Hirsutism
Basics
Description
- Presence of excessive terminal (coarse, pigmented) hair of body and face, in a male pattern
- May be present 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
Epidemiology
Prevalence
5–10% of reproductive age women
Etiology and Pathophysiology
- Due to increased androgenic hormones, either from increased peripheral binding (idiopathic) or increased production from the ovaries, adrenals, or body fat
- Exogenous medications
- Can be a symptom of multiple etiologies such as clinical evidence of PCOS, androgen secreting tumors, virilizing disorders, or androgenic medication use
Genetics
Multifactorial
Risk Factors
- Family history/ethnicity (e.g., Ashkenazi Jews and Mediterranean backgrounds)
- Obesity
General Prevention
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
- Prolonged amenorrhea and anovulation, common
- Acne, common
- Central obesity
- Virilization (rapid onset, clitoromegaly, balding, deepening voice) (1)
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Citation
Domino, Frank J., et al., editors. "Hirsutism." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116280/all/Hirsutism.
Hirsutism. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116280/all/Hirsutism. Accessed December 12, 2024.
Hirsutism. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116280/all/Hirsutism
Hirsutism [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 12]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116280/all/Hirsutism.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Hirsutism
ID - 116280
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116280/all/Hirsutism
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -