[Diagnosis and management of hirsutism]

Apart from being a source of great distress and social embarrassment, hirsutism may be also a sign of an underlying endocrine or malignant disease. The diagnosis should be always methodical and adjusted to the nature of the clinical presentation. The clinical evaluation of the potentially hirsute patient first involves confirming the presence of hirsutism by hormonal assessment and then excluding underlying disorders or associated abnormalities. There is no uniform treatment approach for the management of hirsutism and the therapy is directed at suppressing ovarian or adrenal androgen production, inhibiting the conversion of testosterone to dihydrotestosterone, or antagonizing the effects of androgens at the receptor level. All these tratment options are reviewed. In this paper, we provide the recommended approach to the diagnosis and treatment of hirsute patient.