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

Annie JONES ("bearded woman") is an example of hirsutism.

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 – has an antiandrogenic effect.


References

Source

  • KLENER, Pavel. Vnitřní lékařství. 4. edition. Praha : Galén : Karolinum, 2011. 1174 pp. ISBN 978-80-7262-705-9.