Diagnostik und Therapie der kutanen Androgenisierung im klimakterischen Übergang sowie in der Peri- und Postmenopause: Hirsutismus und Alopezie

The document discussed the diagnosis and treatment of cutaneous androgenization, specifically hirsutism and androgenetic alopecia, during the menopausal transition and peri-/postmenopause. It emphasized focusing on a group of patients with functional cutaneous androgenization (FCA), which could often be diagnosed at the screening level using a classification algorithm. The Ferriman-Gallwey Index and a modified Sinclair Scale were used for grading hirsutism and alopecia, respectively. Hormonal dynamics during the menopausal transition were important for diagnosis. Treatments included wax epilation, laser therapy, Eflornithin cream for hirsutism, and Minoxidil solution for alopecia. Steroidal contraceptive combinations were used during the menopausal transition but were contraindicated postmenopause. Non-steroidal antiandrogens like Spironolactone and Finasteride were suitable during the transition, with Spironolactone also being appropriate for postmenopausal alopecia. Combination preparations with non-contraceptive natural estrogens and antiandrogens were indicated for patients with additional menopausal disorders, with a preference for steroidal combinations containing Dienogest.