New facial hair

New facial hair is hair growing on the chin, upper lip, jaw or cheeks where there was little or none before, or more of it than you used to have.

NHS inform, the NHS in Scotland's health site, lists an increase in facial hair among the common symptoms of the menopause. The main NHS website draws a useful line between two kinds:

• lighter, finer hair, which the NHS says is probably not hirsutism, and which most women get more of with age, particularly after the menopause
• thick, dark hair on the face, neck, chest, tummy, lower back, buttocks or thighs, which the NHS calls hirsutism and says is worth seeing a GP about

Roshara's symptom score asks about dark or coarse hairs on the chin or upper lip. Which kind you have decides what happens next.

Coarse hairs under the chin you can feel before you see them. A shadow on the upper lip in photographs. Plucking before you leave the house, and checking again in the car.

For many women the feeling is mostly about being seen: by a husband, by in-laws, by the aunties at a wedding. That self-consciousness is real, and it is a fair thing to tell a doctor about.

The NHS explains hirsutism as usually linked to changes in androgens, sometimes called male hormones, either because levels rise or because the body becomes more sensitive to them. Testosterone is one of these hormones, and women make it too.

For thick, dark hair, the NHS names polyendocrine metabolic ovarian syndrome, or PMOS, as the most common cause. PMOS is the new name for polycystic ovary syndrome, PCOS. The NHS PMOS page says symptoms usually start around puberty and continue until the menopause, and that you may be more likely to have it if a close relative does or if you are from an Asian background. Rarely, the NHS says, hirsutism comes from some medicines, other hormone conditions, or a tumour affecting hormone levels. Sometimes there is no obvious cause.

That is why the type of hair matters. Fine hair that grows with age is common. Thick, dark hair is a reason to look for a cause.

The NHS hirsutism page lists things a GP may suggest:

• losing weight, if you are overweight, which can help control hormone levels
• removing or lightening hair at home, by shaving, waxing, plucking, hair removal creams or bleaching
• a prescription cream that slows facial hair growth
• a contraceptive pill to help control hormone levels, if you have not been through the menopause yet

It also describes longer-lasting removal by electrolysis or laser, and says neither is usually permanent, both carry risks, and results differ from person to person.

The NHS says a GP may suggest a blood test to measure your hormone levels, since a change in hormones is a common cause of hirsutism and can affect your periods too. If simple measures do not help, or more tests are needed, they may refer you to a specialist.

See a GP about thick, dark hair on your face or body, the NHS says, particularly if your periods have also become irregular.

Ask for an urgent appointment if new thick, dark hair suddenly starts growing on your face and body, if your voice is getting deeper, or if your muscles are getting bigger.

Women often ask what their faith says about removing facial hair: which methods, which areas, and whether it matters who does it. These are real questions with a long history of scholarship behind them, and they belong with a qualified scholar you trust, not with a health website.

At home, remarks about facial hair can sting more than any symptom. You are allowed to answer with a plain fact: it is common, it has a name, and you are getting it checked.