Hirsutism: Its Pathogenesis

    August 1989 in “ Human Reproduction ”
    M. Breckwoldt, H. P. Zahradnik, P Wieacker, M. Breckwoldt, H. P. Zahradnik, P Wieacker
    TLDR Hirsutism in females is caused by high male hormones or sensitive hair follicles.
    Hirsutism in females was understood as a condition characterized by male-pattern body hair distribution, caused by either increased androgen production or heightened sensitivity of hair follicles in sexual areas. The condition involved complex interactions between androgen production, binding, and metabolism. Over 98% of androgens in the blood were bound to plasma proteins, with the synthesis of steroid hormone binding globulin (SHBG) influenced by the oestradiol to testosterone ratio. In hirsutism, decreased SHBG levels led to elevated free androgens. The conversion of testosterone to dihydrotestosterone (DHT) by 5 alpha-reductase was crucial for hair growth in sexual skin areas, with hirsutism patients showing increased conversion rates similar to males. Although the pathogenesis was not fully understood, existing knowledge provided a foundation for further diagnostic and therapeutic strategies.
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