Materiały źródłowe

• #1 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #2 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases. Many medications can also cause hirsutism. In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such as polycystic ovary syndrome, adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, and androgen-secreting tumors. Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass. […] Hirsutism is defined as excess terminal hair that commonly appears in a male pattern in women. It is generally associated with hyperandrogenemia. Hirsutism occurs in approximately 7 percent of women and has an estimated economic burden in the United States of more than $600 million annually. Hirsutism should be distinguished from hypertrichosis, which is generalized excessive hair growth not caused by androgen excess. Hypertrichosis may be congenital or caused by metabolic disorders such as thyroid dysfunction, anorexia nervosa, and porphyria.

• #3 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases. Many medications can also cause hirsutism. In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such as polycystic ovary syndrome, adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, and androgen-secreting tumors. Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass. […] Hirsutism is defined as excess terminal hair that commonly appears in a male pattern in women. It is generally associated with hyperandrogenemia. Hirsutism occurs in approximately 7 percent of women and has an estimated economic burden in the United States of more than $600 million annually. Hirsutism should be distinguished from hypertrichosis, which is generalized excessive hair growth not caused by androgen excess. Hypertrichosis may be congenital or caused by metabolic disorders such as thyroid dysfunction, anorexia nervosa, and porphyria.

• #4 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. […] 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. […] Cushing syndrome. This occurs when your body is exposed to high levels of the hormone cortisol. It can develop from your adrenal glands making too much cortisol or from taking medications such as prednisone over a long period.

• #5 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. It is often the result of a medical condition, such as insulin resistance. […] About half of all people with hirsutism have an excess of androgens. These hormones usually trigger male physical and sexual development. Women normally have low androgen levels, but these levels might vary for a range of reasons. […] Increased levels of androgens or oversensitivity of the hair follicles to androgens can cause hirsutism. […] High levels of insulin, a hormone that unlocks cells to absorb energy from sugars, might also contribute to the development of hirsutism. Insulin can stimulate the ovarian cells to produce androgens. […] Excessive hair growth in women with normal androgen levels, regular menstrual periods, and no other underlying conditions is called idiopathic hirsutism. This means that the disorder has no identifiable cause. […] Tumors of the adrenal glands, pituitary glands, and ovaries can sometimes lead to hirsutism. However, hirsutism that occurs for this reason will generally be more severe and onset more quickly than with hormonal causes.

• #6 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. 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). The pathophysiology and causes of androgen-mediated hair growth are reviewed here. […] The hair growth cycle is comprised of three phases: The growth phase (termed anagen), which varies by body area, is approximately four months for facial hair. Therefore, it takes approximately six months to detect the effects of hormonal therapy for facial hirsutism. […] Causes: Polycystic ovary syndrome, Idiopathic hirsutism, Nonclassic congenital adrenal hyperplasia, Females with virilization or severe hyperandrogenemia, Androgen-secreting tumors, Ovarian hyperthecosis.

• #7 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #8 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #9 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #10 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #11

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Hirsutism is defined as excessive terminal hair growth in a male pattern in females. It typically affects 5 to 10% of reproductive-age women. Excessive hair growth can often cause significant psychological and emotional distress. Hirsutism results from excess production of androgens, often from ovarian or adrenal sources. It is typically associated with a metabolic syndrome like polycystic ovarian syndrome (PCOS), but can be idiopathic or medication-induced. […] Hirsutism is often the initial, and possibly only, sign of an underlying androgen disorder. Therefore, understanding the various causes of hirsutism will help guide the evaluation of these patients. […] Polycystic ovarian syndrome (PCOS) is the most common cause of hirsutism in women. Hirsutism typically develops at puberty. […] The exact cause of PCOS is uncertain, but it is thought to be multifactorial. PCOS develops when the ovaries are stimulated to produce excessive amounts of androgens.

• #12 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. 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.

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

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

  Hirsutism is a condition in women and people assigned female at birth (AFAB) that causes a lot of hair growth. The hair typically grows in areas where it usually appears in men or people assigned male at birth (AMAB). […] Polycystic ovary syndrome (PCOS), high insulin levels, menopause, and certain medications can cause hirsutism. […] Having high levels of male hormones (called androgens) can cause hirsutism. […] Some possible reasons for high levels of androgens include: Polycystic ovary syndrome (PCOS). It causes small cysts, or fluid-filled sacs, to form on your ovaries. […] High insulin levels. Insulin can trigger the ovaries to produce androgens. […] Some women and people AFAB have idiopathic hirsutism, which means there’s no known cause. […] PCOS is the most common cause of hirsutism. But hirsutism, by itself, doesn’t mean you have PCOS. Extra hair growth is simply a symptom of PCOS that affects up to 70% of women and people AFAB with the condition.

• #14 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #15 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. Less common causes include idiopathic hirsutism, nonclassic congenital adrenal hyperplasia, androgen-secreting tumors, medications, hyperprolactinemia, thyroid disorders, and Cushing syndrome. […] Most cases of hirsutism are due to functional causes of excess androgens. The causes of hirsutism and their diagnostic clues are listed in Table 1. 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. It is characterized by normal menses, normal ovaries on ultrasonography, elevated androgen levels, and no secondary causes.

