Materiały źródłowe

• #1 Hirsutism – StatPearls – NCBI Bookshelf

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

  Hirsutism is the most common endocrine disorder affecting nearly 10% of women in the United States. […] The exact prevalence of hirsutism is not well known. It may be 10% or even higher than 50%. […] Hirsutism appears to be most common in dark-skinned individuals. […] Hirsutism can occur in men but is difficult to recognize. […] Hirsutism is also known to occur in women who discontinue the oral contraceptive pill and gain weight.

• #2 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%. […] Hirsutism in PCOS is associated with both androgen excess and individual response of the pilosebaceous unit to androgens. […] 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.

• #3 Pathophysiology and causes of hirsutism – UpToDate

  https://www.uptodate.com/contents/pathophysiology-and-causes-of-hirsutism

  Hirsutism, defined as excessive terminal hair growth, affects between 5 and 10 percent of females of reproductive age. […] The pathophysiology and causes of androgen-mediated hair growth are reviewed here. […] EPIDEMIOLOGY […] Hirsutism may be the initial and possibly only sign of androgen excess, the cutaneous manifestations of which may also include acne and male-pattern hair loss (androgenetic alopecia).

• #4 Hirsutism: Practice Essentials, Pathophysiology, Epidemiology

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

  Hirsutism affects approximately 10% of women in the United States. […] The prevalence rates of hirsutism in northern Europe are similar to those in the United States; in other places, rates are not known with certainty. […] The mortality and morbidity of hirsutism are determined by the underlying cause. Most women with idiopathic hirsutism have no associated mortality or morbidity. On the other extreme, a small number of women may have malignant disease with a grave prognosis. […] Ethnic origin significantly affects terminal hair growth in healthy women. Northern, fair-skinned Europeans have the least amount of terminal hair, whereas southern European, dark-skinned Mediterranean women have the greatest amount of terminal hair. […] A study by Engmann et al reported that among patients with PCOS, aged 18-40 years, the prevalence of hirsutism was significantly greater in Hispanic women than in non-Hispanic white patients (93.8% vs 86.8%, respectively).

• #5 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. […] Hirsutism has been reported in 5% to 15% of women and is often associated with decreased quality of life and significant psychological stress. […] 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. […] Polycystic ovary syndrome (PCOS) is the most common cause of hirsutism, accounting for more than 70% of cases. […] Idiopathic hyperandrogenism accounts for approximately 15% of hirsutism cases.

• #6 Fifteen-minute consultation: Approach to the adolescent presenting with hirsutism | ADC Education & Practice Edition

  https://ep.bmj.com/content/109/2/66

  Hirsutism, unwanted terminal hair growth in androgen-dependent areas, is a common presentation to general paediatricians, dermatologists and endocrinologists. Polycystic ovarian syndrome is the most common cause but can be challenging to diagnose in young people due to the significant overlap of features with the healthy adolescent population. […] Hirsutism is a common condition, estimated to affect 3%20% of adolescent girls with associated psychosocial morbidity. […] The diagnosis of PCOS is challenging in adolescents due to a considerable overlap with the healthy population as features like acne and irregular menstrual cycles are commonplace. […] Hirsutism commonly affects adolescent girls and necessitates careful assessment and tailored investigation.

• #7 Hirsutism, Normal Androgens and Diagnosis of PCOS

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

  Likewise, women may present with excessive body hair growth but normal plasma androgens levels. […] The Ferriman-Gallwey (FG) scoring system has been widely used in clinical practice to visually score excessive terminal hair, thus standardizing hirsutism evaluation and facilitating data comparison. […] Importantly, the data reported by Ferriman and Gallwey were derived from women attending a northern London general medical outpatient clinic, a selected homogeneous population. […] Indeed, the international evidence-based guideline for the assessment and management of PCOS, published in 2018, proposes to consider ethnic origin when evaluating mFG scores in different populations. […] Data from a systematic review comparing hirsutism in women with PCOS from populations of different ethnicities showed that, compared with white women, East Asian women were less hirsute, whereas Hispanic women, South Asian women and Middle Eastern women were more hirsute. […] The biochemical assessment of sex steroids has important technical limitations. […] The concept of hyperandrogenism should be based primarily on clinical findings.

