TLDR Treat hirsutism in premenopausal women with oral contraceptives and consider additional treatments if needed.
The guideline for evaluating and treating hirsutism in premenopausal women, developed by the Endocrine Society and other related organizations, recommended obtaining a random serum total testosterone measurement for women with abnormal hirsutism scores to assess androgen excess. For those with elevated testosterone or at high risk of congenital adrenal hyperplasia, an early-morning 17-hydroxyprogesterone measurement was advised. Pharmacologic treatment should start with oral contraceptive pills (OCPs) for women not seeking pregnancy, with the addition of direct hair removal methods if necessary. Combination therapy with an antiandrogen was suggested if significant hirsutism persisted after 6 months of OCP monotherapy. All recommendations were based on weak and low-quality evidence.
52 citations
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March 2016 in “JAMA dermatology” Patients with PCOS rate their hirsutism higher than clinicians, and these self-ratings are more closely related to their quality of life and risk of depression.
6 citations
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December 2015 in “JAMA” The woman's high testosterone levels indicated PCOS, leading to treatment that improved her symptoms.
502 citations
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February 2008 in “The Journal of Clinical Endocrinology & Metabolism” Treat significant hirsutism with medication and hair removal; use birth control pills first, adding antiandrogens if needed.
2 citations
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July 2008 in “Paediatrics & child health” Severe acne in a young girl may indicate underlying hormonal issues.
135 citations
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August 1994 in “Clinical Endocrinology” Most women with hirsutism or androgenic alopecia had polycystic ovaries, especially if they had irregular periods.
30 citations
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June 2019 in “Frontiers in Endocrinology” The document concludes that managing non-classical congenital adrenal hyperplasia in females requires personalized treatment, genetic counseling, and a team of specialists.
18 citations
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June 2019 in “Clinical research in dermatology” Acne can't be cured but can be managed with treatments like benzoyl peroxide and diet changes; it's costly and can lead to scarring and mental health issues.
26 citations
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July 2012 in “Journal of family planning and reproductive health care” The document says that hirsutism in women usually needs hair removal and hormone treatment to manage symptoms and improve well-being.
November 2014 in “Elsevier eBooks” Gene mutations can cause problems in male genital development.
