Approach to the Patient: Hirsutism

Area of Science:

• Endocrinology
• Dermatology
• Women's Health

Background:

• Hirsutism affects 10% of women globally, causing significant distress and impacting quality of life.
• It is characterized by male-pattern terminal hair growth, influenced by androgens and tissue enzyme activity.
• Diagnosis typically uses the modified Ferriman Gallwey (mFG) scale, with scores >4-6 often indicating hirsutism.

Purpose of the Study:

• To provide a comprehensive overview of hirsutism, including its causes, diagnosis, and management.
• To emphasize the importance of evaluating underlying conditions and patient distress.
• To outline current therapeutic strategies for hirsutism.

Main Methods:

• Review of established diagnostic criteria and scales for hirsutism.
• Discussion of the etiological factors contributing to hirsutism.
• Summary of available medical and mechanical treatment options.

Main Results:

• Hirsutism is most commonly associated with Polycystic Ovary Syndrome (PCOS) in 80-90% of cases.
• Other causes include idiopathic hirsutism, non-classic adrenal hyperplasia, and rarer conditions like neoplasms and endocrine disorders.
• Effective management often requires a combination of therapies tailored to individual needs.

Conclusions:

• Hirsutism necessitates thorough evaluation to identify underlying causes, regardless of visible severity.
• Treatment strategies should be individualized, considering symptom severity, reproductive desires, and patient preferences.
• A combined therapeutic approach, incorporating medical and mechanical methods with shared decision-making, offers the most effective management.