• #8 Hirsutism, Normal Androgens and Diagnosis of PCOS

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

  Importantly, the data reported by Ferriman and Gallwey were derived from women attending a northern London general medical outpatient clinic, a selected homogeneous population. […] Indeed, the international evidence-based guideline for the assessment and management of PCOS, published in 2018, proposes to consider ethnic origin when evaluating mFG scores in different populations. […] Data from a systematic review comparing hirsutism in women with PCOS from populations of different ethnicities showed that, compared with white women, East Asian women were less hirsute, whereas Hispanic women, South Asian women and Middle Eastern women were more hirsute.

• #8 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%. […] Hirsutism in PCOS is associated with both androgen excess and individual response of the pilosebaceous unit to androgens. […] 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.

• #9 Hirsutism: Practice Essentials, Pathophysiology, Epidemiology

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

  A retrospective study by Afifi et al also found hirsutism in women with PCOS to be linked to ethnicity, as well as to Fitzpatrick skin type. […] A study by Chin et al found the prevalence of hirsutism to be 10% within a community sample of over 1500 African American women. […] With the exception of congenital adrenal hyperplasia (CAH), the actual prevalence of diseases that cause hyperandrogenism and hirsutism has not been shown to differ among persons of different races. […] As a medical problem, hirsutism predominates in women. […] Although hirsutism can occur in men, it is more difficult to recognize because of the wide variability of healthy male terminal hair growth. […] The age of onset of hirsutism depends on the etiology. Most forms of nonneoplastic hirsutism become evident around puberty. This includes polycystic ovary syndrome (PCOS), CAH, and idiopathic hirsutism. […] Hirsutism may also develop after weight gain and cessation of the use of oral contraceptives (OCs) in young women.

• #10 Hirsutism

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

  Excessive upper lip hair in a third of women ages 14-45. […] Unwanted chin and sideburn hair in 6-9% of women.

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

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

  Hirsutism is when hair growth becomes excessive, and this may include facial hair growth. […] 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. […] According to the American Academy of Family Physicians, 0.3 percent of hirsutism cases happen due to a tumor that releases androgens. […] When the cause of hirsutism is unknown, it may be genetic. People of East Indian and Mediterranean origin who were assigned female at birth tend to have this type of hair growth. […] Idiopathic hirsutism represents about 10% of all cases of hirsutism and 50% of all mild cases of excessive hair growth. […] Medical treatments can help with excessive or unwanted hair growth due to PCOS. Many people assigned female at birth find that taking birth control pills helps to regulate their hormones and their periods while reducing hair growth.

• #12 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. […] Hirsutism is a common disorder affecting up to 8 percent of women. […] Infrequently, hirsutism may signal more serious pathology, and clinical evaluation should differentiate benign causes from tumors or other conditions that require specific treatment. […] Most women who seek treatment for hirsutism do so for cosmetic reasons, because excess body hair outside of cultural norms can be very distressing. […] With hirsutism, terminal hair grows from androgen-sensitive pilosebaceous units. […] While 60 to 80 percent of women with hirsutism have increased levels of circulating androgens, degrees of hirsutism correlate poorly with androgen levels. […] PCOS affects approximately 6 percent of women of reproductive age, and is represented by chronic anovulation and hyperandrogenemia, excluding other causes such as adult-onset CAH, hyperprolactinemia, and androgen-secreting tumors.

• #13

  https://www.medscape.org/viewarticle/572621_4

  The most common causes of hirsutism are the polycystic ovary syndrome and idiopathic hirsutism. Between 50% and 70% of all hirsute women demonstrate regular menses, suggestive of idiopathic hirsutism. […] Polycystic ovary syndrome affects approximately 6% of women of reproductive age. It is the most common endocrine and metabolic disorder of reproductive-aged women that presents with varied symptoms such as hyperinsulinaemia, anovulatory dysfunction, infertility, obesity and elevated incidence of cardiac problems. […] The prevalence of the metabolic syndrome (including central obesity, hypertension, glucose abnormalities and dyslipidaemia) appears to be very high in women with polycystic ovary syndrome. […] The diagnosis of idiopathic hirsutism is given to women with normal serum androgen concentrations, no menstrual irregularity and no identifiable cause of their hirsutism.

