Materiały źródłowe

• #1 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. […] Women with an abnormal hirsutism score based on the Ferriman-Gallwey scoring system should be evaluated for elevated androgen levels. […] Hirsutism is a clinical diagnosis, and prevalence depends on the diagnostic criteria used. Hirsutism is commonly diagnosed using the modified Ferriman-Gallwey scoring system consisting of nine androgen-sensitive body areas. […] Clinical practice guidelines suggest testing for elevated androgen levels in women with an abnormal hirsutism score. […] Women with hirsutism and menstrual dysfunction, infertility, or any physical examination findings suggestive of endocrine disorders should undergo further hormonal workup.

• #2 Hirsutism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470417/

  Hirsutism is the growth of excessive male-pattern hair in women after puberty. It affects facial and body areas dependent on androgens, namely mustache and beard, pubic hair, buttocks, and thighs. It is a frequent reason for dermatological consultation. This activity reviews the evaluation and management of hirsutism and highlights the role of the healthcare team in the recognition and management of this condition. […] Hirsutism means the growth of excessive male-pattern hair in women after puberty. It affects facial and body areas dependent on androgens, namely mustache and beard, pubic hair, buttocks, and thighs. It is a frequent reason for dermatological consultation. Hirsutism is the most common endocrine disorder affecting nearly 10% of women in the United States. […] The diagnosis of idiopathic hirsutism is a diagnosis of exclusion. Approximately 15% to 50% of women suffering from hirsutism belong to this category. Its pathogenesis is then parallel to that of primary androgenetic alopecia.

• #3 Hirsutism (Excessive Hair Growth in Women): Causes, Treatment

  https://www.healthline.com/health/excessive-or-unwanted-hair-in-women

  Hirsutism, which causes excessive facial hair growth in cisgender females, is typically caused by an increase in hormones called androgens. […] Hirsutism is a common condition, affecting between 5 and 10 percent of women. […] Your doctor will take a detailed medical history when diagnosing hirsutism. Discuss your medication use with a doctor to help them determine the cause of your condition. […] Your doctor will likely order blood tests to measure your hormone levels. In some cases, your doctor may also order blood work to make sure you dont have diabetes. […] Ultrasounds or MRI scans of your ovaries and adrenal glands may be necessary to check for the presence of tumors or cysts. […] The Ferriman-Gallwey index is a method to score the degree of male pattern body hair growth in women. […] Most experts agree that a total of 8 indicates hirsutism. […] The Ferriman-Gallwey score is a simple, inexpensive, and reliable diagnostic tool for hirsutism.

• #4 Hirsutism – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/diagnosis-treatment/drc-20354941

  Tests that measure the amount of certain hormones in your blood, including testosterone or testosterone-like hormones, might help determine whether elevated androgen levels are causing your hirsutism. […] Your doctor might also examine your abdomen and do a pelvic exam to look for masses that could indicate a tumor. […] For hirsutism, some questions to ask your doctor include: What tests do I need? […] Your doctor is likely to ask you questions, such as: Has your menstrual cycle changed, or have you stopped having your period?

• #5 Hirsutism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470417/

  The diagnosis of hirsutism requires the careful collection of medical history data, physical examination, appropriate biological, and radiological investigations. Hirsutism can be idiopathic, which is a diagnosis of elimination or secondary to hyperandrogenism that also encompasses other serious health problems, including diabetes, metabolic syndromes, and infertility. In some cases, a tumor process is involved.

• #6 Hirsutism: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hirsutism

  The Ferriman-Gallwey score is used in evaluation of hirsutism. It reflects the amount of hair over different body areas. This may require adjustment for ethnic group. […] It is important to investigate to establish the cause of hirsutism, even when mild, as the degree of hirsutism does not correlate well with the magnitude of androgen excess. However, the first stage is careful history and examination. If there is no suggestion of hyperandrogenism, full endocrine evaluation may not be required. […] The task is then to establish whether the hirsutism is androgen-mediated and if so, the cause of excess androgen. […] Further investigation is indicated if there are features of androgen excess, rapid progression, infertility or menstrual irregularity. […] Treatment for hirsutism is unnecessary if no abnormal aetiology can be diagnosed and if the patient is not concerned about the cosmetic appearance. Management is mainly directed at any underlying cause if present. Treatment of hirsutism is not usually curative, unless a treatable underlying cause has been found. Because of the cyclical nature of hair growth, any systemic treatment may take up to six months to be effective.