• #16 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #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. […] Adrenal hyperplasia is inherited in an autosomal recessive pattern and is due to deficiency of one of the enzymes involved in adrenal steroid hormone synthesis, causing precursors to be shunted to the androgen pathway. […] Androgen-secreting tumors are a rare cause of hirsutism, can be ovarian or adrenal in origin, and are malignant in more than 50% of cases. […] Other endocrine disorders such as hyperprolactinemia, thyroid disorders, acromegaly, and Cushing syndrome may be associated with hirsutism but rarely present with isolated hirsutism.

• #18 Hirsutism – Wikipedia

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

  Drug-induced: medications were used before the onset of hirsutism. […] Pregnancy: Due to changes in hormone production. […] Idiopathic: When no other cause can be attributed to an individual’s hirsutism, the cause is considered idiopathic by exclusion. […] Around 10 to 15% of women with hirsutism have idiopathic hirsutism. […] Idiopathic hirsutism may be due to increased production of dihydrotestosterone (DHT) in hair follicles and hence may actually still be due to hyperandrogenism.

• #19 Hirsutism Clinical Presentation: History, Physical, Causes

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

  PCOS is the most common ovarian disorder associated with hirsutism. […] The etiology is speculated to be multifactorial. […] The characteristic endocrine abnormality is an elevation in levels of plasma free testosterone that is not suppressed by dexamethasone; however, as many as 50% of patients also show abnormal adrenal androgen secretion. […] Idiopathic hirsutism is a diagnosis of exclusion. […] The patient’s hirsutism is not caused by well-defined abnormalities such as an androgen-secreting tumor or CAH. […] The disorder is often familial and may be associated with obesity and insulin resistance. […] Some patients with idiopathic hirsutism have normal plasma androgen levels. […] Increased activity of the enzyme has been demonstrated based on skin biopsy findings and by a finding of elevated urinary levels of dihydrotestosterone metabolites.

• #20 Hirsutism – Wikipedia

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

  Drug-induced: medications were used before the onset of hirsutism. […] Pregnancy: Due to changes in hormone production. […] Idiopathic: When no other cause can be attributed to an individual’s hirsutism, the cause is considered idiopathic by exclusion. […] Around 10 to 15% of women with hirsutism have idiopathic hirsutism. […] Idiopathic hirsutism may be due to increased production of dihydrotestosterone (DHT) in hair follicles and hence may actually still be due to hyperandrogenism.

• #21 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

• #22 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #23 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

• #24 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. […] 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. […] Cushing syndrome. This occurs when your body is exposed to high levels of the hormone cortisol. It can develop from your adrenal glands making too much cortisol or from taking medications such as prednisone over a long period.

• #25

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Approximately half of all women with mild hirsutism have idiopathic hirsutism. It is usually a diagnosis of exclusion. […] Congenital adrenal hyperplasias are a group of autosomal recessive disorders affecting enzymes responsible for cortisol production. […] Androgen-secreting tumors make up only 5% of all ovarian tumors. They cause hirsutism, typically later in life, and tend to progress more rapidly. […] These are rare causes of hyperandrogenism. Most of these tumors are adrenal carcinomas and typically cause hypercortisolism and excess androgen secretion. […] Cushing’s disease is typically a result of an adrenocorticotrophic hormone-secreting pituitary adenoma resulting in excessive secretion of not only cortisol, but also adrenal androgens, by the adrenal gland. Hirsutism is a common symptom of this disorder along with weight gain, hypertension, rounding of the face, abdominal striae, and irregular menstruation.

• #26

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Approximately half of all women with mild hirsutism have idiopathic hirsutism. It is usually a diagnosis of exclusion. […] Congenital adrenal hyperplasias are a group of autosomal recessive disorders affecting enzymes responsible for cortisol production. […] Androgen-secreting tumors make up only 5% of all ovarian tumors. They cause hirsutism, typically later in life, and tend to progress more rapidly. […] These are rare causes of hyperandrogenism. Most of these tumors are adrenal carcinomas and typically cause hypercortisolism and excess androgen secretion. […] Cushing’s disease is typically a result of an adrenocorticotrophic hormone-secreting pituitary adenoma resulting in excessive secretion of not only cortisol, but also adrenal androgens, by the adrenal gland. Hirsutism is a common symptom of this disorder along with weight gain, hypertension, rounding of the face, abdominal striae, and irregular menstruation.

• #27 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #28 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

• #29 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. […] Adrenal hyperplasia is inherited in an autosomal recessive pattern and is due to deficiency of one of the enzymes involved in adrenal steroid hormone synthesis, causing precursors to be shunted to the androgen pathway. […] Androgen-secreting tumors are a rare cause of hirsutism, can be ovarian or adrenal in origin, and are malignant in more than 50% of cases. […] Other endocrine disorders such as hyperprolactinemia, thyroid disorders, acromegaly, and Cushing syndrome may be associated with hirsutism but rarely present with isolated hirsutism.

• #30 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

• #31 Hirsutism Clinical Presentation: History, Physical, Causes

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

  Because the development of pubic hair depends on adrenal androgens, early development points toward CAH. […] Endogenous androgens originate from either the adrenal cortex or the ovary. Therefore, the evaluation of androgen excess can focus on disorders of these 2 glands. The principal possibilities are tumors of the ovary or the adrenal cortex, Cushing syndrome, CAH, and PCOS. Idiopathic hirsutism is the most common etiology, but it is a diagnosis of exclusion. Therefore, seek other causes first. […] Multiple diseases can cause hyperandrogenism and hirsutism. The etiologic forms of hirsutism include endocrine-related, idiopathic, medication-related, and miscellaneous. Endocrine-related causes include adrenocortical disorders and ovarian disorders. […] Tumors, Cushing syndrome, and CAH are the adrenocortical causes. Tumors (malignant or benign) and PCOS are the ovarian causes of hirsutism.