• #14 Hirsutism | GLOWM

  https://www.glowm.com/section-view/heading/Hirsutism/item/301

  Hirsutism is the presence of terminal (coarse) hairs in females in a male-like pattern; it affects between 5% and 15% of women surveyed. […] Hirsutism usually is obvious, it is important to standardize the examination for future reference by use of a scoring system. […] Not all hyperandrogenic women demonstrate hirsutism, such as Asian women. […] The differential diagnoses of hirsutism can be divided into those causes that are independent of excessive androgen action (i.e. nonandrogenic causes), those that are related to excessive production or ingestion of androgens (androgen causes), and idiopathic hirsutism (IH), which is presumed to occur in response to the excessive peripheral utilization of androgens. […] PCOS affects approximately 4% of reproductive-aged women in the United States.

• #15 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. […] 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. […] Several factors can influence your likelihood of developing hirsutism, including: Family history. Several conditions that cause hirsutism, including congenital adrenal hyperplasia and polycystic ovary syndrome, run in families. […] 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.

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

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

  Hirsutism is when women experience excessive hair growth on parts of the body where men usually grow hair. About 8 percent of women in the United States have some form of excessive hair growth. […] Women of Middle Eastern, South Asian, and Mediterranean ancestry are more likely to develop hirsutism than women of other ethnicities. About half of women with hirsutism produce high levels of male hormones called androgens from their ovaries and adrenal glands. Hormonal disorders, such as polycystic ovary syndrome (PCOS), may cause this to happen. […] Hirsutism occurs in 80 percent of women who have PCOS. […] Many women with hirsutism don’t have a hormonal imbalance or they have hair that is more sensitive to small amounts of hormones. About half of women with excessive hair growth do have an underlying hormonal condition that makes hair grow thicker and faster. Some medications can stimulate excessive hair growth as well.

• #17 Hirsutism in Women | AAFP

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

  Idiopathic hirsutism is a diagnosis of exclusion that accounts for approximately 10% of cases in women who have normal menses, normal ovarian morphology, and normal levels of serum androgens. […] Hirsutism is most often due to benign conditions, although it can be a sign of an underlying hyperandrogenic disorder that requires specific treatment and has implications for reproduction, adverse health effects, or even life-threatening neoplasia. […] Clinical practice guidelines suggest testing for elevated androgen levels in women with an abnormal hirsutism score.

• #18 EXCESSIVE HAIR GROWTH (HIRSUTISM)

  https://laivfclinic.com/excessivehairgrowth/

  Polycystic ovary syndrome (PCOS) is the most common ovarian cause of hirsutism. The syndrome presents with irregular ovulation and thus irregular menstrual cycles, increased hair growth or presence of acne, and in some cases polycystic appearing ovaries (small growing follicles not true cysts). […] Congenital adrenal hyperplasia is the most common adrenal cause of hirsutism, although this is a rare clinical entity in an adult. […] Another rare disease called Cushings syndrome can also result in hirsutism, although other signs and symptoms are common and include high blood pressure, diabetes, muscle weakness, fatigue, red stretch marks and obesity. […] In some cases, there is no identifiable cause or association with another disorder and such cases are labeled as idiopathic hirsutism.

• #19 Hirsutism in Women (Excess Body Hair Growth)

  https://myhealth.umassmemorial.org/library/Encyclopedia/85,P00327

  Hirsutism is excess hair growth on the body or face. For women, the hair may grow in areas where men often have a lot of hair but women often don’t. This includes the upper lip, chin, chest, and back. It’s caused by an excess of male hormones called androgens. All women naturally produce small amounts of androgens. But high levels of these hormones can lead to hirsutism. […] Hirsutism can run in families. It may also be caused by polycystic ovary syndrome (PCOS). This is the most common cause of hirsutism in women. It is a disorder that causes hormone problems. […] You are more at risk for hirsutism if you have any of these: Polycystic ovary syndrome (PCOS), parents or siblings with excess hair growth, disorders of the pituitary gland, adrenal gland, or thyroid gland, severe insulin resistance, changes in hormones from menopause, use of anabolic steroids or corticosteroids, use of medicine to treat endometriosis.

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

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

  Causes of hirsutism may include: Congenital adrenal hyperplasia, Cushing’s syndrome, Polycystic ovary syndrome, Tumors on the adrenal glands or ovaries, Severe insulin resistance, Medications like phenytoin, minoxidil, diazoxide, cyclosporine, and hexachlorobenzene, Anabolic steroids, Danazol, a substance used to treat endometriosis. […] Your daughter should have a blood test to detect possibly elevated androgen levels and diagnose a hormonal condition that could be causing the hair growth. […] Boston Children’s Hospital’s Reproductive Endocrinology and PCOS Program, part of the Division of Adolescent/Young Adult Medicine, provides expert evaluation and treatment of adolescents and young women with excessive hair growth.

• #21 A Hairy Issue: Dealing with Hirsuitism

  https://www.contemporaryobgyn.net/view/hairy-issue-dealing-hirsuitism

  Hirsutism is the medical term for excess body or facial hair in women. It is usually caused by an increased production of androgens (the male hormones) or an increased sensitivity of androgen receptors in the follicles of the skin. […] Two methods are used to diagnose hirsutism. The Ferriman-Gallwey model requires a visual inspection for the presence of excess hair growth. This model quantifies the amount of hair growth on nine areas of the body. Hair growth is rated using a scale of 0 (no terminal hair) to 4 (maximal growth) for a total score of 36. A score of 8 or more indicates the presence of excess androgens (Patel and Korytkowski, 2000). […] Another method for determining hirsutism is blood tests for excess androgens. These tests include free testosterone, total testosterone, and dehydropiandosterone sulfate (DHEAS). Women with PCOS tend to have elevated levels of free testosterone in their systems because they do not have enough sex hormone-binding globulin produced by the liver.

• #22 Hirsutism, Normal Androgens and Diagnosis of PCOS

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

  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. […] Hirsutism is defined as the presence of terminal hair of the female body in male pattern. […] While in the general population, hirsutism affects 4-11% of women, in PCOS, its prevalence is estimated at 65-75% and severity varies according to the degree of androgen excess and individual variability in the sensitivity of the pilosebaceous unit to androgens. […] Most women with androgen levels more than twice the upper limit of the reference range have some degree of hirsutism, but it has been demonstrated that androgen levels, measured by conventional techniques, correlate poorly with the severity of hirsutism.

• #23 Hirsutism | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/hirsutism?content_id=CON-20212573

  Hirsutism is excess hair most often noticeable around the mouth and chin. […] 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. […] Hirsutism may be caused by: Polycystic ovary syndrome (PCOS). This condition, which often begins with puberty, causes an imbalance of sex hormones. Over years, PCOS may slowly result in excess hair growth, irregular periods, obesity, infertility and sometimes multiple cysts on the ovaries. […] Several factors can influence your likelihood of developing hirsutism, including: Family history. Several conditions that cause hirsutism, including congenital adrenal hyperplasia and polycystic ovary syndrome, run in families.

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

  https://patient.info/doctor/hirsutism

  Hirsutism is a common disorder affecting between 5% and 10% of women of reproductive age. […] It is less common in Asian people. […] There is variation in amount of terminal body hair amongst different ethnicities. […] 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. […] Obesity is associated with increased hirsutism.

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

  https://www.webmd.com/women/hirsutism-hair-women

  About 5%-10% of women in the U.S. have hirsutism. […] Hirsutism causes excessive hair growth, mainly in women and people AFAB. […] Hirsutism can start at any age, but most people start having symptoms during puberty. […] Having obesity can make your body produce more androgen, which could make hirsutism worse. […] If left untreated, hirsutism can contribute to mental health problems like depression, anxiety, low self-esteem, poor body image, and more. Because hirsutism could be due to underlying health conditions like polycystic ovary syndrome and Cushing’s syndrome, not treating it may cause your symptoms to worsen and increase your risk of complications like heart disease, type 2 diabetes, fertility problems, and high blood pressure.

• #26 Hirsutism: Symptoms, causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/182659

  Hirsutism refers to coarse or colored hair that grows on the face and body of some females. […] Hirsutism could occur in anywhere between 5 and 10 percent of women depending on local and cultural definitions of a normal amount of hair. […] Prevalence increases with age, especially after the menopause. […] Increased levels of androgens or oversensitivity of the hair follicles to androgens can cause hirsutism. […] High levels of insulin may also activate the insulin-like growth factor-I (IGF-1) receptor in those same cells, similarly increasing androgen production. […] Hirsutism can be an adverse effect of certain medications. […] Excessive hair growth in women with normal androgen levels, regular menstrual periods, and no other underlying conditions is called idiopathic hirsutism.