• #7 Hirsutism: What It Is, In Women, Causes, PCOS & Treatment

  https://my.clevelandclinic.org/health/diseases/14523-hirsutism

  Hirsutism is a common condition that causes excessive hair growth. It primarily affects females. […] Hirsutism is a condition that causes excess hair to grow on certain parts of your body. It mainly affects females. […] Your healthcare provider will conduct a physical examination to determine the extent of the uncommon hair growth. […] Once your healthcare provider has diagnosed hirsutism, they may use the Ferriman-Gallwey scale to grade its severity. […] If you have hirsutism, your healthcare provider may perform a variety of tests, including blood tests to check your hormone levels. […] Yes, hirsutism is treatable. Treatments include weight loss, medications and other hair removal options. […] Hirsutism requires ongoing treatment. None of the treatments make the hair go away completely, but they help make your hair grow more slowly and decrease the amount of unwanted hair.

• #8 Hirsutism – OBGYN | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/conditions-treated/hirsutism

  Hirsutism in women is defined as excessive coarse hair appearing in a male-type pattern. It represents exposure of hair follicles to high levels of the male hormone androgen in the blood and/or the hair follicle itself. […] The first step in assessing hirsutism is to have a complete history and physical examination performed by a trained health care provider. A careful history and physical examination can assess the degree of hirsutism, acne or hair loss, and other problems that are important in directing diagnostic testing and management. […] Blood tests may be recommended to determine whether the body is producing excess amounts of androgen. These blood tests can be combined with physical examination to determine whether a common condition known as polycystic ovary syndrome (PCOS) exists. […] A successful management plan for unwanted hair addresses a woman’s own concerns and allows for an individualized strategy that balances time spent on mechanical hair removal with prevention of further hair growth through medical therapy.

• #9 SciELO Brazil – Hirsutism: diagnosis and treatment Hirsutism: diagnosis and treatment

  https://www.scielo.br/j/abem/a/t5GTrmpRNGJ7nDzYkqwtmpL/

  Hirsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women, which grows in a typical male distribution pattern. […] A woman’s history and physical examination are particularly important in evaluating excess hair growth. The vast majority of women with hirsutism have the idiopathic variety, and the diagnosis is made by exclusion. […] Family history and physical exam are particularly important in evaluating excess hair growth in women, because there is no absolute clinical distinction between physiologic and pathologic hirsutism. The vast majority of women with hirsutism have the idiopathic variety, and diagnosis is made by exclusion. […] Once hirsutism has been identified, it is prudent to search for other associated manifestations of androgen excess, including recalcitrant acne, female-pattern alopecia, and seborrhea.

• #10 Hirsutism Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/hirsutism

  Hirsutism is a common condition in which a woman develops excessive growth of thick (male pattern) hair in areas where thick hair is not usually present. […] The goal of treatment is to identify the underlying condition and treat the excess hair. […] History of the symptoms and physical examination by the doctor to determine the severity of the abnormal hair growth and find out other physical signs that may be present with the hair growth, such as acne, is crucial in diagnosis. […] Certain tests are advised if excessive hair growth is diagnosed as hirsutism. These include blood tests to detect increased hormone levels such as androgens, androstenedione, DHEA-S, and testosterone, thyroid function tests including thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), prolactin. […] Imaging studies may also be performed, such as ultrasound of the ovaries to further evaluate Polycystic Ovary (PCO) or tumors. Other tests may also be performed to assess ovaries and adrenal glands, to rule out other medical conditions. 90% of the cases are due to PCOS and idiopathic hirsutism.

