Women With Clinically Significant Hirsutism Always Have Detectable Endocrinological Abnormalities

In a 1997 study of 120 Saudi women with clinically significant hirsutism, 78 were found to have hormonal abnormalities, with 85.9% showing elevated androgen levels. Polycystic ovary syndrome (PCOS) was the most common cause, present in 59% of patients, followed by hyperprolactinemia in 34.6%, and congenital adrenal hyperplasia in 14.1%. The study concluded that a two-step laboratory work-up could usually identify the cause of hirsutism and recommended detailed hormonal profiling for affected women. The findings suggest that idiopathic hirsutism is likely overused as a diagnosis and that most cases of hirsutism have an identifiable endocrinological cause.