• #27

  https://www.medscape.org/viewarticle/572621_4

  Hirsutism can be a mild cosmetic problem that requires reassurance and cosmetic therapy or it can have considerable psychological or medical impact. […] Lifestyle therapies are first-line treatment in women with polycystic ovary syndrome, particularly if they are overweight. […] It has been shown that obese women with polycystic ovary syndrome who manage to lose more than 5% of their initial body weight have a significant improvement in their biochemical profile, including a reduction of testosterone, an increase in sex hormone-binding globulin and an improvement in their Ferriman-Gallway scores. […] Most therapies fall into two major categories. One group of drugs acts by suppressing androgen production from either the ovaries or the adrenal glands. The other group acts peripherally to reduce the effect of androgens on the skin.

• #28 The Ultimate Guide to Hirsutism: Symptoms, Causes, and Treatment

  https://flo.health/menstrual-cycle/health/symptoms-and-diseases/hirsutism

  Hirsutism may occur slightly more often with age. […] Occurring in about 5 to 10 percent of all women, hirsutism may occur slightly more often with age. […] The most common cause of hirsutism is PCOS, which accounts for 72 to 82 percent of all cases. […] Women who live in the Middle East, South Asia, or Mediterranean area are more likely to have hirsutism with no identifiable cause.

• #29 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

  Several different conditions can lead to hirsutism. The two most common causes of hirsutism are polycystic ovary syndrome (PCOS) and idiopathic hirsutism. […] 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). […] Hirsutism is associated with depression and anxiety (independent of obesity and a PCOS diagnosis) that improve with the treatment of their hirsutism. […] Your provider will monitor the progress of treatment and may repeat tests if he or she is concerned about an underlying condition. […] Treatment for hair growth related to PCOS may also involve lifestyle changes including weight loss, treatment of infertility, diabetes, and risk factors for cardiovascular disease.

• #30 Hirsutism | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/hirsutism?content_id=CON-20212573

  Hirsutism can be emotionally distressing. Some women feel self-conscious about having unwanted hair. Some develop depression. […] Hirsutism generally isn’t preventable. But losing weight if you’re overweight might help reduce hirsutism, particularly if you have polycystic ovary syndrome. […] 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. […] Treatment of hirsutism with no sign of endocrine disorder is not necessary. For women who do need or seek treatment, it may involve treating any underlying disorder, developing a self-care routine for unwanted hair, and trying various therapies and medications. […] If cosmetic or self-care methods of hair removal haven’t worked for you, talk with your doctor about drugs that treat hirsutism. […] Eflornithine (Vaniqa) is a prescription cream specifically for excessive facial hair in women. […] Self-care methods such as the following temporarily remove or reduce the visibility of unwanted facial and body hair.

• #31 Screening and Management of the Hyperandrogenic Adolescent | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/10/screening-and-management-of-the-hyperandrogenic-adolescent

  Reports of hirsutism and acne should be taken seriously because of their possible association with medical disorders, their substantial effect on self-esteem and quality of life, and the potential for psychosocial morbidity. […] The diagnosis of hyperandrogenism can be based on clinical symptoms or measurement of serum androgens. […] Treatment of acne and hirsutism should not be withheld during the ongoing longitudinal evaluation for possible PCOS. […] Polycystic ovary syndrome is the most common cause of persistent hyperandrogenism beyond early puberty in adolescent girls and women and is estimated to affect 615% of reproductive-aged women. […] There are no clear consensus guidelines on the diagnostic criteria for PCOS in adolescent girls within 2 years of menarche; thus, obstetriciangynecologists should exercise caution in assigning this diagnosis prematurely.

• #32 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

  Hirsutism refers to the growth of coarse, dark hair in areas where females typically grow fine hair or no hair at all: above the lip and on the chin, chest, abdomen, and back. This excess hair growth is caused by an increased level of male hormones (androgens). […] Females with excess hair growth need to be evaluated by a health care provider, especially if the hair develops or worsens rapidly, or if relatives have comparatively less hair growth. In the vast majority of cases, hirsutism is not caused by a serious medical condition; however, the cause of hirsutism should be determined, and underlying conditions may need to be treated. […] Hirsutism is caused by an excess production or action of hormones called androgens. Androgens are secreted by the ovaries and adrenal glands into the circulation. Hair follicles respond to androgens by growing thick hair and producing sebum.

