Hirsutism

Hirsutism means increased growth of pigmented hair in women in places where male hair is typically present (face, upper lip, chin, neck, chest, back, inner thighs).

Complications include acne, oily skin, oligomenorrhea or amenorrhea.

Etiology
The cause of hirsutism is increased production of androgens in the ovaries or adrenal glands (tumors, polycystic ovary syndrome, adrenogenital syndrome). Increased 5α-reductase activity in the hair follicle (it changes testosterone to dihydrotestosterone), or there is drug hirsutism - anabolics, danazol, cyclosporine...). Furthermore, it may arise due to increased plasma concentrations of free androgens (due to decreased SHBG production).

With significant androgen overproduction, virilization can occur. These are somatic changes including rougher voice, breast atrophy, enlarged clitoris and male muscle formation.

Treatment
Treatment is always according to etiology.


 * Antiandrogens – they block the effect of androgens on receptors (cyproterone acetate),
 * contraceptives,
 * 5α-reductase inhibitors (finasteride),
 * spironolactone – it has an antiandrogenic effect.

Related Articles

 * Endocrine diseases of the gonads
 * Adrenogenital syndrome
 * Hypertrichosis