• #11 Hirsutism, Normal Androgens and Diagnosis of PCOS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9406611/

  Hirsutism is defined as the presence of terminal hair with male pattern distribution in women. While in the general population, hirsutism affects around 4-11% of women, it is the main manifestation of hyperandrogenism in women with polycystic ovary syndrome (PCOS), with a prevalence estimated at 65-75%. […] The modified Ferriman-Gallwey (mFG) scoring system has been widely used in clinical practice to visually score excessive terminal hair, thus standardizing hirsutism evaluation and facilitating data comparison. […] Indeed, while most women with PCOS and hirsutism also have higher than reference values for serum androgen levels, some of them may not present with biochemical hyperandrogenism, representing a challenge to the diagnosis of PCOS. […] Although hirsutism reflects androgen action in the hair follicle, local factors, sensitivity to androgen, duration of exposure and local conversion of testosterone to a more potent androgen, DHT, by 5-reductase may be more important than plasma androgen levels.

• #12 Hirsutism: Causes, Treatments for Excessive Hairiness in Women

  https://www.webmd.com/women/hirsutism-hair-women?page=1

  Hirsutism Diagnosis Your doctor will look at your hair growth and check for any other signs of hirsutism, such as acne. They might rule out other conditions with tests such as: Blood tests to check your hormone levels […] Once a diagnosis is made, your doctor might use the Ferriman-Gallwey scale. This tool helps them determine the severity of your condition by looking at hair growth in nine areas of your body. To calculate the Ferriman-Gallwey score, health providers use a scale that ranges from 0 to 4 for each body location. A lower score means your hirsutism is mild, while a higher score indicates a more severe condition.

• #13 Hirsutism, Normal Androgens and Diagnosis of PCOS

  https://www.mdpi.com/2075-4418/12/8/1922

  Hirsutism is defined as the presence of terminal hair with male pattern distribution in women. While in the general population, hirsutism affects around 4–11% of women, it is the main manifestation of hyperandrogenism in women with polycystic ovary syndrome (PCOS), with a prevalence estimated at 65–75%. […] The modified Ferriman–Gallwey (mFG) scoring system has been widely used in clinical practice to visually score excessive terminal hair, thus standardizing hirsutism evaluation and facilitating data comparison. […] Although a universal mFG score cutoff would be useful for comparisons, ethnic variations, as well as skin type and other factors, should be considered when evaluating hirsutism in distinct populations. […] Indeed, while most women with PCOS and hirsutism also have higher than reference values for serum androgen levels, some of them may not present with biochemical hyperandrogenism, representing a challenge to the diagnosis of PCOS.

• #14 Hirsutism

  https://mobile.fpnotebook.com/Derm/Hair/Hrstsm.htm

  Hirsutism, Excessive Hair Growth in Women […] Hirsutism onset […] Hyperandrogenism in women results in Terminal Hair development […] Androgens stimulate facial Hair Growth (mustache, bear, sideburns) […] Androgens inhibit scalp Hair Growth and may result in Androgenic Alopecia […] Hirsutism […] Excessive Terminal Hairs in women in sex-specific regions (male distribution) […] Diagnosis […] Evaluation of secondary cause (indicated for moderate to severe Hirsutism or red flags above) […] Total Testosterone 200 ng/dl should prompt complete endocrine workup with Abdomen and Pelvis imaging […] Total Testosterone levels are also mildly elevated in Polycystic Ovary Syndrome […] Consider urine free Cortisol level […] Indicated if Cushing Syndrome suspected […] Step 1: Initial […] History including Ferriman-Gallway Scale […] Step 2: Consider evaluation for androgen Secreting tumor […] Step 3: Moderate Hirsutism (Ferriman-Gallwey Score 8-15) or PCOS suspected […] Step 4: Mild Hirsutism (Ferriman-Gallwey Score 8-15)

• #15 SciELO Brazil – Hirsutism: diagnosis and treatment Hirsutism: diagnosis and treatment

  https://www.scielo.br/j/abem/a/t5GTrmpRNGJ7nDzYkqwtmpL/

  A recent clinical practice guideline published by the Endocrine Society recommends against testing for increased androgen levels among women with mild hirsutism (FG score 8-15), since hyperandrogenemia is undetectable in approximately 50% of these cases using conventional laboratory tests, and because of the low likelihood of identifying a medical disorder that would alter management or outcome. Testing of androgen levels is recommended in women with moderate to severe hirsutism and in women with any degree of hirsutism when it is sudden in onset, rapidly progressive, or when it is associated with any of the following: menstrual irregularity, central obesity, acanthosis nigricans, or clitoromegaly. […] Initial laboratory tests to exclude a serious underlying disease include serum testosterone (on days four to ten of the menstrual cycle) and DHEAS, because the measurement of these two hormone levels can detect most androgen-producing tumors.

