[Endocrinologic diagnosis in hirsutism and androgenetic alopecia in women]

In women, hirsutism and male pattern baldness are due to an enhanced effect of androgens on the hair follicle, which in turn can be caused by an increased supply of bio-available androgens and/or an increased sensitivity of the target organ to androgens. There are no definite correlations between circulating androgens and the degree of their biological effects. Although in most cases the hyperandrogenemia is not severe, the patients should be treated with antiandrogens in order to avoid progression of the disturbance and its consequences on metabolism and fertility. Sometimes hirsutism can be observed as a clinical sign of a defect in the steroid biosynthesis or of Cushing's syndrome. In severe hyperandrogenemia with a testosterone level of more than 2 ng/ml and a DHEA-S level of more than 8000 ng/ml, tumors of the ovaries or the adrenal glands have to be excluded.