Hirsutism

Int J Clin Pract. 2008 Mar;62(3):433-43. doi: 10.1111/j.1742-1241.2007.01621.x. Epub 2007 Dec 11.

Abstract

Hirsutism is defined as the excessive growth of terminal hair on the face and body of a female in a typical male pattern distribution. Hirsutism is a common clinical problem in women and the treatment depends on the cause of hirsutism. Untreated hirsutism can be associated with considerable loss of self-esteem and psychological morbidity. Hyperandrogenemia is the key trigger for excess hair growth. Polycystic ovary syndrome and idiopathic hirsutism are the most common cause of hirsutism. As with all medical problems, investigation begins with a careful history, examination and then investigation directed at the possible cause. A raised serum testosterone level of > 150 ng/dl (5.2 nmol/l) should prompt further investigations to exclude an underlying androgen-secreting tumour. The treatment of hirsutism is most effective using combination therapy, including lifestyle therapies, androgen suppression, peripheral androgen blockage and cosmetic treatments. Women should be warned not to expect improvement or at least 3-6 months after therapy is begun and lifelong therapy may be needed to prevent recurrence. The current review discusses definition, pathogenesis, differential diagnosis, diagnostic strategies, management, guidelines and the authors' recommendations about hirsutism.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diagnosis, Differential
  • Eflornithine / therapeutic use*
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Hair Removal
  • Hirsutism* / diagnosis
  • Hirsutism* / etiology
  • Hirsutism* / therapy
  • Humans
  • Hypertrichosis / diagnosis
  • Laser Therapy
  • Life Style
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / therapy
  • Practice Guidelines as Topic
  • Testosterone / metabolism
  • Treatment Outcome
  • Weight Loss

Substances

  • Enzyme Inhibitors
  • Testosterone
  • Eflornithine