Dear Dr. G,

I noted you almost exclusively respond to male readers. I am hoping you can also solve certain conundrum in my life concerning sex.

I am a 25-year-old woman who just started sexual relationship with my partner. I have noticed several changes in my physique that really concern me.

It all started when my period became erratic and irregular, just like my mood swings. Then I started noticing myself putting on tremendous amount of weight and finding it difficult to shed.

In recent months, I also noticed myself to be more hairy than most women. I mean not just all over my body, but also on my face.

Apart from my facial hair, I also started getting lots of pimples on my face and my back. These skin changes really adversely affect my self-esteem, as I noticed many people staring at me.

Despite having all these issues, my boyfriend is very supportive and accepts me the way I am. I am very glad that I have found myself a loyal partner who loves me the way I am.

Don’t get me wrong. It is not all bad, despite being hairy and overweight, something very peculiar is that I have heightened sex drive, in comparison to my peers. Sometimes, it really worries me whether such increase in sexual appetite in a woman is acceptable or normal.

I really would like to put Dr. G on the spot of my situation.

Have you ever come across women with similar presentation?

Can anything be done about my weight, hairiness and acne?

Lastly, although I enjoy my heightened libido, should I embrace or dampen the desire?

Hairy Helga

The disturbance of excessive male hormones, affecting the homeostasis and balance of female hormones, often occurs in women suffering from Polycystic Ovarian Syndrome (PCOS). PCOS results in a set of symptoms caused by elevated androgens. These include weight gain, irregular menstruation, pigmented skin, acne, and excessive bodily and facial hair. The condition can also influence changes in sexual needs. PCOS is common endocrine disorder affecting women aged 18 to 45. The condition was described in Italian medical literature since 1721.

Modern studies revealed the prevalence ranging from 2% to 20% of the adult female population with the World Health Organisation estimating that PCOS affects 116 million women worldwide, as of 2010, which is 3.4% of the female population. The real etiology of PCOS is unknown. However, studies support both genetic and environmental causes contributing to the disorder, including family history and sedentary lifestyle.

PCOS is also associated with serious medical conditions such as infertility, diabetes, obstructive sleep apnea, and heart disease and endometrial cancer. The pathogenesis of PCOS is essentially high levels of masculinising hormone, known as hyperandrogenism.

The manifestation of excessive testosterone results in male pattern hair growth on face and chest. In severe cases, the androgenic effects also cause increased hair thinning and male pattern baldness. There is no cure for PCOS. The utilisation of oral contraceptive pills, anti-androgen and diabetic medications may be useful to improve acne, hair growth and menstruation.

However, the most effective way to reduce the symptoms is weight loss and exercise. A scientific review in 2013 revealed weight reduction resulted in improvement of fertility, menstruation and undesirable skin changes. The impact on libido is somewhat confusing in women with PCOS. The high levels of androgen, accompanied by low levels of Sex Hormone Binding Globulin (SHBG) are noted to enhance sexual desire.

On the other hand, many women also describe low self-esteem and reduction in sex drive, due to adverse bodily image, resulting in sexual dysfunction. Therefore, the sexual impact is variable between individuals. The complex balance of male and female hormones in us determines manifestation of our masculine and feminine characteristics. The acceptance of stereotype male and female traits and appearance is predetermined by society. English novelist and outspoken supporter of social justice George Orwell once said: “Happiness can exist only in acceptance”.

When Dr. G is put on the spot by women with PCOS with various degrees of “hairiness and horniness”, self-acceptance and motivation to improve lifestyle is the only step to happiness. The further acceptance by a partner and enhancement of libido is just the icing on the cake!

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