Hirsutism: A Guide for the Obstetrician and Gynecologist

    April 2025 in “ The Obstetrician & Gynaecologist ”
    Srividya Sundararajan, Parivakkam S. Arunakumari, A. M. Skellett, Vijaya Srinivas
    TLDR Hirsutism is managed by assessing testosterone levels and using oral contraceptives, with ethical considerations on treatment access.
    The review provides a comprehensive guide for obstetricians and gynecologists on managing hirsutism, characterized by excess terminal hair in androgen-dependent areas in women. It highlights the Ferriman–Gallwey score as a tool for quantifying hirsutism and identifies polycystic ovary syndrome as the most common cause. The review emphasizes the importance of measuring total testosterone levels in patients with abnormal scores or clinical signs of hyperandrogenism. Hair reduction and removal methods are crucial in management, with combined oral contraceptives recommended as the first-line pharmacological treatment for those not seeking fertility. The review also discusses the ethical considerations of whether hirsutism treatment should be available on the NHS and if hair removal methods should be considered cosmetic or medical.
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