• #32

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Hyperthecosis occurs when an area of luteinization develops along with stromal hyperplasia in the ovary. The luteinized thecal cells overproduce androgens, more specifically testosterone, resulting in hirsutism and virilization. […] This is a condition in which cells fail to respond normally to insulin. Severe hyperinsulinemia causes increased GnRH pulse frequency, increased androgen production, and decreased SHBG, resulting in elevated levels of free or active testosterone. Women who have severe insulin resistance or hyperinsulinemia often develop hirsutism. […] There are many drugs that may be associated with the development of hirsutism.

• #33

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Hyperthecosis occurs when an area of luteinization develops along with stromal hyperplasia in the ovary. The luteinized thecal cells overproduce androgens, more specifically testosterone, resulting in hirsutism and virilization. […] This is a condition in which cells fail to respond normally to insulin. Severe hyperinsulinemia causes increased GnRH pulse frequency, increased androgen production, and decreased SHBG, resulting in elevated levels of free or active testosterone. Women who have severe insulin resistance or hyperinsulinemia often develop hirsutism. […] There are many drugs that may be associated with the development of hirsutism.

• #34 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

• #35 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. […] Adrenal hyperplasia is inherited in an autosomal recessive pattern and is due to deficiency of one of the enzymes involved in adrenal steroid hormone synthesis, causing precursors to be shunted to the androgen pathway. […] Androgen-secreting tumors are a rare cause of hirsutism, can be ovarian or adrenal in origin, and are malignant in more than 50% of cases. […] Other endocrine disorders such as hyperprolactinemia, thyroid disorders, acromegaly, and Cushing syndrome may be associated with hirsutism but rarely present with isolated hirsutism.

• #36 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

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

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

  Excessive body or facial hair growth can also result from taking any of the following medications: minoxidil, anabolic steroids, testosterone, and cyclosporine. […] In some cases, women may experience idiopathic hirsutism, which means that theres no detectable cause for why the hirsutism developed.

• #38 Hirsutism – Symptoms & causes – Mayo Clinic

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

  Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands. […] Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands can cause hirsutism. […] Medications. Some medications can cause hirsutism. These include minoxidil (Minoxidil, Rogaine); danazol, which is used to treat women with endometriosis; testosterone (Androgel, Testim); and dehydroepiandrosterone (DHEA). If your partner uses topical products containing androgens, you can be affected as well, through skin-to-skin contact. […] Often hirsutism occurs with no identifiable cause.

• #39 Hirsutism – Symptoms & causes – Mayo Clinic

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

  Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands. […] Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands can cause hirsutism. […] Medications. Some medications can cause hirsutism. These include minoxidil (Minoxidil, Rogaine); danazol, which is used to treat women with endometriosis; testosterone (Androgel, Testim); and dehydroepiandrosterone (DHEA). If your partner uses topical products containing androgens, you can be affected as well, through skin-to-skin contact. […] Often hirsutism occurs with no identifiable cause.

• #40 Hirsutism – Symptoms & causes – Mayo Clinic

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

  Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands. […] Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands can cause hirsutism. […] Medications. Some medications can cause hirsutism. These include minoxidil (Minoxidil, Rogaine); danazol, which is used to treat women with endometriosis; testosterone (Androgel, Testim); and dehydroepiandrosterone (DHEA). If your partner uses topical products containing androgens, you can be affected as well, through skin-to-skin contact. […] Often hirsutism occurs with no identifiable cause.

• #41 Hirsutism – Symptoms & causes – Mayo Clinic

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

  Congenital adrenal hyperplasia. This inherited condition is characterized by abnormal production of steroid hormones, including cortisol and androgen, by your adrenal glands. […] Tumors. Rarely, an androgen-secreting tumor in the ovaries or adrenal glands can cause hirsutism. […] Medications. Some medications can cause hirsutism. These include minoxidil (Minoxidil, Rogaine); danazol, which is used to treat women with endometriosis; testosterone (Androgel, Testim); and dehydroepiandrosterone (DHEA). If your partner uses topical products containing androgens, you can be affected as well, through skin-to-skin contact. […] Often hirsutism occurs with no identifiable cause.

• #42 FloridaHealthFinder | Excessive or unwanted hair in women | Health Encyclopedia | FloridaHealthFinder

  https://quality.dev.healthfinder.fl.gov/health-encyclopedia/HIE/1/007622

  Most of the time, women have fine hair above their lips and on their chin, chest, abdomen, or back. The growth of coarse dark hair in these areas (more typical of male-pattern hair growth) is called hirsutism. […] Women normally produce low levels of male hormones (androgens). If your body makes too much of this hormone, you may have unwanted hair growth. […] A common cause of hirsutism is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormone conditions that cause unwanted hair growth may also have: […] If these symptoms start suddenly, you may have a tumor that releases male hormones. […] Other, less common causes of unwanted hair growth may include: […] Use of certain medicines may also be the cause of unwanted hair growth, including: […] Female body builders may take male hormones (anabolic steroids), which may result in excessive hair growth. […] In rare cases, women with hirsutism have normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified.

