Hirsutism in Polycystic Ovary Syndrome: Pathophysiology and Management

    July 2016 in “ Current pharmaceutical design ”
    Poli Mara Spritzer, Carolina Rocha Barone, Fabiana Bazanella de Oliveira
    TLDR The document concludes that managing hirsutism in PCOS involves long-term treatment guided by severity, using oral contraceptives and possibly antiandrogens, with attention to individual patient needs.
    The study reviewed the pathophysiology and management of hirsutism in women with polycystic ovary syndrome (PCOS), noting that 70-80% of women with PCOS experience hirsutism compared to 4-11% in the general population. Hirsutism in PCOS was linked to ovarian-derived androgen excess and individual sensitivity to androgens. Treatment options included combined oral contraceptives (OCPs) to suppress androgen excess, with metformin and lifestyle changes as alternatives for those with contraindications to OCPs. The severity of hirsutism, assessed by the modified Ferriman-Gallwey score, and the distress it caused to patients guided treatment choices, which needed to be maintained for 6-12 months. Mild cases were treated with non-pharmacological methods and OCPs, while moderate to severe cases required antiandrogens and OCPs or a safe contraceptive method if OCPs were not suitable. Individualized management considering metabolic comorbidities and menstrual disturbances was emphasized for effective treatment.
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