DEAR DR. DONOHUE: My daughter, 22, has a mustache and whiskers on her chin. She tells me she has hair around her nipples, too. She is upset about this. What’s the cause, and what can be done for her? – C.P.

ANSWER: Lots of women have hair in places that are common to male hair growth – the upper lip, the face, the chin, the breasts, the upper and lower back, the upper arms and the upper legs. This might be only a family trait, or it might be due to an overproduction of male hormones or an unusual sensitivity to the action of male hormones. Women do make these hormones normally (and men make female hormones). The ovaries and the adrenal glands are the sites of male hormone production in women.

High on the list of causes for increased male hormone production by women is polycystic ovary syndrome. Its signs are: large ovaries studded with cysts, male pattern hair growth, diminution or cessation of menstrual periods, obesity, infertility and abnormal blood sugar. Women do not have to have all those signs to qualify as having the syndrome. The visible manifestations might be quite unimpressive. But all women with the syndrome have a high blood level of testosterone and a high level of FSH, a hormone that stimulates the ovaries to produce testosterone.

Many medicines are used for polycystic ovary syndrome. Birth-control pills restore normal female hormone status. The water pill spironolactone blocks the action of testosterone.

Your daughter should see a gynecologist who can check her hormone levels and guide her in the choice of treatments if her levels are abnormal. Polycystic ovary syndrome is only one cause of hormone imbalance.

If her hormones are normal, then she has many options for hair removal. Vaniqa cream is one. Bleaching the hair and chemical hair removers are two others. Electrolysis and laser treatments, depending of the extent of hair growth, are also possible choices.

DEAR DR. DONOHUE: I am a 40-year-old man and have no complaints. I am and have always been athletic. Recently I had a physical exam, and blood was taken as part of the exam. My bilirubin is high. The doctor went over the tests with me, and he thinks I have Gilbert’s syndrome. I have no symptoms – none. How could I possibly be sick? – G.M.

ANSWER: If you have Gilbert’s syndrome, you aren’t sick and won’t become sick. It shouldn’t be called a syndrome. That makes it sound like an illness. It’s a quirk, not an illness.

Worn-out red blood cells release their hemoglobin, the stuff that holds on to oxygen. Eventually hemoglobin turns into bilirubin, a pigment. The liver disposes of bilirubin.

When the level of bilirubin in the blood rises, the whites of the eyes turn yellow. Caucasian skin yellows.

People with Gilbert’s handle bilirubin a bit differently than non-Gilbert’s people do. From time to time, their blood bilirubin levels rise even to the point where their eyes and skin can turn yellow. Their livers transiently stop processing bilirubin. The yellow lasts only a brief time. Fasting, alcohol, exercise and even a slight rise in body temperature can cause the Gilbert’s liver to slow down its disposal of bilirubin. This is not a health issue. Forget it. It’s an inherited trait.

DEAR DR. DONOHUE: I’m a bodybuilder and have won several local contests. I have bad varicose veins on my legs, and I think judges deduct from my overall score because of them. If I have them removed, will that interfere with circulation to my legs? – D.P.

ANSWER: Varicose veins that can be seen are directly beneath the skin. There is another set of leg veins buried deeply in muscles that returns blood back to the heart very ably when the surface veins are removed. Circulation is not the least bit impaired.

The booklet on varicose veins explains this popular topic in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 108, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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