Androgen Dependence of Hirsutism, Acne, and Alopecia in Women
January 2009
in “Medicine”
TLDR Hirsutism is more linked to high androgen levels than acne or hair loss, and a mix of hormonal tests is best for diagnosis; certain treatments can reduce symptoms.
The document from 2009 presents a study on the androgen dependence of hirsutism, acne, and alopecia in women, analyzing hormonal data from 279 patients. It found that hirsutism is more strongly associated with hyperandrogenism than alopecia and acne, with patients with hirsutism having higher levels of androstenedione, DHEAS, and salivary testosterone, and lower levels of SHBG. The study also showed that salivary testosterone is a better marker for hirsutism than total testosterone. Treatment with ethinylestradiol and high-dose cyproterone acetate significantly reduced hirsutism scores by 53.5% at 1 year and was also effective for acne and alopecia. Spironolactone alone was effective for treating isolated alopecia in patients with normal androgens. The study concluded that no single androgenic parameter could identify all cases of hyperandrogenism, but a combination of parameters was most effective. Ethnic origin did not affect the clinical-biological correlation, and the prevalence of nonclassic adrenal hyperplasia (NCAH) was found to be 4.7% among the study population. The study suggests that while antiandrogenic therapy is less beneficial for alopecia than for hirsutism or acne, it still offers some improvement, indicating a lesser androgen dependence of alopecia.
View this study on journals.lww.com →
Cited in this study
research Antiandrogens for the Treatment of Hirsutism: A Systematic Review and Metaanalyses of Randomized Controlled Trials
Antiandrogens are somewhat effective in reducing excessive hair growth in women.
research Insulin Sensitizers for the Treatment of Hirsutism: A Systematic Review and Metaanalyses of Randomized Controlled Trials
Insulin sensitizers may slightly reduce hirsutism but are less effective than other treatments.
research A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia among Women Presenting with Hyperandrogenic Symptoms and Signs
About 2.2% of women with symptoms of high male hormones have a mild form of congenital adrenal hyperplasia, and measuring a specific hormone level can accurately diagnose it.
research Hair Loss in Women
Over one-third of women experience hair loss, with female-pattern hair loss being most common, and treatments include minoxidil and possibly hair transplantation.
research A new classification of pattern hair loss that is universal for men and women: Basic and specific (BASP) classification
The BASP classification is a detailed and accurate way to categorize hair loss in both men and women.
research Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline
Polycystic Ovary Syndrome should be seen mainly as a condition of excess male hormones, with a focus on this in its definition.
research Relative Prevalence of Different Androgen Excess Disorders in 950 Women Referred because of Clinical Hyperandrogenism
Most women referred for excess male hormone symptoms had polycystic ovary syndrome (PCOS), with other conditions being less common.
research Hirsutism
The document likely offers guidance on treating a woman's excessive hair growth, considering her symptoms and obesity.
research Evaluation and treatment of male and female pattern hair loss
Early diagnosis and treatment, using finasteride, minoxidil, or hair transplantation, improves hair loss outcomes.
research Androgen Excess in Women: Experience with Over 1000 Consecutive Patients
Most women with excess male hormones have Polycystic Ovary Syndrome, and hormonal therapy can improve symptoms but may cause side effects.
research Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome
The 2003 consensus updated PCOS diagnosis criteria and highlighted increased risks of diabetes and heart disease for those affected.
research Comparison of Diane 35 and Diane 35 plus finasteride in the treatment of hirsutism
Diane 35 plus finasteride is more effective for treating hirsutism.
research Comparison of Diane 35 and Diane 35 plus finasteride in the treatment of hirsutism
Diane 35 plus finasteride is more effective in reducing hair growth and androgen levels, but may decrease libido.
research The control of hair growth: An overview
Hair growth is influenced by interactions between skin layers, growth factors, and hormones, but the exact mechanisms are not fully understood.
research Cyproterone acetate as initial treatment and maintenance therapy for hirsutism
Cyproterone acetate is effective for treating hirsutism, but some patients may feel worse on low-dose maintenance therapy.
Related
research Correlation of clinical and biochemical hyperandrogenism in Thai women with polycystic ovary syndrome
Blood tests are needed to confirm high male hormone levels in women with PCOS, as physical signs alone are not reliable.
research Hyperandrogenism in Women: Polycystic Ovary Syndrome
The document concludes that more research is needed to create suitable diagnostic criteria and understand PCOS in Korean women, and genetics may allow for personalized treatment.
research Diagnosis of hyperandrogenism: clinical criteria
The document concludes that hirsutism is the main sign for diagnosing hyperandrogenism, which requires a detailed patient history and physical exam.