• #16 Hirsutism Workup: Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/121038-workup

  Approximately 50% of women with even minimal hirsutism have excessive androgen. Laboratory studies in hirsutism serve both to confirm the clinical impression of hyperandrogenism and to identify the source of excess androgens, either adrenal or ovarian. The workup described in the image below recommends 2 visits, a baseline evaluation followed by a 2-week dexamethasone treatment period. Specific discussion of the testing is below. […] The most important assay is the level of serum testosterone, the major circulating androgen. If the total serum testosterone level is normal, measure the free serum level because hyperandrogenism (and insulin resistance, if present) decreases sex steroid-binding globulin, such that the unbound, biologically active testosterone moiety may be elevated even if the total level is unremarkable.

• #17 Hirsutism Workup: Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/121038-workup

  Measurement of elevated plasma levels of DHEAS, an androgen synthesized almost exclusively by the adrenal cortex, can indicate excess adrenal function. […] Laboratory testing of testosterone (free or total) and DHEAS can be performed on the initial visit. At the same time, a diagnostic trial of dexamethasone therapy for 7-14 days can be initiated to help exclude adrenocorticotropin hormone (ACTH)dependent hirsutism. […] An ACTH-stimulation test (250 mcg for 30 min) can help to differentiate between CAH and idiopathic hirsutism because CAH produces abnormal findings (elevations in metabolic precursors of cortisol). […] Investigation of subnormal dexamethasone suppression of androgens can be guided by the patients cortisol level, without the need for an ACTH-stimulation test. […] Women with hirsutism and amenorrhea of unknown cause should have a serum prolactin or FSH test to evaluate for either a prolactinoma or ovarian failure.

• #18 Hirsutism – Causes, Symptoms, Diagnosis, Treatment and Prevention

  https://www.medindia.net/health/conditions/hirsutism.htm

  Hirsutism is a condition where women have excessive unwanted hair in areas where the growth is normal in males but absent in females. […] Diagnosis of hirsutism is based on history obtained from the patient, physical examination and certain tests. […] To evaluate hirsutism in females, Ferriman-Gallwey score is used that measures amount and location of the hair. […] Blood tests include tests for hormones like: 17-hydroxyprogesterone levels, TSH (thyroid-stimulating hormone), Prolactin, Testosterone (to determine if higher androgen levels is the cause), Cortisol. […] Urine test is done to estimate cortisol level. […] Imaging tests to detect cysts or tumors in the ovarian and adrenal glands. These include: CT scan, Ultrasound.

• #19 Hirsutism (excessive hair) – women | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hirsutism-excessive-hair-women

  Hirsutism in women is diagnosed using a number of tests, which may include: […] medical history […] physical examination […] specific questioning for example, about whether the onset of hairiness was gradual or sudden […] assessment of body hair using a standard scoring system […] blood tests to check testosterone levels […] thyroid function tests […] tests to check for PCOS hormone tests and ultrasound scan of the ovaries […] tests to check for an androgen-secreting tumour various scans.

• #20 Hirsutism: what it is, symptoms, diagnosis and treatment. Clínica Universidad de Navarra

  https://www.cun.es/en/diseases-treatments/diseases/hirsutism

  In general terms, it is usually necessary to determine testosterone, dehydroepiandrosterone-sulfate, androstendione, 17-hydroxyprogesterone, sex hormone carrier protein, glucuronide, luteinizing hormone and follicle-stimulant. […] In case of suspicion of late adrenal hyperplasia, it is advisable to perform a stimulation test with ACTH.

• #21 Hirsutism Workup: Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/121038-workup

  Women with hirsutism, PCOS, obesity, or acanthosis nigricans may have insulin resistance, and screening for diabetes and hyperlipidemia is warranted. […] If indicated based on the findings from the clinical evaluation and laboratory testing, perform ovarian ultrasonography and adrenal CT scanning or MRI to evaluate for either ovarian or adrenal sources of androgen production.

