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Hirsutism. Practical therapeutic guidelines

J W Delahunt1

  • 1Wellington School of Medicine, New Zealand.

Drugs
|February 1, 1993
PubMed
Summary
This summary is machine-generated.

Hirsutism treatment focuses on managing excess terminal hair growth, often caused by hormonal imbalances. Spironolactone is typically the first-line drug, with ovarian hormones added if needed after a 12-month trial.

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Area of Science:

  • Endocrinology
  • Dermatology
  • Gynecology

Background:

  • Hirsutism involves the conversion of vellus hair to terminal hair due to androgenic stimulation.
  • Common causes include familial predisposition, idiopathic factors, and polycystic ovarian disease (PCOD).
  • Patient distress is a primary driver for initiating therapeutic interventions.

Purpose of the Study:

  • To outline the therapeutic approach for managing hirsutism.
  • To detail the recommended duration for drug treatment assessment.
  • To specify first-line and alternative pharmacologic options.

Main Methods:

  • Pharmacological management of hirsutism.
  • Assessment of treatment response after a minimum of 12 months.
  • Sequential use of medications based on efficacy.

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Main Results:

  • Spironolactone is the initial drug of choice for hirsutism management.
  • Combined hormonal therapies (e.g., medroxyprogesterone acetate/ethinylestradiol or cyproterone acetate/ethinylestradiol) are considered for inadequate responses.
  • Treatment efficacy is evaluated after a prolonged treatment period.

Conclusions:

  • Hirsutism requires a sustained therapeutic approach, often exceeding 12 months.
  • Spironolactone is a key agent, with combination therapy as a subsequent option.
  • Effective management addresses patient distress and clinical presentation of terminal hair growth.