Bearded lady: UVA doctors seek a cure

Bearded women once were considered the stuff of circus sideshows, but Dr. John Marshall says the hormonal disorder that causes the condition occurs in almost seven percent of women.

"For women who experience minor hair growth, it's inconvenient, but for others who have the more severe form, it's debilitating,'' says Marshall, director of the Center for Research and Reproduction at the University of Virginia.

"The effects vary from increased hair growth and irregular periods to infertility, diabetes, and uterine cancer,'' he says, noting that 20 to 30 percent of women with the disorder have the more severe form.

UVA researchers will receive a $5.5 million grant from the National Institutes of Health to study why the hormone disorder– polycystic ovarian syndrome– occurs.

There are two leading theories about what causes the syndrome. One is that it's caused by an abnormality in a part of the brain called the hypothalamus that tells the ovaries to produce too much testosterone. The second theory is that there's something wrong with the ovaries, making them produce too much male hormone.

"There's no doubt the ovaries are abnormal,'' Marshall said. "But is that because there's something wrong with them, or are they getting the wrong message?'' Marshall believes the cause lies in the brain. "All of the women with the disorder have too much LH, a hormone from the pituitary gland that signals the ovary to make male hormone,'' Marshall said.

Suzanne Moenter, a UVA associate professor of medicine and cell biology, is studying facets of the hormone disorder in mice. She also believes the brain abnormality is the culprit.

"Our preliminary results indicate that in the presence of increased testosterone, the brain cells controlling reproduction are more stimulated,'' Moenter said.

Women with the syndrome produce about twice the amount of testosterone as other women. Onset tends to occur at puberty. In an effort to determine the cause, UVA researchers are studying adolescent girls with and without the disorder.

"We are comparing signals from the brain and pituitary hormones,'' Marshall says. "If we can identify what the differences are, then we can begin to figure out why it happens and how to change it.''

Marshall says the disorder can be treated with female hormones and fertility drugs– but that early detection is critical.

"The problem is that adolescents who experience increased hair growth and missed periods don't discuss these issues,'' Marshall says. "Usually by the time I see these women they are infertile and have heavy hair growth.''

He said the problem is much harder to treat by that point. "It's very difficult to get hair to stop growing once it's established,'' he said.