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Related Experiment Videos

Approach to patients with hirsutism

R Sakiyama1

  • 1Division of Family Medicine, University of California, Los Angeles (UCLA), School of Medicine 90095-1628, USA.

The Western Journal of Medicine
|December 1, 1996
PubMed
Summary
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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.

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  • 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.