Idiopathic Hirsutism: Androgen Role and Treatment Options

The document from August 2000 explores idiopathic hirsutism (IH), a condition of excessive hair growth in women, affecting 5-10% of the female population. It highlights the role of androgens and local 5α-reductase activity in hair follicle behavior, with a focus on the production of dihydrotestosterone (DHT). Diagnosis of IH is limited to women with normal ovulatory function and androgen levels, which strictly defined, includes less than 20% of all hirsute women. The pathophysiology is thought to involve increased skin 5α-reductase activity and possibly altered androgen receptor function. Treatment options include antiandrogens, 5α-reductase inhibitors, and new strategies like laser epilation. The document also discusses genetic factors, such as androgen receptor gene polymorphisms, and the need for further research into the genetic, molecular, and metabolic aspects of IH. Specific studies mentioned include one with 12 men and 12 women on androgenetic alopecia, and others with 132 and 598 hirsute women, finding only 17% and 6%, respectively, meeting the criteria for IH. The document concludes that more research is needed to better understand IH and that the term "idiopathic" remains appropriate for patients with regular ovulation, normal circulating androgens, and hirsutism.