Hirsutism Causes and Treatments

Approximately 10% of women in the US experienced hirsutism, a condition requiring careful management to rule out serious medical conditions and to establish a treatment plan. Physicians needed to assess excess terminal hair, take a detailed history, and determine the source of androgens through serum testosterone and DHEAS tests. High levels of both hormones suggested an adrenal cortex origin, while elevated testosterone alone indicated an ovarian source. Differential diagnoses included adrenal and ovarian tumors, polycystic ovary syndrome, Cushing syndrome, congenital adrenal hyperplasia, and idiopathic hirsutism. Treatments varied based on the cause and could include oral contraceptives, dexamethasone, and spironolactone. A case study from Boston University involved a 35-year-old woman with symptoms of hirsutism and elevated androgen levels, who was diagnosed with congenital adrenal hyperplasia. Dexamethasone therapy reduced her androgen levels, regularized her menstrual cycle, and eventually enabled her to conceive and deliver a full-term infant.