Related Experiment Videos
Approach to patients with hirsutism
1Division of Family Medicine, University of California, Los Angeles (UCLA), School of Medicine 90095-1628, USA.
Insights
Hirsutism, often due to PCOS or unknown causes, can signal serious conditions like tumors or congenital adrenal hyperplasia. Early medical history, examination, and lab tests guide diagnosis and treatment for women
Area of Science:
- Endocrinology
- Gynecology
Background:
- Hirsutism, characterized by excess male-pattern hair growth in women, is frequently associated with Polycystic Ovary Syndrome (PCOS) or is idiopathic.
- However, it can also indicate serious underlying endocrine disorders, including ovarian or adrenal tumors, congenital adrenal hyperplasia, and Cushing's syndrome.
Purpose of the Study:
- To outline the diagnostic approach for hirsutism, differentiating common causes from potentially severe conditions.
- To highlight key laboratory investigations for identifying the etiology of hirsutism.
Main Methods:
- Detailed medical history and physical examination to identify patients requiring further investigation.
- Laboratory screening including serum testosterone, dehydroepiandrosterone (DHEA), and 17 alpha-hydroxyprogesterone levels.
- Measurement of 24-hour urinary cortisol concentrations to assess for Cushing's syndrome.
Main Results:
- A thorough clinical evaluation effectively identifies women with hirsutism who warrant laboratory testing.
- Specific hormone level measurements serve as crucial screening tools for various androgen excess disorders.
- Elevated levels of specific androgens or cortisol can pinpoint serious underlying pathologies.
Conclusions:
- Hirsutism necessitates a careful diagnostic workup to rule out significant endocrine abnormalities.
- Timely laboratory evaluation is essential for accurate diagnosis and appropriate management of hirsutism.
- Therapeutic strategies target androgen production, conversion, or receptor activity to manage hirsutism effectively.
Abstract:
Hirsutism is a common medical condition that in most women is due to the polycystic ovary syndrome or is idiopathic. For a few women, hirsutism signals a serious underlying disorder such as an ovarian or adrenal tumor, congenital adrenal hyperplasia, or Cushing's syndrome. A detailed medical history and examination can identify women in whom a serious disease is suspected and for whom laboratory evaluation is warranted. Measurements of serum testosterone, dehydroepiandrosterone, and 17 alpha-hydroxyprogesterone levels, and 24-hour urinary cortisol concentrations are important screening tests. 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.