Hirsutism

The 1995 document provides an in-depth analysis of hirsutism, which is characterized by excessive hair growth in women due to androgen excess. It differentiates hirsutism from hypertrichosis and virilization, noting that polycystic ovary syndrome (PCOS) and idiopathic hirsutism are the most common causes, with a study of 100 women showing 78% had PCOS and 15% had idiopathic hirsutism. The evaluation of hirsutism includes history, physical examination, and laboratory tests, with extensive investigation reserved for those with signs of serious underlying disease. Treatment options vary based on the cause and include oral contraceptives, antiandrogens like spironolactone, and surgery for tumors. Spironolactone is preferred for patients with obesity or hypertension but has side effects such as menstrual irregularities and hyperkalemia. Cyproterone is effective but can cause weight gain, while flutamide shows promise despite the risk of liver toxicity. Cosmetic therapies are also recommended, with electrolysis being the only permanent hair removal method. The document emphasizes managing patient expectations, as treatments aim to prevent new hair growth rather than reverse existing hair.