• 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


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


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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