• #22 Hirsutism (Excessive Hair Growth in Females): Symptoms, Causes, Treatment, and Prognosis

  https://www.verywellhealth.com/hirsutism-7091786

  Hirsutism also known as excessive hair growth is a condition that occurs in 5 to 10% of females. […] A healthcare provider can diagnose it through a physical exam and diagnostic testing. […] The provider may order one or more of the following tests, which they can use to diagnose hirsutism. They are: Blood test: Testosterone test, DHEA sulfate test, and 17-hydroxyprogesterone blood test. […] If someone has virilization the growth of male characteristics then a healthcare provider may use a pelvic ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) for diagnosis.

• #23 Hirsutism Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/hirsutism

  The main symptom of hirsutism is hair growing on the abdomen, breasts, and upper lip (male-pattern hair growth in women). […] Your doctor will examine you and take a medical history. You may be asked about your menstrual cycle, what medications you take, and your family history. Your doctor will check you for hair growth and also may do a pelvic examination to check for tumors or cysts on the ovaries. After doing the physical exam, your doctor may order one of the following tests: […] Blood tests, may show high androgen levels. […] Imaging tests, including CT scan, MRI, pelvic ultrasound, used to find cysts or tumors on the ovaries or adrenal glands.

• #24 Hirsutism. Excessive hair in females

  https://dermnetnz.org/topics/hirsutism

  Hirsutism is diagnosed clinically. Investigations are not usually necessary unless the patient has a Ferriman-Gallwey score of 15 when blood tests are done to evaluate male hormone levels and underlying diseases. […] A pelvic examination and abdominal/transvaginal ultrasound examination of the ovaries may be performed, as polycystic ovaries are a common cause of hirsutism. […] Diagnostic features for polycystic ovary syndrome are: Oligo/anovulation, Clinical/biochemical signs of hyperandrogenism, Presence of 12 follicles in each ovary, measuring 29 mm in diameter and/or increased ovarian volume (10 mL) on pelvic/transvaginal ultrasound (optional).

• #25 Hirsutism Causes, Symptoms, and Treatments

  https://www.upmc.com/services/womens-health/conditions/hirsutism

  Women who have visible symptoms of hirsutism but normal menstrual cycles and androgen levels may be diagnosed with idiopathic hirsutism. Idiopathic means there’s no obvious cause. […] Your doctor may order: Blood tests to check your hormone levels. Imaging tests such as a pelvic ultrasound, CT scan, or MRI, if virilization is present.

• #26 Hirsutism differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Hirsutism_differential_diagnosis

  Hirsutism must be differentiated based on the different diseases causing hirsutism such as 21-hydroxylase deficiency, 11- hydroxylase deficiency, 3 beta-hydroxysteroid dehydrogenase deficiency, polycystic ovary syndrome, Cushing’s syndrome, and hyperprolactinemia. […] The diagnosis of hirsutism requires the exclusion of related disorders with peripheral androgen activity. […] Hirsutism must be differentiated from other diseases causing excessive hair growth on the body such as 21-hydroxylase deficiency, 11- hydroxylase deficiency, 3 beta-hydroxysteroid dehydrogenase deficiency, polycystic ovary syndrome, Cushing’s syndrome, and hyperprolactinemia.

• #27 Assessment of hirsutism – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/247

  Common differentials include Polycystic ovary syndrome and Idiopathic hirsutism. […] Uncommon differentials include Hyperprolactinaemia, Non-classical congenital adrenal hyperplasia, Cushing’s syndrome (benign), Androgenic medications, Androgen-secreting ovarian tumour, Ovarian hyperthecosis, and Adrenocortical carcinoma.

• #28 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  The two most common causes of hirsutism are polycystic ovary syndrome (PCOS) and idiopathic hirsutism. Both are diagnosed by physical examination, medical and family history, and sometimes blood tests. […] Females with PCOS often have hirsutism in combination with irregular menstrual cycles. […] When cycles are this irregular, it usually means that a female is not ovulating on a regular basis. […] PCOS is a chronic condition, but several treatments can reduce hair growth. […] The treatment of hirsutism requires patience because hair follicles have a life cycle of approximately six months. Most medications must be taken for six months before a noticeable improvement occurs. […] Your provider will monitor the progress of treatment and may repeat tests if he or she is concerned about an underlying condition.

