Hirsutism: Diagnosis and management

• Published in: Gender medicine Vol. 7; no. 2; pp. 79 - 87
• Main Authors: Brodell, Lindsey Ann, MS, Mercurio, Mary Gail, MD
• Format: Journal Article
• Language: English
• Published: New York, NY EM Inc USA 01.04.2010; Elsevier
• Subjects: 5-alpha Reductase Inhibitors; Adrenal Hyperplasia, Congenital - complications; Biological and medical sciences; Causality; congenital adrenal hyperplasia; Contraceptives, Oral - therapeutic use; Dermatology; Diagnosis, Differential; Eflornithine - therapeutic use; Female; Finasteride - therapeutic use; functional ovarian hyperandrogenism; Gynecology. Andrology. Obstetrics; Hair and nails disorders; Hair Removal - methods; hirsutism; Hirsutism - diagnosis; Hirsutism - epidemiology; Hirsutism - etiology; Hirsutism - therapy; Humans; hyperandrogenism; hypertrichosis; Hypoglycemic Agents - therapeutic use; Internal Medicine; Laser Therapy - methods; Medical sciences; Metformin - therapeutic use; Mineralocorticoid Receptor Antagonists - therapeutic use; Miscellaneous; Neoplasms - complications; Ornithine Decarboxylase Inhibitors; Polycystic Ovary Syndrome - complications; Puberal and climacteric disorders (male and female); Public health. Hygiene; Public health. Hygiene-occupational medicine; Spironolactone - therapeutic use; functional ovarian hyperandrogenism; hirsutism; hypertrichosis; hyperandrogenism; congenital adrenal hyperplasia; Endocrinopathy; Gender medicine; Skin disease; Adrenal cortex diseases; Hyperadrenocorticism; Polycystic ovary; Enzymopathy; Cyst; Adrenal gland diseases; Hypertrichosis; Hyperandrogenism; Benign neoplasm; Diagnosis; Hair; Hirsutism; Female sterility; Management; Female genital diseases; Congenital adrenal hyperplasia syndrome; Ovarian diseases; Masculinization; Clinical management; Treatment
• ISSN: 1550-8579; 1878-7398
• DOI: 10.1016/j.genm.2010.04.002

Abstract Background: Hirsutism is defined as excess hair growth in androgen-dependent areas of the body in women. Objective: This article provides an updated review of hirsutism, focusing on the etiologies, clinical features, approach to diagnostic evaluation, and treatment options. Methods: The PubMed database was searched for English-language articles published from 1981 to the present, using the terms hirsutism, polycystic ovarian syndrome, congenital adrenal hyperplasia, hirsutism diagnosis, and hirsutism treatment . Reference lists from review articles on hirsutism during this time period were also examined. Results: While there are many causes of hirsutism, the majority of patients have a benign process that may be idiopathic. In some circumstances, hirsutism is a sign of functional ovarian hyperandrogenism or congenital adrenal hyperplasia. Even more rarely, it is the presenting sign of an internal malignancy. Conclusions: Hirsutism clinically presents in women as excessive hair growth in androgen-dependent areas. It is a particularly important diagnosis to make, because it often significantly affects a woman's perception of her femininity and less commonly can be a sign of an underlying malignancy or a cutaneous manifestation of a condition with significant cardiovascular or other morbidity. A variety of treatments exist to help minimize the appearance of unwanted hair.