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

  https://patient.info/doctor/hirsutism

  Drug-induced hirsutism – eg, glucocorticoids, danazol, sodium valproate and androgenic progestogens. […] Ovarian causes: PCOS: virilisation is minimal and hirsutism is often prominent. This is the most common cause and is present in approximately 70% of cases. Menopause. Androgen-producing ovarian tumours – eg, luteoma of pregnancy, arrhenoblastomas, Leydig cell tumours, hilar cell tumours, thecal cell tumours. […] Adrenal causes: Androgen-producing adrenal tumour. Congenital adrenal hyperplasia (CAH). Cushing’s syndrome. […] Other causes include severe insulin resistance, anorexia nervosa, prolactinoma, acromegaly, hypothyroidism and porphyria.

• #44 Hirsutism – Harvard Health

  https://www.health.harvard.edu/a_to_z/hirsutism-a-to-z

  Occasionally, the overproduction of androgen hormones is caused by an abnormality in the ovaries, the adrenal glands or the pituitary gland of the brain. […] Some excessive hair growth does not fit the pattern of growth triggered by androgen hormones (for example, hair between the eyes, on the forehead, on the temples or high on the cheeks of the face). This hair growth, called hypertrichosis, can be caused by thyroid problems or by anorexia nervosa. It also can result from long-term use of certain oral medications, including cyclosporin (Neoral, Sandimmune, SangCya), phenytoin (Dilantin), minoxidil (Loniten), and penicillamine (Cuprimine, Depen).

• #45 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #46 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #47 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #48 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. 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.

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

  https://johnshopkinshealthcare.staywellsolutionsonline.com/RelatedItems/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. […] In some cases, the cause isn’t known. This is called idiopathic hirsutism. […] 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.

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

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

  Hirsutism usually results from high levels of male hormones (androgens, such as testosterone) or from increased sensitivity to normal levels of male hormones in the body. […] Conditions that tip the hormonal balance in favor of male hormones can cause hirsutism. The balance may be tipped by excess production of male hormones. However, in hirsutism that runs in families (familial hirsutism), women’s hair follicles simply appear to be more sensitive to normal levels of male hormones. […] The most common cause of hirsutism is Polycystic ovary syndrome (PCOS). […] There are many less common causes of hirsutism: Pituitary, ovarian, or adrenal gland disorders that result in overproduction of male hormones; Tumors that produce male hormones; Use of certain medications such as testosterone, danazol, or birth control pills that have a high dose of progesterone; A familial trait, most often occurring in people of Mediterranean, Middle Eastern, or South Asian descent; Sometimes after menopause or during pregnancy when hormone balance changes. […] When hirsutism is caused by increased levels of androgens, women often have virilization. Virilization is the development of masculine or other characteristics in addition to excess face and body hair.

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

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

  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.

• #52

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12235

  Hirsutism is common in women who have polycystic ovary syndrome (PCOS). This syndrome affects your hormone balance, ovulation, and menstrual periods. […] In some women, hirsutism may be caused by higher-than-normal levels of male hormones called androgens. These hormones are found in both men and women, though men have a lot more of them. In women, androgens are produced by the ovaries or the adrenal glands. […] But some women with hirsutism don’t have PCOS or any other cause that can be found. Their hormone levels are normal, and so are their menstrual cycles. These women may have been born with hair follicles that are more sensitive to androgens. […] Hirsutism may also occur in some women who have diabetes or who are obese. […] In rare cases, the ovaries or adrenal glands may have a problem that can cause this hair growth.

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

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

  Hirsutism is a condition that causes excess hair to grow on certain parts of your body. It mainly affects females. Hirsutism doesn’t have a known cause, but it’s a symptom of other conditions, including polycystic ovary syndrome. Treatment options include weight loss, medications and other hair removal options. […] Hirsutism is a common condition that causes excessive hair growth. It primarily affects females. […] In many cases, hirsutism doesn’t have a known cause. But several conditions cause hirsutism, including: The natural production of androgens. All people have androgens, but males make more of them. If a female has high androgen levels or their hair follicles are more sensitive to androgens, they may develop hirsutism. Polycystic ovarian syndrome (PCOS). PCOS is a common hormonal condition that causes females to produce too many androgens. Other symptoms of PCOS include acne, abnormal menstruation, diabetes, weight gain and fertility problems. Postmenopause. The hormonal changes that take place in your body after menopause may lead to increased facial hair, including a mustache or whiskers. Cushing’s syndrome. Cushing’s syndrome happens when your body has too much of the hormone cortisol, which can impact the set of organs that affect your hair, skin, nails, glands and nerves (integumentary system). Other symptoms of Cushing’s syndrome may include rapid weight gain in your face, wounds that heal poorly, high blood pressure (hypertension) and diabetes. Other conditions. If hirsutism occurs suddenly along with symptoms like a deeper voice, acne or increased muscle development, you may have a more serious condition. More serious conditions may include an adrenal gland disorder or an ovary disorder, such as congenital adrenal hyperplasia or a tumor on your adrenal glands or ovaries that produce androgen. Medications. Some medications can cause hirsutism, including anabolic steroids, testosterone, cyclosporine (Sandimmune), minoxidil (Rogaine), danazol (Danocrine) and phenytoin (Dilantin). […] PCOS isn’t the only cause of hirsutism. However, 70% to 80% of all people with PCOS develop hirsutism.

