Hormone imbalance is a known cause for some. Men and women have both male and female hormones. It isn’t estrogen or progesterone that causes it. It is androgens. My husband is on android and testosterone suppression medicine for cancer. But estrogen and progesterone controls androgen. Hormones control everything in the human body not just making babies and they work in synergy. Many different hormones control androgens even my thyroid medicine is involved in it. An imbalance causes many different types of diseases. In my husband’s case cancer cells use androgen and testosterone to manufacture cancer cells like a little factory. In HS excess androgens in some people can cause the HS. But different people have different root problems for their HS such as diabetes, or lupus. Excess blood sugar raises androgens. HS causes inflammation in hair follicles whenever a follicle gets blocked with secretions from hair follicle gland and the body overreacts to that inflammation by sending cells in the blood to fight it which makes pus and more inflammation. So if a person changes their hormones but had diabetes it isn’t likely to help. Or if a diabetic starts taking metforamin but has a real bad hormone imbalance also it still may not help. It has to be a process of evaluating each individual and ruling out different things through blood tests and such. There are articles on this website i think on some of these things.