Hirsutism

The 1993 study discussed hirsutism, a condition characterized by male pattern hair distribution in women. This condition could be caused by hypersecretion of androgens by the adrenal glands or the ovaries, or by increased skin sensitivity to circulating androgens due to hyperactivity of 5 alpha-reductase. The degree of hirsutism was evaluated through physical examination, and the cause was suspected through plasma testosterone essays. If the testosterone level was above 1.2 ng/mL, it was necessary to investigate if hirsutism was caused by a virilizing tumor of the ovary or the adrenal gland, or by a late presentation of congenital adrenal hyperplasia. If the testosterone level was below 0.6 ng/mL, hirsutism was considered idiopathic. Between these two figures, the condition was often idiopathic, but the patient needed to be investigated for polycystic ovarian dystrophy, adrenal hyperplasia, or tumor. Treatment was primarily aetiological, but always symptomatic, consisting of electrical depilation of the face and, mainly, antiandrogens (e.g. Androcur) associated with oestrogens. This treatment was usually effective and transformed the outcome of hirsutism, even when the disease was idiopathic.