Hirsutism in women

David Bode, Dean Seehusen, Drew Baird

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

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. Patients without these findings who have mild symptoms and normal menses can be treated empirically. For patients with moderate or severe symptoms, an early morning total testosterone level should be obtained, and if moderately elevated, it should be followed by a plasma free testosterone level. A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor. Further workup is guided by history and physical examination, and may include thyroid function tests, prolactin level, 17-hydroxyprogesterone level, and corticotropin stimulation test. Treatment includes hair removal and pharmacologic measures. Shaving is effective but needs to be repeated often. Evidence for the effectiveness of electrolysis and laser therapy is limited. In patients who are not planning a pregnancy, first-line pharmacologic treatment should include oral contraceptives. Topical agents, such as eflornithine, may also be used. Treatment response should be monitored for at least six months before making adjustments.

Original languageEnglish (US)
Pages (from-to)373-380
Number of pages8
JournalAmerican Family Physician
Volume85
Issue number4
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Hirsutism
Androgens
Testosterone
Polycystic Ovary Syndrome
Neoplasms
Hair Removal
Eflornithine
Electrolysis
17-alpha-Hydroxyprogesterone
Virilism
Thyroid Function Tests
Menstruation
Cushing Syndrome
Laser Therapy
Oral Contraceptives
Prolactin
Hair
Adrenocorticotropic Hormone
Signs and Symptoms
Physical Examination

ASJC Scopus subject areas

  • Family Practice

Cite this

Bode, D., Seehusen, D., & Baird, D. (2012). Hirsutism in women. American Family Physician, 85(4), 373-380.

Hirsutism in women. / Bode, David; Seehusen, Dean; Baird, Drew.

In: American Family Physician, Vol. 85, No. 4, 01.01.2012, p. 373-380.

Research output: Contribution to journalArticle

Bode, D, Seehusen, D & Baird, D 2012, 'Hirsutism in women', American Family Physician, vol. 85, no. 4, pp. 373-380.
Bode D, Seehusen D, Baird D. Hirsutism in women. American Family Physician. 2012 Jan 1;85(4):373-380.
Bode, David ; Seehusen, Dean ; Baird, Drew. / Hirsutism in women. In: American Family Physician. 2012 ; Vol. 85, No. 4. pp. 373-380.
@article{96e59ddef7b14f719acfa50cd74212f0,
title = "Hirsutism in women",
abstract = "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. Patients without these findings who have mild symptoms and normal menses can be treated empirically. For patients with moderate or severe symptoms, an early morning total testosterone level should be obtained, and if moderately elevated, it should be followed by a plasma free testosterone level. A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor. Further workup is guided by history and physical examination, and may include thyroid function tests, prolactin level, 17-hydroxyprogesterone level, and corticotropin stimulation test. Treatment includes hair removal and pharmacologic measures. Shaving is effective but needs to be repeated often. Evidence for the effectiveness of electrolysis and laser therapy is limited. In patients who are not planning a pregnancy, first-line pharmacologic treatment should include oral contraceptives. Topical agents, such as eflornithine, may also be used. Treatment response should be monitored for at least six months before making adjustments.",
author = "David Bode and Dean Seehusen and Drew Baird",
year = "2012",
month = "1",
day = "1",
language = "English (US)",
volume = "85",
pages = "373--380",
journal = "American Family Physician",
issn = "0002-838X",
publisher = "American Academy of Family Physicians",
number = "4",

}

TY - JOUR

T1 - Hirsutism in women

AU - Bode, David

AU - Seehusen, Dean

AU - Baird, Drew

PY - 2012/1/1

Y1 - 2012/1/1

N2 - 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. Patients without these findings who have mild symptoms and normal menses can be treated empirically. For patients with moderate or severe symptoms, an early morning total testosterone level should be obtained, and if moderately elevated, it should be followed by a plasma free testosterone level. A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor. Further workup is guided by history and physical examination, and may include thyroid function tests, prolactin level, 17-hydroxyprogesterone level, and corticotropin stimulation test. Treatment includes hair removal and pharmacologic measures. Shaving is effective but needs to be repeated often. Evidence for the effectiveness of electrolysis and laser therapy is limited. In patients who are not planning a pregnancy, first-line pharmacologic treatment should include oral contraceptives. Topical agents, such as eflornithine, may also be used. Treatment response should be monitored for at least six months before making adjustments.

AB - 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. Patients without these findings who have mild symptoms and normal menses can be treated empirically. For patients with moderate or severe symptoms, an early morning total testosterone level should be obtained, and if moderately elevated, it should be followed by a plasma free testosterone level. A total testosterone level greater than 200 ng per dL (6.94 nmol per L) should prompt evaluation for an androgen-secreting tumor. Further workup is guided by history and physical examination, and may include thyroid function tests, prolactin level, 17-hydroxyprogesterone level, and corticotropin stimulation test. Treatment includes hair removal and pharmacologic measures. Shaving is effective but needs to be repeated often. Evidence for the effectiveness of electrolysis and laser therapy is limited. In patients who are not planning a pregnancy, first-line pharmacologic treatment should include oral contraceptives. Topical agents, such as eflornithine, may also be used. Treatment response should be monitored for at least six months before making adjustments.

UR - http://www.scopus.com/inward/record.url?scp=84857410892&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857410892&partnerID=8YFLogxK

M3 - Article

VL - 85

SP - 373

EP - 380

JO - American Family Physician

JF - American Family Physician

SN - 0002-838X

IS - 4

ER -