Assessment, diagnosis and treatment of a patient with hirsutism
March 2008
in “Nature clinical practice endocrinology & metabolism”
TLDR A combined drug and laser treatment improved hirsutism in a PCOS patient, also enhancing her heart health and requiring regular liver and kidney checks.
In 2008, a 20-year-old woman with hirsutism and irregular menstrual cycles was diagnosed with polycystic ovary syndrome (PCOS). Her condition was confirmed through hormonal analyses and a pelvic ultrasound, revealing elevated testosterone levels and polycystic ovaries. She was treated with cyproterone acetate, ethinylestradiol, spironolactone, and laser hair removal. After one year, her symptoms and testosterone levels improved, and her cardiovascular risk profile was better. The case study underlines the effectiveness of a combined pharmacological and mechanical treatment approach for hirsutism in PCOS patients, the necessity for psychological support, and the importance of monitoring for cardiometabolic risks. Treatment results are typically seen after 6 months, with optimal outcomes in 12-24 months, and liver and kidney functions should be tested before and during treatment.
View this study on nature.com →
Cited in this study
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 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.
research Recent advances in the treatment of polycystic ovary syndrome
Treatments for Polycystic Ovary Syndrome (PCOS) focus on reducing symptoms, restoring regular periods, and helping with pregnancy. Common treatments include hormone suppressors, fertility drugs, and insulin-sensitising agents.
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 Anti-androgens for the treatment of hirsutism
Different anti-androgen medications can help treat excessive hair growth, but the right choice depends on accurate diagnosis.
research Hirsutism
Hirsutism is when women have too much hair growth, often due to a bit more androgen hormones and sensitive skin.
Related
research Treatment of Hirsutism, Acne and Alopecia with Cyproterone Acetate
Cyproterone acetate was effective in treating acne, hirsutism, and alopecia with few side effects.