Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline

The guideline suggested testing for elevated androgen levels in women with abnormal hirsutism scores but not in eumenorrheic women with unwanted local hair growth. For women with significant hirsutism unresponsive to cosmetic measures, pharmacological therapy was recommended, with direct hair removal methods like electrolysis or photoepilation for additional cosmetic benefits. In cases of mild hirsutism without endocrine disorders, either pharmacological therapy or direct hair removal was suggested. Oral combined estrogen-progestin contraceptives were recommended as the primary pharmacological treatment, with the addition of an antiandrogen if needed after 6 months. Antiandrogen monotherapy was advised against unless adequate contraception was used, and insulin-lowering drugs were not recommended. Laser/photoepilation was suggested for most women opting for hair removal therapy.