• #29 Hirsutism – Wikipedia

  https://en.wikipedia.org/wiki/Hirsutism

  Hirsutism is a clinical diagnosis of excessive androgenic, terminal hair growth. […] A complete physical evaluation should be done prior to initiating more extensive studies, the examiner should differentiate between widespread body hair increase and male pattern virilization. […] One method of evaluating hirsutism is the Ferriman-Gallwey Score which gives a score based on the amount and location of hair growth. […] Diagnosis of patients with even mild hirsutism should include assessment of ovulation and ovarian ultrasound, due to the high prevalence of polycystic ovary syndrome (PCOS), as well as 17-hydroxyprogesterone (because of the possibility of finding non-classic 21-hydroxylase deficiency). […] People with hirsutism may present with an elevated serum dehydroepiandrosterone sulfate (DHEA-S) level, however, additional imaging is required to discriminate between malignant and benign etiologies of adrenal hyperandrogenism. […] Levels greater than 700 g/dL are indicative of adrenal gland dysfunction, particularly congenital adrenal hyperplasia due to 21-hydroxylase deficiency. […] However, PCOS and idiopathic hirsutism make up 90% of cases.

• #30 Evaluation and Treatment of Women with Hirsutism | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0615/p2565.html

  Hirsutism is a common disorder, often resulting from conditions that are not life-threatening. It may signal more serious clinical pathology, and clinical evaluation should differentiate benign causes from tumors or other conditions such as polycystic ovary syndrome, late-onset adrenal hyperplasia, and Cushing’s syndrome. Laboratory testing should be based on the patient’s history and physical findings, but screening for levels of serum testosterone and 17-hydroxyprogesterone is sufficient in most cases. Women with irregular menses and hirsutism should be screened for thyroid dysfunction and prolactin disorders. […] Hirsutism is defined as the presence of excessive terminal hair in androgen-dependent areas of a woman’s body. The disorder is a sign of increased androgen action on hair follicles, from increased circulating levels of androgens (endogenous or exogenous) or increased sensitivity of hair follicles to normal levels of circulating androgens.

• #31 Hirsutism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/symptoms-causes/syc-20354935

  Hirsutism (HUR-soot-iz-um) is a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern face, chest and back. […] With hirsutism, extra hair growth often arises from excess male hormones (androgens), primarily testosterone. […] If you think you have too much coarse hair on your face or body, talk with your doctor about treatment options. […] Excess facial or body hair is often a symptom of an underlying medical problem. See your doctor for assessment if over a few months you experience severe or rapid hair growth on your face or body or signs of virilization. You may be referred to a doctor who specializes in hormone disorders (endocrinologist) or skin problems (dermatologist). […] Hirsutism may be caused by: Polycystic ovary syndrome (PCOS). This condition, which often begins with puberty, causes an imbalance of sex hormones. Over years, polycystic ovary syndrome (PCOS) may slowly result in excess hair growth, irregular periods, obesity, infertility and sometimes multiple cysts on the ovaries.

• #32 Excessive or unwanted hair in women: Causes and natural treatments

  https://www.medicalnewstoday.com/articles/323540

  Hirsutism can occur due to a number of underlying medical conditions. In some cases, there may not be an underlying cause. […] The most common cause of excess body hair in people assigned female at birth is polycystic ovary syndrome (PCOS), which is a hormonal disorder causing the body to produce too many androgens. The condition accounts for more than 70% of hirsutism cases. […] Doctors do screen for conditions that cause adrenal hyperplasia. However, mild cases may not be possible to diagnose until puberty. […] According to the American Academy of Family Physicians, 0.3 percent of hirsutism cases happen due to a tumor that releases androgens. […] In addition to looking at the Ferriman-Gallwey scale, a doctor will diagnose hirsutism usually by excluding other causes for excessive hair growth. If an initial exam suggests a person has excessive hair growth, a doctor must then look for the reason.

• #33 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0801/p168.html

  Rapid development of hirsutism, late onset, progression despite therapy, or signs of virilization may indicate an androgen-secreting tumor. […] The Endocrine Society recommends treating patient-important hirsutism, which is unwanted sexual hair growth of sufficient extent to cause patient distress.

