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- Presence of excessive terminal (coarse, pigmented) hair of body and face, in a male pattern
- May be present in normal adults as an ethnic characteristic or may develop as a result of androgen excess
- Often seen in polycystic ovary syndrome (PCOS) which is characterized by hirsutism, acne, menstrual irregularities, and obesity
- System(s) affected: dermatologic, endocrine, metabolic, reproductive
5–10% of reproductive age women
Etiology and Pathophysiology
- Hirsutism is due to increased androgenic (male) hormones, either from increased peripheral binding (idiopathic) or increased production from the ovaries, adrenals, or body fat.
- Exogenous medications can also cause hirsutism.
- Family history
- Ethnicity—increased in Ashkenazi Jews and Mediterranean backgrounds
Women with late-onset congenital adrenal hyperplasia (CAH) should be counseled that they may be carriers for the severe early-onset childhood disease.
Commonly Associated Conditions
- PCOS: the most common cause of premenopausal hirsutism (1)
- Insulin resistance, common
- Prolonged amenorrhea and anovulation, common
- Emotional distress and depression, common
- Acne, common
- Central obesity
- Hypothyroidism/hyperthyroidism, rare
- Hyperprolactinemia, rare
- Risk for endometrial hyperplasia or carcinoma, rare
- Virilization (rapid onset, clitoromegaly, balding, deepening voice) (2)
- Cushing syndrome: characterized by moon facies, striae, hypertension, rare
- Acromegaly, rare
- Vitamin D deficiency
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