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Summary
Hirsutism, or increased male-pattern hair growth, is influenced by genetics and hormones. The ovary, not the adrenal cortex, is the primary source of testosterone, impacting hirsutism treatment.
Area of Science:
- Endocrinology
- Dermatology
Background:
- Hirsutism is defined as increased masculine-type sexual hair growth.
- It is distinct from hypertrichosis (generalized hair increase) and virilism (masculinizing organ changes).
- Hirsutism is influenced by age, race, heredity, hair follicle sensitivity, and androgen levels.
Purpose of the Study:
- To clarify the origins of testosterone and androstanedione relevant to hirsutism.
- To review current and potential treatment modalities for hirsutism.
Main Methods:
- Distinguishing hirsutism from related conditions.
- Identifying the primary source of testosterone and androstanedione via catheterization studies.
- Evaluating external treatments and hormonal therapies for hirsutism.
Main Results:
- Catheterization studies indicate the ovary is the main source of testosterone and androstanedione, challenging previous assumptions about the adrenal cortex.
- External treatments like plucking and shaving are suitable for mild hirsutism.
- Corticoids can treat amenorrhea associated with hirsutism, yielding limited regression (one-third) over time.
- Reverse-sequence therapy with cyproterone acetate and ethinyl estradiol shows good results but is costly and has side effects.
Conclusions:
- The ovary is the principal source of androgens contributing to hirsutism.
- Treatment strategies vary from external methods for mild cases to hormonal therapies for severe or complex presentations.
- Combined anti-androgen and estrogen therapy offers efficacy but requires careful consideration due to cost and potential side effects.