• #34 Hirsutism: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hirsutism

  Features of Cushing’s syndrome (weight gain, stretch marks, easy bruising, proximal muscle weakness). […] Abnormal results of levels of testosterone, 17-hydroxyprogesterone, prolactin, etc. […] Hirsutism not controlled by measures advised in primary care. […] Features of an androgen-secreting tumour (two-week wait referral): Sudden onset or rapidly-progressing hair growth. Signs of virilisation (voice deepening, increased muscle bulk, clitoromegaly). Pelvic or abdominal mass. […] Hirsutism may have a detrimental impact on a woman’s body image. […] Facial hirsutism may cause considerable emotional distress and social embarrassment to women; hirsutism exceeding culturally normal levels can be very distressing. […] Hirsutism is commonly associated with lower quality of life and symptoms of anxiety and depression.

• #35 Hirsutism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hirsutism/symptoms-causes/syc-20354935

  Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some develop depression. Also, although hirsutism doesn’t cause physical complications, the underlying cause of a hormonal imbalance can. […] If you have hirsutism and irregular periods, you might have polycystic ovary syndrome, which can inhibit fertility. Women who take certain medications to treat hirsutism should avoid pregnancy because of the risk of birth defects.

• #36 Evaluation and Treatment of Women with Hirsutism | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0615/p2565.html

  Diagnosis often can be made on clinical assessment alone or by limited laboratory testing. Virilization should be noted, and thorough abdominal and pelvic examinations should be performed to exclude any masses. […] Identification of serious underlying disorders is the primary purpose of laboratory testing and should be individualized. About 95 percent of these patients have PCOS or idiopathic hirsutism. History and physical examination can exclude most underlying disorders, and full hormonal investigation is usually warranted only in those patients with rapid progression of hirsutism, abrupt symptom onset, or virilization. […] Hirsutism outside of the perimenarchal period, rapid progression of hirsutism, or signs of Cushing’s syndrome or virilization should indicate the possibility of an ovarian or adrenal neoplasm. Diagnostic testing should examine levels of serum testosterone, 17-OHP, and DHEAS. Levels of serum testosterone greater than 200 ng per dL (6.94 nmol per L) and/or DHEAS greater than 700 ng per dL (24.3 nmol per L) are strongly indicative of virilizing tumors.

• #37 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics/print

  PCOS may also be associated with other medical problems, such as infertility (due to irregular menstrual cycles), overweight/obesity, type 2 diabetes mellitus, high cholesterol levels, sleep apnea, depression, anxiety, and possibly heart disease (although this is not proven). […] Your provider will monitor the progress of treatment and may repeat tests if he or she is concerned about an underlying condition. […] If a medication is ineffective initially, the dose or type of medication may be changed. […] The treatment of hirsutism requires patience because hair follicles have a life cycle of approximately six months. Most medications must be taken for six months before a noticeable improvement occurs. […] Several medications are available for the treatment of hirsutism. These medications can decrease the amount of body hair, stop the growth of new hair, and decrease the growth rate and coarseness of existing hair.

• #38 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics/print

  Most of these medications must be taken for at least six months before improvement is detectable, and not all medications are equally effective in all females. […] Combined estrogen-progestin contraceptive pills, rings, and patches lower the levels of androgens produced by the ovaries and adrenal glands. They are usually the first choice for the treatment of hirsutism, and between 60 and 100 percent of females with hirsutism will notice improvement when taking these medications. […] Antiandrogens are medications that directly decrease androgen production or block the action of androgens on the hair follicle. […] The most commonly used antiandrogen is spironolactone. Spironolactone may be recommended, in addition to the birth control pill, if excess hair growth does not improve adequately after taking a birth control pill for six months.

• #39 Excessive Hair Growth (Hirsutism) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/excessive-hair-growth-hirsutism

  Treatment of hirsutism depends on the underlying cause influencing your daughter’s hair growth. […] If hirsutism is caused by a hormonal condition, she may be prescribed: Oral contraceptives, such as birth control pills, which treat excessive hair growth because the estrogen and progestin they contain prevent the ovaries from producing androgens. […] Anti-androgens, drugs that stop androgens from attaching to receptors in the female body and prevent their effects. The most common anti-androgen is spironolactone (Aldactone). […] Topical creams, which work directly on the skin to slow down the growth of female facial hair. Eflorinthin (Vaniqua) takes up to two months to have an effect.

