The clinical evaluation of hirsutism

Abstract

Hirsutism is a disorder of excess growth of terminal hairs in androgen-dependent areas in women. Other cutaneous conditions associated with androgen excess are androgenetic alopecia, acanthosis nigricans, and acne. Hirsutism is often associated with measurably elevated androgen levels, but not in all cases. Androgens in women arise from the ovary and adrenal glands, and peripherally from skin and fat. The most common cause of hirsutism is polycystic ovarian syndrome. Patients with "idiopathic" hirsutism have normal ovulatory cycles and androgen levels. Other causes are late onset congenital adrenal hyperplasia, Cushing's syndrome, and the HAIR-AN syndrome. Pituitary, ovarian, and adrenal tumors are important, but rare causes of hirsutism. A thorough history and examination are important. Laboratory investigation is essential in women with moderate to severe, sudden onset or rapidly progressing hirsutism. Identification of the underlying etiology does not alter management, but detects patients at risk for infertility, diabetes, cardiovascular disease and endometrial carcinoma.

Bearded ladies: females suffer fitness consequences when bearing male traits

“…Females sometimes bear rudimentary versions of male sexual ornaments if genetic correlation for the trait exists between the sexes [2][3][4]. Human females, for example, may experience male-pattern facial hair growth as a result of excess androgen production [5], although usually to a lesser degree than average males. The assumption that females experience fitness costs of masculinization is central to key ideas in evolutionary biology, including the evolution of sex-specific chromosomes and sex-biased gene regulation [6][7][8], the origin of sexual dimorphism [2,3,7] and maintenance of phenotypic variation in a population [9].…”

Hyperandrogenism in adolescents

“…[30] Dermatolog dan›fl›m› ile antibiyotikler, topikal benzoyl peroksit, 13-cis-retinoik asit yararl› olabilir. [31,32] Sonuç olarak, hiperandrojenizm adolesanlarda kozmetik, metabolik ve psikolojik olumsuz etkileri olan önemli bir sorundur. Hastalar öncelikle endokrinolojik aç›dan tetkik edilmeli ve altta yatan problem a盤a ç›ka-fiekil 2.…”

Evaluación Clínica De Vello Corporal Terminal Y Prevalencia De Hirsutismo en Estudiantes Universitarias De La Ciudad De Manizales (Caldas), 2012

“…Se ha demostrado que el hirsutismo está asociado con problemas como infertilidad de origen anovulatorio (7), síndrome de ovario poliquístico (SOP) -patología de mayor asociación que se relaciona con síndrome metabólico, diabetes mellitus 2, hipertensión arterial, cáncer endometrial, infertilidad, entre otros- (3,8), cáncer endometrial en la menopausia, aumento de riesgo materno y perinatal, trastornos metabólicos (9), trastornos cardiovasculares (10), intolerancia a los carbohidratos (10)(11)(12), diabetes mellitus (13,14), síndrome metabólico, obesidad, efectos psicológicos (15), trastornos de la función tiroidea y de la glándula suprarrenal e hiperprolactinemia. En cuanto al componente psicológico, el hirsutismo está asociado con detrimento de la calidad de vida, alta prevalencia de desórdenes ansiosos y baja autoestima en adolescentes (2,16,17).…”

“…Manizales, Colombia. Correo electrónico: orange187@gmail.com 3 Médico Ginecólogo y Obstetra, Médico Ginecoobstetra Hospital Departamental San Juan de Dios Armenia Quindio, Colombia. Correo electrónico: doc.montilla@gmail.com 4 Médica, Magíster en Educación.…”