• #54 Hirsutism and Polycystic Ovary Syndrome (PCOS) patient education booklet | ReproductiveFacts.org

  https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hirsutism-and-polycystic-ovary-syndrome-pcos/

  Polycystic ovary syndrome is a condition associated with hormonal imbalances that cause the ovaries to overproduce androgens. It is a common cause of hirsutism. […] The most common abnormality of the adrenal glands that can result in hirsutism is an inherited disorder called non-classical adrenal hyperplasia (NCAH), which causes the adrenal glands to overproduce androgens. […] Some women are born with insulin resistance, a defect in the ability of insulin to control blood sugar levels. […] Cushing syndrome refers to overproduction of cortisol by the adrenal glands. […] On rare occasions, an androgen-producing tumor may develop in the ovaries or adrenal glands. […] Around the time of menopause, the ovaries stop producing estrogen but continue to produce androgens. […] Drugs with characteristics of androgens may cause hirsutism.

• #55 Hirsutism – Wikipedia

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

  Drug-induced: medications were used before the onset of hirsutism. […] Pregnancy: Due to changes in hormone production. […] Idiopathic: When no other cause can be attributed to an individual’s hirsutism, the cause is considered idiopathic by exclusion. […] Around 10 to 15% of women with hirsutism have idiopathic hirsutism. […] Idiopathic hirsutism may be due to increased production of dihydrotestosterone (DHT) in hair follicles and hence may actually still be due to hyperandrogenism.

• #56 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases. Many medications can also cause hirsutism. In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such as polycystic ovary syndrome, adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, and androgen-secreting tumors. Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass. […] Hirsutism is defined as excess terminal hair that commonly appears in a male pattern in women. It is generally associated with hyperandrogenemia. Hirsutism occurs in approximately 7 percent of women and has an estimated economic burden in the United States of more than $600 million annually. Hirsutism should be distinguished from hypertrichosis, which is generalized excessive hair growth not caused by androgen excess. Hypertrichosis may be congenital or caused by metabolic disorders such as thyroid dysfunction, anorexia nervosa, and porphyria.

• #57 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #58 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). […] 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. Once activated, hair follicles can also convert circulating weak androgens into stronger androgens. Several different conditions can lead to hirsutism. The two most common causes of hirsutism are polycystic ovary syndrome (PCOS) and idiopathic hirsutism. […] Polycystic ovary syndrome — Females with PCOS often have hirsutism in combination with irregular menstrual cycles. Instead of the normal 24- to 38-day menstrual cycle length, females with PCOS often have cycle lengths that are >38 days. Females with PCOS typically have fewer than six cycles per year. When cycles are this irregular, it usually means that a female is not ovulating on a regular basis. Females with PCOS may also have acne and balding or increased hair loss near the front of the head. PCOS is a chronic condition, but several treatments can reduce hair growth. […] Hirsutism is associated with depression and anxiety (independent of obesity and a PCOS diagnosis) that improve with the treatment of their hirsutism.

• #59 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. 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). The pathophysiology and causes of androgen-mediated hair growth are reviewed here. […] The hair growth cycle is comprised of three phases: The growth phase (termed anagen), which varies by body area, is approximately four months for facial hair. Therefore, it takes approximately six months to detect the effects of hormonal therapy for facial hirsutism. […] Causes: Polycystic ovary syndrome, Idiopathic hirsutism, Nonclassic congenital adrenal hyperplasia, Females with virilization or severe hyperandrogenemia, Androgen-secreting tumors, Ovarian hyperthecosis.

• #60 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. Androgens are a group of hormones present in both the male and female, but the levels are much higher in the male (ie. testosterone). […] Severe form of hirsutism is called virilization. Virilization presents with deepening of the voice, male type balding, changes in body habitus and enlargement of the clitoris. Virilization is due to excessive amount of androgen production and generally related to tumors releasing androgenic hormones (adrenal hyperplasia, androgen producing tumors of the ovary and the adrenal gland). […] Androgenic hormones include dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS) and testosterone (T). Testosterone is converted to dehydrotestosterone (DHT) in the hair follicle by the enzyme 5-alpha reductase. DHT is the most potent androgenic hormone involved in hair growth and distribution.

• #61

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Approximately half of all women with mild hirsutism have idiopathic hirsutism. It is usually a diagnosis of exclusion. […] Congenital adrenal hyperplasias are a group of autosomal recessive disorders affecting enzymes responsible for cortisol production. […] Androgen-secreting tumors make up only 5% of all ovarian tumors. They cause hirsutism, typically later in life, and tend to progress more rapidly. […] These are rare causes of hyperandrogenism. Most of these tumors are adrenal carcinomas and typically cause hypercortisolism and excess androgen secretion. […] Cushing’s disease is typically a result of an adrenocorticotrophic hormone-secreting pituitary adenoma resulting in excessive secretion of not only cortisol, but also adrenal androgens, by the adrenal gland. Hirsutism is a common symptom of this disorder along with weight gain, hypertension, rounding of the face, abdominal striae, and irregular menstruation.

• #62 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #63

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5419053/

  Approximately half of all women with mild hirsutism have idiopathic hirsutism. It is usually a diagnosis of exclusion. […] Congenital adrenal hyperplasias are a group of autosomal recessive disorders affecting enzymes responsible for cortisol production. […] Androgen-secreting tumors make up only 5% of all ovarian tumors. They cause hirsutism, typically later in life, and tend to progress more rapidly. […] These are rare causes of hyperandrogenism. Most of these tumors are adrenal carcinomas and typically cause hypercortisolism and excess androgen secretion. […] Cushing’s disease is typically a result of an adrenocorticotrophic hormone-secreting pituitary adenoma resulting in excessive secretion of not only cortisol, but also adrenal androgens, by the adrenal gland. Hirsutism is a common symptom of this disorder along with weight gain, hypertension, rounding of the face, abdominal striae, and irregular menstruation.

