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Hirsutism in Women.

Eric Matheson1, Jennifer Bain1

  • 1Medical University of South Carolina, Charleston, SC, USA.

American Family Physician
|July 31, 2019
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Summary
This summary is machine-generated.

Hirsutism, excessive male-pattern hair growth in women, often indicates high androgen levels. Polycystic ovary syndrome is the most common cause, but evaluation is crucial for other conditions and effective treatment.

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Area of Science:

  • Endocrinology
  • Dermatology

Background:

  • Hirsutism is defined as excessive terminal hair growth in a male pattern on a female, frequently signaling elevated androgen levels.
  • Polycystic ovary syndrome (PCOS) and idiopathic hyperandrogenism are the leading causes, representing over 85% of cases.
  • Other potential causes include nonclassic congenital adrenal hyperplasia, androgen-secreting tumors, and endocrine disorders like Cushing syndrome or thyroid dysfunction.

Purpose of the Study:

  • To provide a comprehensive overview of hirsutism, encompassing its causes, diagnostic approaches, and therapeutic strategies.
  • To highlight the importance of evaluating elevated androgen levels in women presenting with abnormal hirsutism scores.
  • To emphasize the need for timely diagnosis, especially in cases of rapid onset or virilization, which may indicate androgen-secreting tumors.

Main Methods:

  • Assessment of hirsutism typically involves the Ferriman-Gallwey scoring system to quantify hair growth.
  • Diagnostic evaluation includes biochemical testing for androgen levels to identify underlying causes.
  • Review of current pharmacologic therapies and hair removal techniques for managing hirsutism.

Main Results:

  • Elevated androgen levels are a key indicator for women with abnormal hirsutism scores.
  • Rapid onset of hirsutism or signs of virilization warrant immediate investigation for androgen-secreting tumors.
  • Pharmacologic treatments like combined oral contraceptives, finasteride, spironolactone, and topical eflornithine are effective, requiring at least six months of use.

Conclusions:

  • Hirsutism necessitates a thorough evaluation to determine the underlying cause, with PCOS being the most prevalent.
  • Prompt diagnosis and management are essential, particularly when suspecting serious conditions like androgen-secreting tumors.
  • A combination of pharmacologic therapy and hair removal methods offers effective, albeit sometimes temporary or costly, management options.