Hirsutism: Evaluation and Treatment

    Kimberly Liu, Tarek Motan, Paul Claman
    TLDR The conclusion is that proper diagnosis and long-term treatment, including medication, hair removal, and lifestyle changes, are important for improving hirsutism, especially in PCOS patients.
    The document "No. 350-Hirsutism: Evaluation and Treatment" from 2017 reviewed the causes, evaluation, and treatment of hirsutism, emphasizing a comprehensive approach involving history, physical examination, and laboratory evaluations. It identified polycystic ovary syndrome (PCOS) as the most common cause, followed by idiopathic hirsutism. Treatment options included pharmacologic interventions to suppress androgen production and block androgen receptors, mechanical hair removal, and lifestyle modifications, with improvement typically requiring 6-9 months. The Ferriman-Gallwey score was recommended for assessing severity. Combined hormonal contraceptive therapy was suggested as the first-line treatment, with anti-androgens for more severe cases. Permanent hair reduction was achievable through laser hair removal and electrolysis. The guidelines stressed the importance of a comprehensive evaluation to address long-term health consequences associated with hyperandrogenism and PCOS.
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