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

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

  Up to 70 percent of patients with PCOS have signs of hyperandrogenism. […] 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. […] 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. […] Treatment options for patients who have hirsutism can be divided into those measures targeting local manifestations of hirsutism and pharmacologic therapy aimed at the underlying causes. […] Pharmacologic treatment for hirsutism should be aimed at blocking androgen action at hair follicles or suppression of androgen production.

• #34 Hairiness – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/hair-disorders/hairiness

  Hirsutism is excessive growth of thick or dark body hair in women in locations that are more typical of male hair growth. […] The most common cause of hirsutism is Polycystic ovary syndrome (PCOS). […] If women also develop signs of virilization (such as a deepened voice, increased muscle mass, scalp hair loss, or irregular or absent menstrual periods), they may have a hormone disorder that requires prompt evaluation by a doctor. […] If excess body hair appears suddenly and grows rapidly, the cause may be cancer.

• #35 Hirsutism | GLOWM

  https://www.glowm.com/section-view/heading/Hirsutism/item/301

  Patients with PCOS comprise between 60% and 80% of all hyperandrogenic women seen. […] The primary goal of hormonal therapy is to stop the progression of hirsutism. […] Hormonal therapy may also decrease the growth rate, diameter, and pigmentation of terminal hairs that are already present. […] Women with hirsutism require long-term follow-up, counseling, and emotional support, because these disorders are usually lifelong and progressive unless adequately treated.

• #36 Hirsutism in Women: Understanding and Managing – Prof. Dr. Basak Baksu

  https://basakbaksu.com.tr/en/kadinlarda-hirsutizm/

  Regular health checkups play a critical role in early diagnosis and management of hirsutism. By identifying the underlying causes, doctors can create personalized treatment plans. Regular monitoring of ovarian and adrenal gland function helps detect potential problems early. […] If hirsutism is left untreated, hormonal imbalances can worsen and underlying medical conditions can worsen. Additionally, the psychological effects can increase, leading to loss of self-esteem and depression. Treatment is important to manage symptoms and prevent complications.

• #37 Hirsutism | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/hirsutism

  Hirsutism is excessive growth of „male” pattern hair that appears on the face, back, chest, abdomen, and thighs in women. Hirsutism is common and is usually a sign of an underlying endocrine disorder, most commonly polycystic ovary syndrome (PCOS). Hirsutism is very common, affecting 5% – 10% of all women. […] There are available treatments that can help decrease and slow hair growth to improve overall quality of life. […] Some studies have found weight loss is associated with slight improvement in unwanted hair growth. Women with hirsutism and PCOS should consider making lifestyle changes to improve their overall health.

• #38

  https://healthmatch.io/pcos/pcos-facial-hair

  According to the American Obstetricians and Gynecologists (ACOG), at least seven in ten women with PCOS experience excess hair growth, also known as hirsutism. […] This condition affects about 70% of women with PCOS. […] Hirsutism is usually a sign of an underlying medical problem. If you think you have excess hair on your face, talk to your doctor about treatment options. […] The good news is that PCOS can be treated, even if there is no known cure. We know that our lifestyle can make PCOS symptoms worse or better. […] PCOS facial hair is the excess hair growth on your face. Though not painful, this condition can affect your general outlook and confidence. It is caused mainly by excess androgen levels. […] Early treatment of PCOS can reduce the growth of excess hair. The doctor can diagnose the condition and recommend the appropriate medications to help regulate your androgen levels. Ensure you visit the doctor as soon as you notice the symptoms of PCOS, including hirsutism.

• #39 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

  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. […] 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.

• #40 Presentation of severe hirsutism in a young woman with polycystic ovary syndrome – Polish Archives of Internal Medicine

  https://www.mp.pl/paim/issue/article/16058

  Hirsutism is an excessive growth of terminal hair that appears in a male pattern in women. The majority of women with hirsutism have polycystic ovary syndrome (PCOS), although other hyperandrogenic endocrinopathies need to be excluded as possible causes. […] Although PCOS is a common endocrine disorder, severe hyperandrogenism is rare and other possible major causes should be taken into consideration. The excessive hair growth is a result of an interaction between free androgen levels and the sensitivity of the hair follicle. An increased activity of 5RD potentiating androgen action in the pilosebaceous unit could be the possible cause. In therapy, androgen suppression using oral contraceptives as well as antiandrogens has a documented efficacy in reducing hirsutism. Due to the long hair growth cycle, treatment effects are visible after 6 to 9 months. The combination therapy needs monitoring with respect to efficacy and side effects.