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

  https://library.southcoast.org/Library/DiseasesConditions/Adult/85,P00327

  Symptoms can occur a bit differently in each person. They include darker or thicker hairs growing on parts of the body such as: upper lip, chin, jawline, chest, back, buttocks. […] Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. You may also have blood tests to check for increased androgen levels. These tests can also check for other problems that may cause excess hair growth. […] Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person. […] Other medicines can reduce the hormones that cause hair growth. It can take 6 months or longer for you to see results from these medicines. […] Hirsutism is often a long-term (chronic) condition. But you can manage it by working with your healthcare provider to create a treatment plan.

• #65 Hirsutism Clinical Presentation: History, Physical, Causes

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

  An accurate history of the patient’s onset of hirsutism and developmental milestones can be helpful in the etiologic diagnosis. […] Idiopathic hirsutism and the other less-serious causes of hirsutism usually begin at puberty. […] Conversely, hirsutism that occurs in middle-aged or older women should suggest an adrenal or ovarian tumor. […] A patient with a family history of hirsutism is consistent with congenital adrenal hyperplasia (CAH); however, idiopathic hirsutism and polycystic ovary syndrome (PCOS) can also be familial. […] The history of a benign form of hirsutism is usually characterized by pubertal onset with slow progression over many years. This is often true of hirsutism with PCOS. […] When a history of rapid severe hirsutism or other signs of virilization are obtained, an androgen-secreting tumor is a possibility.

• #66 Hirsutism Clinical Presentation: History, Physical, Causes

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

  An accurate history of the patient’s onset of hirsutism and developmental milestones can be helpful in the etiologic diagnosis. […] Idiopathic hirsutism and the other less-serious causes of hirsutism usually begin at puberty. […] Conversely, hirsutism that occurs in middle-aged or older women should suggest an adrenal or ovarian tumor. […] A patient with a family history of hirsutism is consistent with congenital adrenal hyperplasia (CAH); however, idiopathic hirsutism and polycystic ovary syndrome (PCOS) can also be familial. […] The history of a benign form of hirsutism is usually characterized by pubertal onset with slow progression over many years. This is often true of hirsutism with PCOS. […] When a history of rapid severe hirsutism or other signs of virilization are obtained, an androgen-secreting tumor is a possibility.

• #67 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. Less common causes include idiopathic hirsutism, nonclassic congenital adrenal hyperplasia, androgen-secreting tumors, medications, hyperprolactinemia, thyroid disorders, and Cushing syndrome. […] Most cases of hirsutism are due to functional causes of excess androgens. The causes of hirsutism and their diagnostic clues are listed in Table 1. 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. It is characterized by normal menses, normal ovaries on ultrasonography, elevated androgen levels, and no secondary causes.

• #68 Hirsutism Clinical Presentation: History, Physical, Causes

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

  An accurate history of the patient’s onset of hirsutism and developmental milestones can be helpful in the etiologic diagnosis. […] Idiopathic hirsutism and the other less-serious causes of hirsutism usually begin at puberty. […] Conversely, hirsutism that occurs in middle-aged or older women should suggest an adrenal or ovarian tumor. […] A patient with a family history of hirsutism is consistent with congenital adrenal hyperplasia (CAH); however, idiopathic hirsutism and polycystic ovary syndrome (PCOS) can also be familial. […] The history of a benign form of hirsutism is usually characterized by pubertal onset with slow progression over many years. This is often true of hirsutism with PCOS. […] When a history of rapid severe hirsutism or other signs of virilization are obtained, an androgen-secreting tumor is a possibility.

• #69 FloridaHealthFinder | Excessive or unwanted hair in women | Health Encyclopedia | FloridaHealthFinder

  https://quality.dev.healthfinder.fl.gov/health-encyclopedia/HIE/1/007622

  Most of the time, women have fine hair above their lips and on their chin, chest, abdomen, or back. The growth of coarse dark hair in these areas (more typical of male-pattern hair growth) is called hirsutism. […] Women normally produce low levels of male hormones (androgens). If your body makes too much of this hormone, you may have unwanted hair growth. […] A common cause of hirsutism is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormone conditions that cause unwanted hair growth may also have: […] If these symptoms start suddenly, you may have a tumor that releases male hormones. […] Other, less common causes of unwanted hair growth may include: […] Use of certain medicines may also be the cause of unwanted hair growth, including: […] Female body builders may take male hormones (anabolic steroids), which may result in excessive hair growth. […] In rare cases, women with hirsutism have normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified.

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

  https://library.southcoast.org/Library/DiseasesConditions/Adult/85,P00327

  Symptoms can occur a bit differently in each person. They include darker or thicker hairs growing on parts of the body such as: upper lip, chin, jawline, chest, back, buttocks. […] Your healthcare provider will ask about your symptoms and health history. They will give you a physical exam. You may also have blood tests to check for increased androgen levels. These tests can also check for other problems that may cause excess hair growth. […] Treatment depends on personal preference. Hair growth causes no physical harm. The decision to remove or reduce hair varies from person to person. […] Other medicines can reduce the hormones that cause hair growth. It can take 6 months or longer for you to see results from these medicines. […] Hirsutism is often a long-term (chronic) condition. But you can manage it by working with your healthcare provider to create a treatment plan.

