Endocrine Evaluation of Hirsutism

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.