Hirsutism: diagnosis and treatment

Abstract

Hirsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women, which grows in a typical male distribution pattern. Hirsutism is a common clinical problem in women, and the treatment depends on the cause. The condition is often associated with a loss of self--esteem. Hirsutism reflects the interaction between circulating androgen concentrations, local androgen concentrations, and the sensitivity of the hair follicle to androgens. Polycystic ovary syndrome and idiopathic hirsutism are the most common causes of the condition. A woman's history and, physical examination are particularly important in evaluating excess hair growth. The vast majority of women with hirsutism have the idiopathic variety, and the diagnosis is made by exclusion. Serum testosterone level > 200 ng/dL is highly suggestive of adrenal or ovarian tumor. Treatment of hirsutism should be based on the degree of excess hair growth presented by the patient and in the pathophysiology of the disorder. Treatment includes lifestyle therapies, androgen suppression, peripheral androgen blockage, and cosmetic treatments. The current review discusses definition, pathogenesis, physiopathology, differential diagnosis, diagnostic strategies, and treatment. Arq Bras Endocrinol Metab. 2014;58 (2) PATHOGENESIS OF HIRSUTISMH irsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women. Hair appears in a masculine distribution pattern and is coarse. Hirsutism is more than a cosmetic problem. It may be linked to significant underlying diseases, and is often associated with a decreased quality of life, and an impaired self-image of the patient feminine identity (1). The causes of hirsutism may be divided into androgenic factors, non-androgenic factors, and idiophatic hirsutism. Non-androgenic factors are relatively rare, while androgenic causes account for more than 80% of patients, and include polycystic ovary syndrome (PCOS), which affects about 70-80% of hirsute women.Hirsutism must be distinguished from hypertrichosis, which is characterized by increased hair growth in a generalized nonsexual distribution and is independent of androgens. Usually, hypertrichosis presents generalized or localized growth of vellus type (non-terminal) http://dx

Review of Hair Follicle Dermal Papilla cells as in vitro screening model for hair growth

“…However, due to their limited efficacy and side effects, there has been a dramatic progress in the development of novel hair growth promoters . On the other hand, excessive terminal hair growth in androgen‐dependent areas in women with a typical male distribution pattern is known as Hirsutism . Currently, anti‐androgens, Gonadotropin‐releasing hormone (GnRH) agonist, insulin‐lowering drugs and Eflornithine hydrochloride are used to manage hirsutism.…”

Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management

“…Bleaching, shaving, waxing, and laser hair removal are definitively useful but may be painful and expensive. Medical treatment includes oral contraceptives, gonadotropin-realizing hormone agonists, insulin-sensitizing agents such as metformin, or drugs with antiandrogenic effects such as cyproterone acetate, eflornithine, and spironolactone [69, 70]. …”

Efeitos da poluição do ar na adrenal de camundongas: aspectos histomorfométricos e imunoistoquímicos

“…Em mulheres normais, os androgênios são sintetizados em pequenas quantidades (Voutilainen e Jääskeläinen, 2014), tendo em vista que a maior parte da produção de testosterona estaria relacionada com a produção folicular dos ovários (Gleicher et al, 2014). No entanto, se a adrenal tiver aumento significante da produção de esteroides pró-androgênicos, pode haver hirsutismo e até, nos casos mais extremos, virilização (Hohl et al, 2014; Voutilainen e Jääskeläinen, 2014). Este fato é bem conhecido nas hiperplasias congênitas da adrenal, onde a deficiência de algumas enzimas pode levar ao aumento da produção de androstenediona e DHEA (Voutilainen e Jääskeläinen, 2014).…”

“…Este fato é bem conhecido nas hiperplasias congênitas da adrenal, onde a deficiência de algumas enzimas pode levar ao aumento da produção de androstenediona e DHEA (Voutilainen e Jääskeläinen, 2014). Em casos extremos, estas mulheres podem ter também queda de cabelo, crescimento excessivo dos pêlos e alteração da voz (Hohl et al, 2014;Voutilainen, Jääskeläinen, 2014). Esta alteração em camundongas não é possível de avaliar devido ao metabolismo específico deste animal, bem como o comportamento do pelo ser diferente do ser humano.…”