Endocrine Evaluation of Hirsutism

    February 2017 in “ International Journal of Women's Dermatology ”
    John Mihailidis, Racha Dermesropian, Pamela Taxel, Pooja Luthra, Jane M. Grant‐Kels
    From the encyclopedia
    Cyproterone →

    a synthetic anti-androgen and weak progestogen that inhibits DHT binding to androgen receptor

    Metformin →

    diabetes drug with anti-inflammatory, immunomodulatory, and insulin-sensitizing properties

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    Studysummary This article provides an endocrine perspective on evaluating and managing hirsutism but reports no new research findings. Our plain-language summary of this paper — not a Tressless recommendation.
    The 2017 article on hirsutism, affecting 5 to 10% of reproductive-age women, highlights the need for a comprehensive endocrine evaluation for women with excessive male-pattern hair growth. It emphasizes the psychological impact of the condition and the necessity of identifying underlying disorders, such as PCOS, through history, physical examination, and biochemical tests like serum testosterone and DHEA-S levels. Treatment options include oral contraceptives, particularly those containing cyproterone acetate, antiandrogens (with caution due to teratogenic effects), insulin-sensitizing agents like metformin, topical treatments, and lifestyle changes. The Endocrine Society's 2008 guidelines recommend oral contraceptives as the first-line treatment, with the addition of an antiandrogen after 6 months if needed. The article concludes that managing hirsutism effectively requires an interdisciplinary approach that addresses both medical and psychological needs.
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