• #71 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. Less common causes include idiopathic hirsutism, nonclassic congenital adrenal hyperplasia, androgen-secreting tumors, medications, hyperprolactinemia, thyroid disorders, and Cushing syndrome. […] Most cases of hirsutism are due to functional causes of excess androgens. The causes of hirsutism and their diagnostic clues are listed in Table 1. 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. It is characterized by normal menses, normal ovaries on ultrasonography, elevated androgen levels, and no secondary causes.

• #72 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

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

  https://patient.info/doctor/hirsutism

  Drug-induced hirsutism – eg, glucocorticoids, danazol, sodium valproate and androgenic progestogens. […] Ovarian causes: PCOS: virilisation is minimal and hirsutism is often prominent. This is the most common cause and is present in approximately 70% of cases. Menopause. Androgen-producing ovarian tumours – eg, luteoma of pregnancy, arrhenoblastomas, Leydig cell tumours, hilar cell tumours, thecal cell tumours. […] Adrenal causes: Androgen-producing adrenal tumour. Congenital adrenal hyperplasia (CAH). Cushing’s syndrome. […] Other causes include severe insulin resistance, anorexia nervosa, prolactinoma, acromegaly, hypothyroidism and porphyria.

• #74 Hirsutism Clinical Presentation: History, Physical, Causes

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

  Adrenocortical tumors are almost always malignant in patients who present with hirsutism. These tumors are usually large and are associated with a very poor prognosis. […] In most instances, Cushing syndrome is caused by glucocorticoid therapy. […] CAH is actually a family of defects in one of five enzymes that are responsible for the biosynthesis of cortisol. […] The resulting cortisol deficiency heightens the secretion of ACTH and thereby leads to adrenal cell proliferation. […] However, only three of these defects can produce hirsutism 21-hydroxylase (most frequent), 3-hydroxysteroid dehydrogenase (less frequent), and 11–hydroxylase deficiency (least frequent). […] Ovarian tumors may be malignant, and the threat can be serious. Androgen-secreting ovarian tumors are a less-serious threat.

• #75 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  The most common cause of hirsutism is polycystic ovary syndrome (PCOS), which accounts for 72 to 82 percent of hirsutism cases. PCOS is defined by the presence of at least two of the following three signs: menstrual dysfunction, clinical or biochemical evidence of hyperandrogenemia, and polycystic ovaries on ultrasonography. Other characteristics of PCOS include obesity, infertility, and insulin resistance. Insulin resistance and hyperinsulinemia stimulate the adrenal glands and ovaries to produce more androgens. Hyperinsulinemia also inhibits the hepatic synthesis of sex hormone-binding globulin, which binds testosterone and makes it inactive. […] Hirsutism is caused by idiopathic hyperandrogenemia in less than 20 percent of cases, and is characterized by normal ovulatory cycles and no other identifiable cause of elevated androgen levels. Idiopathic hirsutism, in which androgen levels are normal, accounts for 4 to 7 percent of cases and is a diagnosis of exclusion.

• #76 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

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

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

  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.

• #78 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). […] 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. Once activated, hair follicles can also convert circulating weak androgens into stronger androgens. Several different conditions can lead to hirsutism. The two most common causes of hirsutism are polycystic ovary syndrome (PCOS) and idiopathic hirsutism. […] Polycystic ovary syndrome — Females with PCOS often have hirsutism in combination with irregular menstrual cycles. Instead of the normal 24- to 38-day menstrual cycle length, females with PCOS often have cycle lengths that are >38 days. Females with PCOS typically have fewer than six cycles per year. When cycles are this irregular, it usually means that a female is not ovulating on a regular basis. Females with PCOS may also have acne and balding or increased hair loss near the front of the head. PCOS is a chronic condition, but several treatments can reduce hair growth. […] Hirsutism is associated with depression and anxiety (independent of obesity and a PCOS diagnosis) that improve with the treatment of their hirsutism.

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

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

  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.

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

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

  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.

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

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

  Some medications can cause additional hair growth. […] Hyperprolactinemia is a condition that causes the body to produce high levels of the hormone prolactin. […] When the thyroid malfunctions, it may create an imbalance of hormones that causes excess body hair growth in rare cases. […] Sometimes hirsutism has no apparent cause, and doctors can find no clear evidence of an underlying disorder. […] Idiopathic hirsutism represents about 10% of all cases of hirsutism and 50% of all mild cases of excessive hair growth. […] Hirsutism happens when someone assigned female at birth experiences the growth of excessive male-looking hair. When the cause is an underlying condition, a person can seek treatment for the underlying cause to reduce excessive hair growth. […] Most hormonal disorders, including PCOS, respond to medical treatments. Proper treatment can reduce the amount of body hair a person experiences.

• #82 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

• #83 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases. Many medications can also cause hirsutism. In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such as polycystic ovary syndrome, adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, and androgen-secreting tumors. Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass. […] Hirsutism is defined as excess terminal hair that commonly appears in a male pattern in women. It is generally associated with hyperandrogenemia. Hirsutism occurs in approximately 7 percent of women and has an estimated economic burden in the United States of more than $600 million annually. Hirsutism should be distinguished from hypertrichosis, which is generalized excessive hair growth not caused by androgen excess. Hypertrichosis may be congenital or caused by metabolic disorders such as thyroid dysfunction, anorexia nervosa, and porphyria.