• #41 Hirsutism, Normal Androgens and Diagnosis of PCOS

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

  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. […] Most women with androgen levels more than twice the upper limit of the reference range have some degree of hirsutism, but it has been demonstrated that androgen levels, measured by conventional techniques, correlate poorly with the severity of hirsutism. […] The Ferriman–Gallwey (FG) 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.

• #42 Hirsutism, Normal Androgens and Diagnosis of PCOS

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

  Importantly, the data reported by Ferriman and Gallwey were derived from women attending a northern London general medical outpatient clinic, a selected homogeneous population. […] Indeed, the international evidence-based guideline for the assessment and management of PCOS, published in 2018, proposes to consider ethnic origin when evaluating mFG scores in different populations. […] Data from a systematic review comparing hirsutism in women with PCOS from populations of different ethnicities showed that, compared with white women, East Asian women were less hirsute, whereas Hispanic women, South Asian women and Middle Eastern women were more hirsute.

• #43 Experts issue recommendations to manage unwanted hair growth in women | Endocrine Society

  https://www.endocrine.org/news-and-advocacy/news-room/2018/experts-issue-recommendations-to-manage-unwanted-hair-growth-in-women

  All women who have unwanted dark, coarse hair growing on the face, chest or back should undergo testing for polycystic ovary syndrome (PCOS) and other underlying health problems, Endocrine Society experts concluded in an updated Clinical Practice Guideline released today. Hirsutism affects 5 percent to 10 percent of women. Society experts now suggest all women with hirsutism undergo blood tests for testosterone and other male sex hormones called androgens. Hirsutism can cause personal distress, anxiety and depression when it is not treated. The Society suggests treating mild cases with no sign of an underlying condition with medication or direct hair removal. The new guideline is co-sponsored by the Androgen Excess and Polycystic Ovary Syndrome Society and the European Society of Endocrinology. […] The Society established the Clinical Practice Guideline Program to provide endocrinologists and other clinicians with evidence-based recommendations in the diagnosis and treatment of endocrine-related conditions.

• #44

  https://mgriblog.org/2018/04/04/recommendations-hirsutism/

  For the first time since 2008, the Endocrine Society Task Force which includes representatives from Massachusetts General Hospital has issued an update to its Clinical Practice Guideline on hirsutism, a condition in which women experience unwanted hair growth in areas men typically grow hair. […] The condition affects 5 to 10 percent of women and can cause personal distress, anxiety and depression when its not treated. Excess facial or body hair is not only distressing to women, it is often a symptom of an underlying medical problem, said Kathryn Martin, MD, an endocrinologist and investigator at Mass General, and a member of the Endocrine Society Task Force responsible for developing the new guidelines. […] After conducting two systematic reviews and looking at the best available published evidence, the task force revised the guidelines for diagnosing and treating hirsutism. […] The updated guidelines now suggest all women with hirsutism undergo blood tests for androgens. […] The guidelines previously called for testing for women with moderate to severe hirsutism, but the recommendation was broadened to improve diagnosis rates of PCOS and other underlying conditions.

• #45

  https://www.medscape.org/viewarticle/572621_4

  The high frequency of polycystic ovary syndrome as a cause of hirsutism warrants attention to evidence of anovulation (such as menstrual irregularity), obesity, the metabolic syndrome or insulin resistance (such as the presence of acanthosis nigricans, skin tags or a family history of type 2 diabetes mellitus). […] Diagnosis rests on the finding of polycystic ovaries on pelvic ultrasound, which are reported in 60-97% of women presenting with hirsutism. […] The basic approach to the differential diagnosis should be: documentation of the degree of androgen excess and exclusion of the serious but rare causes of hirsutism such as androgen-secreting tumours. […] Several clinical findings that suggest one of the rare and more serious causes of hirsutism include: abrupt onset, rapid pace of development or progression of hirsutism or evidence of virilisation.

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