• #40 EXCESSIVE HAIR GROWTH (HIRSUTISM)

  https://laivfclinic.com/excessivehairgrowth/

  Hirsutism is defined as excessive hair growth in various body areas commonly known as androgen-dependent sites. […] Clinical evaluation of hirsutism should be initiated by taking a detailed history and physical examination. […] It is important to exclude all causes of androgen access especially if there is virilization because the cause may be due to a tumor. […] In almost all cases of excessive androgen production related to tumor growth, clinical signs require advanced testing to identify the tumor. […] The choice of treatment depends on patients age, desire for pregnancy or contraception and co-existing metabolic disorders such as insulin resistance. […] Birth control pills (BCP oral contraceptives) are one of the most commonly used agents in hirsutism treatment. […] Anti-androgenic agents include spironolactone, finasteride and flutamide. […] Mechanical hair removal should be combined with hormonal or non-hormonal treatments and can include shaving, bleaching, using depilating agents, electrolysis and laser hair removal.

• #41 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics/print

  Over time, many females find that a multipronged approach that includes direct hair removal (such as laser), suppression of androgen production with estrogen-progestin contraceptives and androgen blockade with an antiandrogen (spironolactone) may produce the maximal reduction in bothersome hair growth.

• #42 Patient education: Hirsutism (excess hair growth in females) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/hirsutism-excess-hair-growth-in-females-beyond-the-basics

  Several medications are available for the treatment of hirsutism. These medications can decrease the amount of body hair, stop the growth of new hair, and decrease the growth rate and coarseness of existing hair. […] Combined estrogen-progestin contraceptive pills, rings, and patches lower the levels of androgens produced by the ovaries and adrenal glands. […] Antiandrogens are medications that directly decrease androgen production or block the action of androgens on the hair follicle. […] The most commonly used antiandrogen is spironolactone. […] Over time, many females find that a multipronged approach that includes direct hair removal (such as laser), suppression of androgen production with estrogen-progestin contraceptives and androgen blockade with an antiandrogen (spironolactone) may produce the maximal reduction in bothersome hair growth.

• #43 Hirsutism – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/hirsutism/?q=https://knowyourskin.britishskinfoundation.org.uk/condition/

  The combined oral contraceptive pill reduces the amount of circulating free androgens and may help to reduce hirsutism, especially those that have a progestin component that is less androgenic or are combined with an anti-androgen such as cyproterone acetate or drospirenone. […] Anti-androgens. The doctor may prescribe these to block the action of the androgens that can cause hirsutism. These medicines include finasteride, cyproterone acetate or spironolactone. They may take several months to have an effect and the hirsutism tends to return when the medicine is stopped. […] They can harm an unborn male baby and female patients of child-bearing potential taking these medicines must use effective contraception. Therefore, these medicines are often used together with the oral contraceptive pill or with other forms of contraception such as the intrauterine device (coil).

• #44 Hirsutism: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/121038-overview

  Hirsutism requires a careful and systematic clinical evaluation coupled with a rational approach to treatment. Throughout this process, the patient must understand that, although diagnostic testing can be time consuming (and even inconclusive), it is sometimes essential for the determination of an effective intervention.

• #45 Hirsutism: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/121038-overview

  Although hirsutism is broadly defined as excessive hairiness, the common clinical use of the term refers to women with excess growth of terminal hair in a male pattern. […] The major objectives in the management of hirsutism are to rule out a serious underlying medical condition and to devise a plan of treatment. […] Approximately 50% of women with even minimal hirsutism have excessive androgen. Laboratory studies in hirsutism serve both to confirm the clinical impression of hyperandrogenism and to identify the source of excess androgens, either adrenal or ovarian. […] If indicated based on the findings from the clinical evaluation and laboratory testing, perform ovarian ultrasonography and adrenal computed tomography (CT) scanning or magnetic resonance imaging (MRI) to evaluate for either ovarian or adrenal sources of androgen production.

Zobacz więcej