Idiopathic Hirsutism: Is It Really Idiopathic or Is It a Misnomer?

The study questioned the classification of idiopathic hirsutism, suggesting it might be a misnomer. Although idiopathic hirsutism was defined by normal ovulatory function, serum androgen levels, and ovarian morphology, the research indicated that patients exhibited relatively higher serum androgen levels compared to healthy subjects, termed as relative hyperandrogenemia. Additionally, increased expression of steroid sulphatase and 17-beta hydroxysteroid dehydrogenase mRNA in specific skin areas suggested enhanced local androgen metabolism. These findings implied that idiopathic hirsutism might not be truly idiopathic but rather a form of "normoandrogenic hirsutism" or an early stage of hyperandrogenic disorders like PCOS. The study proposed that prospective follow-up of patients could clarify this condition's progression.