take a detailed look at how hormonal imbalance can trigger facial hair growth in women, which medical conditions it may be associated with, and which treatment and hair removal methods truly work.

Why Do Women Grow Facial Hair?

Excessive facial hair growth in women is often linked to hormones, particularly androgens. These are male sex hormones that are also present in women, but in much smaller amounts. The main androgens involved are testosterone and its more potent form, dihydrotestosterone (DHT). When these hormones are elevated, or when the body becomes more sensitive to them, fine vellus hairs on the face may transform into coarse, dark terminal hairs.

• Androgens are produced in the ovaries and adrenal glands. Even at normal levels, these hormones can affect hair follicles, especially if the skin more actively converts testosterone to DHT, a process facilitated by the enzyme 5α-reductase.
• DHT stimulates hair growth more strongly than testosterone. It “activates” the hair follicle, prompting it to produce thicker, darker hair.
• Under normal conditions, a woman’s body balances androgens with estrogens and progesterone, which help suppress excessive hair growth. Estrogens increase levels of sex hormone-binding globulin (SHBG), which binds free testosterone in the bloodstream, while progesterone can inhibit the conversion of testosterone into DHT.

However, when estrogen levels drop (for example, during menopause), androgens may begin to dominate, leading to increased facial hair growth in some women over the age of 45.

Common Hormonal Imbalances and Conditions That Cause Unwanted Hair Growth

Hirsutism – the excessive growth of coarse, dark hair on the face and body of women often indicates a significant hormonal imbalance. In most cases, “extra” hair appears due to elevated levels of male hormones (androgens), menstrual irregularities, and metabolic disturbances. Below are the main conditions associated with hormonal imbalances that may lead to increased facial hair growth in women.

PCOS is the most common hormonal disorder in women of reproductive age and the leading cause of hirsutism. In PCOS, immature follicles accumulate in the ovaries, and androgen secretion increases. Classic symptoms of PCOS include irregular or infrequent menstruation, acne, obesity, and infertility. One of the most noticeable signs is often the excessive growth of facial and body hair.

According to various estimates, PCOS affects approximately 5–10% of women, and 70–80% of those diagnosed with the condition experience hirsutism (2). Among them, many report the growth of hair above the upper lip, on the chin, and cheeks, noticeably darker and coarser than normal vellus hair.

Metabolic disturbances such as decreased glucose sensitivity and excess body weight are directly linked to hormonal imbalances and increased hair growth. Adipose tissue reduces the body’s sensitivity to insulin, the hormone that regulates blood sugar levels. In response, the body produces more insulin. Elevated insulin levels, in turn, stimulate the ovaries and adrenal glands to produce more male hormones – androgens.

This is particularly common in women with PCOS: many of them suffer from insulin resistance and are overweight. A significant proportion of women with PCOS (38–88%) have obesity, which further increases the risk of developing type 2 diabetes and cardiovascular diseases (3).

In addition, excess weight by itself can promote the growth of unwanted hair. Even a moderate weight loss (5% or more) can help reduce androgen levels and slow down hair growth.

Thus, excess weight and insulin resistance create a vicious cycle: they intensify hormonal imbalances, which in turn contribute to excessive hair growth in women.

With the onset of menopause, levels of female hormones, especially estrogen, decline significantly. At the same time, levels of male hormones (androgens), such as testosterone, either remain unchanged or decline at a slower rate. This shift in hormonal balance leads to androgen dominance, which can stimulate the growth of coarser and darker facial hair, particularly on the chin and upper lip.

In addition, lower estrogen levels can reduce the production of sex hormone-binding globulin (SHBG). This leads to an increase in free testosterone in the body, enhancing its impact on hair follicles.

This phenomenon, where women develop unwanted facial hair after menopause, is known as postmenopausal hirsutism. Although this condition can cause discomfort and affect self-esteem, it is relatively common and associated with natural hormonal changes in the female body.

During pregnancy, a woman’s hormonal environment undergoes dramatic changes: levels of estrogens, androgens, and other hormones rise sharply. As a result, many expectant mothers notice an increase in hair growth, including on the face. For instance, some women report the appearance or thickening of hair above the upper lip, on the chin, or cheeks during pregnancy. Although androgen levels typically remain within the normal range, their increase can stimulate hair follicles, causing previously fine vellus hairs to become more noticeable.

However, these changes are usually reversible: after childbirth and the normalization of hormone levels, the excess hair typically sheds gradually.

“Pregnancy and lactation cause temporary hormonal fluctuations, including elevated levels of androgens and estrogens. Any hair that grows during this period usually disappears after breastfeeding ends,” notes Anna Saprykina, lead specialist at Body Silk Clinic.

In addition to the ovaries, the adrenal glands are a key source of hormones. In certain endocrine disorders, the adrenal glands may be the source of excessive androgens and cortisol. A classic example is Cushing’s syndrome, in which the body produces too much cortisol, often due to a tumor or prolonged use of corticosteroids. In addition to the characteristic “moon face” and swelling, women with Cushing’s syndrome frequently develop coarse, dark facial hair (such as a mustache or beard) and irregular menstrual cycles.

Another example is congenital adrenal hyperplasia (CAH). In this rare genetic disorder, a deficiency of cortisol leads to the accumulation of androgens. In girls, these imbalances can manifest with male-pattern traits, such as a deepened voice and excessive hair growth on the face, chest, and abdomen.

Lastly, rare tumors of the ovaries or adrenal glands that secrete androgens may cause a sudden onset of hirsutism. Although adrenal-related hormonal conditions are uncommon, it is important to rule them out when facial hair growth progresses rapidly, especially when accompanied by other symptoms like acne or voice changes.

Hormonal imbalances can result not only from internal causes but also from external ones. Certain medications and substances either contain androgens or stimulate their production, leading to excessive hair growth.

“Anabolic steroids and direct testosterone supplementation often cause pronounced hirsutism. I’ve also seen cases where long-term medications – from anticonvulsants to immunosuppressants – lead to hypertrichosis. These include phenytoin, danazol, cyclosporine, and even topical hair growth stimulants like minoxidil,” says Saprykina.

Therefore, when taking hormone-containing or hormone-active drugs (such as hormone replacement therapy, sports supplements, or certain contraceptives), one should be aware of potential side effects like excessive hair growth. These factors are generally beyond physiological control but should be considered when evaluating the causes of facial hair growth in women.