Investigations in the assessment and management of patients with hirsutism

Most hirsute women have polycystic ovaries. The few women who have a more sinister cause for their hirsutism can probably be identified by clinical symptoms and signs. Therefore, the purpose of investigation is to identify those women, and this can probably be best achieved by a first-line measurement of serum testosterone. If this is normal, subsequent investigations are only required to guide the choice and use of any systemic therapy. It is probably unnecessary to measure any endocrine parameters once therapy has been initiated, since there is no relationship between these variables and hair growth.