Hirsutism is defined as excessive terminal hair growth in androgen-sensitive areas, following a male pattern, and occurs in 5% to 10% of women of reproductive age
Pathophysiology
- Hirsutism is often a symptom of underlying hyperandrogenism, which can result from several mechanisms including insulin resistance, hyperinsulinemia, elevated LH-related increases in theca cell androgen production, and increased adrenal androgen output
- Polycystic ovary syndrome (PCOS) is the most common cause of hirsutism, with idiopathic hirsutism being the second most common
- Insulin resistance has been observed in nonobese patients with idiopathic hirsutism, suggesting a potential role in the pathophysiology of the condition
Clinical course and prognosis
- The clinical course of hirsutism can vary depending on the underlying cause. For instance, in PCOS, hirsutism may persist or worsen over time if not adequately managed.
- The prognosis of hirsutism largely depends on the underlying cause and the effectiveness of the treatment regimen. With appropriate management, the severity of hirsutism can be significantly reduced, improving the patient's quality of life.
Risk factors
- Risk factors for hirsutism include conditions associated with hyperandrogenism such as PCOS and nonclassical congenital adrenal hyperplasia
- Certain medications can also induce hirsutism
- Insulin resistance, even in nonobese individuals, has been associated with idiopathic hirsutism
In conclusion, hirsutism is a common disorder with a significant impact on quality of life. It is often a symptom of underlying hyperandrogenism, with PCOS being the most common cause. The clinical course and prognosis of hirsutism depend on the underlying cause and the effectiveness of the treatment regimen. Risk factors include conditions associated with hyperandrogenism, certain medications, and insulin resistance.