• #84 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. The causes of hirsutism are variable. The condition may be of ovarian or adrenal origin, tumoral or not. Hirsutism is most often due to hyperproduction of androgens, of ovarian or adrenal origin. Hyperandrogenism of tumor origin, which is very severe, must be distinguished from non-tumor hyperandrogenism, which is often minimal or moderate. Polycystic Ovary Syndrome (PCOS) represents the most common cause of hirsutism and causes about 75% of all cases. Hyperandrogenism due to ovarian or adrenal tumors is rare. It is responsible for only 0.2% of all cases of hirsutism. Non-classical Congenital Adrenal Hyperplasia (NCAH) is a common autosomal recessive disorder, caused by a partial 21-hydroxylase deficiency, and represents the most common adrenal etiology of hyperandrogenism. Many drugs can cause hirsutism: androgens, glucocorticosteroids, progestins, estrogen antagonists, minoxidil, cyclosporine, danazol, diazoxide, phenytoin, D-penicillamine, and interferon. The responsibility of the endocrinopathies in the occurrence of hirsutism is rare, and other more specific symptoms and signs dominate the clinical picture. Moderate hirsutism can be observed in pregnant women and postmenopausal women. Idiopathic hirsutism defines the hirsutism that occurs in association with regular menses, normal ovarian morphology, and normal plasmatic androgen levels. It represents about 10% of all cases of hirsutism and 50% of cases of mild hirsutism.

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

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

  Hirsutism is a condition that causes excess hair to grow on certain parts of your body. It mainly affects females. Hirsutism doesn’t have a known cause, but it’s a symptom of other conditions, including polycystic ovary syndrome. Treatment options include weight loss, medications and other hair removal options. […] Hirsutism is a common condition that causes excessive hair growth. It primarily affects females. […] In many cases, hirsutism doesn’t have a known cause. But several conditions cause hirsutism, including: The natural production of androgens. All people have androgens, but males make more of them. If a female has high androgen levels or their hair follicles are more sensitive to androgens, they may develop hirsutism. Polycystic ovarian syndrome (PCOS). PCOS is a common hormonal condition that causes females to produce too many androgens. Other symptoms of PCOS include acne, abnormal menstruation, diabetes, weight gain and fertility problems. Postmenopause. The hormonal changes that take place in your body after menopause may lead to increased facial hair, including a mustache or whiskers. Cushing’s syndrome. Cushing’s syndrome happens when your body has too much of the hormone cortisol, which can impact the set of organs that affect your hair, skin, nails, glands and nerves (integumentary system). Other symptoms of Cushing’s syndrome may include rapid weight gain in your face, wounds that heal poorly, high blood pressure (hypertension) and diabetes. Other conditions. If hirsutism occurs suddenly along with symptoms like a deeper voice, acne or increased muscle development, you may have a more serious condition. More serious conditions may include an adrenal gland disorder or an ovary disorder, such as congenital adrenal hyperplasia or a tumor on your adrenal glands or ovaries that produce androgen. Medications. Some medications can cause hirsutism, including anabolic steroids, testosterone, cyclosporine (Sandimmune), minoxidil (Rogaine), danazol (Danocrine) and phenytoin (Dilantin). […] PCOS isn’t the only cause of hirsutism. However, 70% to 80% of all people with PCOS develop hirsutism.

• #86 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Hirsutism is excess terminal hair that commonly appears in a male pattern in women. Although hirsutism is generally associated with hyperandrogenemia, one-half of women with mild symptoms have normal androgen levels. The most common cause of hirsutism is polycystic ovary syndrome, accounting for three out of every four cases. Many medications can also cause hirsutism. In patients whose hirsutism is not related to medication use, evaluation is focused on testing for endocrinopathies and neoplasms, such as polycystic ovary syndrome, adrenal hyperplasia, thyroid dysfunction, Cushing syndrome, and androgen-secreting tumors. Symptoms and findings suggestive of neoplasm include rapid onset of symptoms, signs of virilization, and a palpable abdominal or pelvic mass. […] Hirsutism is defined as excess terminal hair that commonly appears in a male pattern in women. It is generally associated with hyperandrogenemia. Hirsutism occurs in approximately 7 percent of women and has an estimated economic burden in the United States of more than $600 million annually. Hirsutism should be distinguished from hypertrichosis, which is generalized excessive hair growth not caused by androgen excess. Hypertrichosis may be congenital or caused by metabolic disorders such as thyroid dysfunction, anorexia nervosa, and porphyria.

• #87 Hirsutism in Women | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0215/p373.html

  Less than 5 percent of patients with hirsutism have adrenal hyperplasia, a defect in adrenal cortisol synthesis that diverts precursors into the androgen synthesis pathway. Classic adrenal hyperplasia is diagnosed at birth by ambiguous genitalia, but nonclassic adrenal hyperplasia can remain asymptomatic until after puberty, when women develop menstrual dysfunction and anovulation. […] Androgen-secreting tumors are rare in women with hirsutism, comprising 0.2 percent of cases in two studies of women presenting with clinical hyperandrogenemia. Neoplasms may be adrenal or ovarian in origin, and often cause large elevations in androgen level. More than one-half are malignant. Rapid onset of hirsutism, virilization, or a palpable abdominal or pelvic mass all raise suspicion for an androgen-secreting tumor. […] Several other endocrinopathies can present with hirsutism but often have more distinctive presentations. These include acromegaly, Cushing syndrome, hyperprolactinemia, and thyroid dysfunction.

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