Hirsutism: From Diagnosis to Use of Antiandrogens

The document from 2012 discusses hirsutism, a condition of excessive body hair in women, often due to increased androgen levels or sensitivity, with PCOS being the most common cause. It highlights the need to rule out other conditions and life-threatening pathologies before diagnosing PCOS and suggests that while tumors should be treated surgically, pharmacological treatment is the main approach for other cases. Antiandrogens are the primary treatment, with contraception required to prevent fetal harm during pregnancy. The document critiques the accuracy of commercial serum androgen measurements and suggests more sensitive methods. It notes that treatment often exceeds 6 months, with no perfect antiandrogen drug available, and emphasizes the importance of effective, safe, and affordable treatment options. Drospirenone and flutamide are mentioned as effective antiandrogens, although flutamide has a lower safety profile. Metformin is presented as an alternative, especially for PCOS patients, and can be combined with antiandrogens to increase effectiveness. The treatment should be individualized based on the underlying cause, including PCOS, idiopathic hirsutism, and idiopathic hyperandrogenemia.