Hirsutism

Česká verzia

Authors: M. Fanta
Authors place of work: Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. A. Martan, DrSc.
Published in the journal: Ceska Gynekol 2017; 82(3): 237-242

Summary

Objective:
Overview of excessive hair growth in women, hirsutism. Although women with hirsutism typically present because of cosmetic concerns, the majority also have an underlying endocrine disorder.

Design:
Review article.

Setting:
Department of Gynecology and Obstetrics, General Faculty Hospital and 1st Faculty of Medicine of Charles Universtity, Prague.

Material and methods:
Hirsutism is a clinical diagnosis defined by the presence of excess terminal hair growth (dark, coarse hairs) in androgen-sensitive areas. It affects between five and ten percent of women of reproductive age. It may be the initial, and possibly only, sign of an underlying androgen disorder.

Conclusions:
The most common cause of hirsutism is polycystic ovary syndrome (PCOS). In some cases, hirsutism is mild and requires only reassurance and local (nonsystemic) therapy, while in others it causes significant psychological distress and requires more extensive therapy. In case of rapid progressive hair growth should be first exclude androgen-secerning tumour (ovarian, adrenal) as the most serious condition.

Keywords:
hirsutism, androgens, testosterone, androgen-secerning neoplasm, combined oral contraeptives, antiandrogens

Zdroje

1. Burkman, RT. Jr. The role of oral contraceptives in the treatment of hyperandrogenic disorders. Am J Med, 1995, 98, p. 130S.

2. Cosma, M., Swiglo, BA., Flynn, DN., et al. Clinical review: Insulin sensitizers for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials. J Clin Endocrinol Metab, 2008, 93, p. 1135.

3. DeUgarte, CM, Woods, KS., Bartolucci, AA., Azziz, R. Degree of facial and body terminal hair growth in unselected black and white women: toward a populational definition of hirsutism. J Clin Endocrinol Metab, 2006, 91, p. 1345.

4. Escobar-Morreale, HF., Carmina, E., Dewailly, D., et al. Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update, 2012, 18, p. 146.

5. Ferriman, D., Gallwey, JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab, 1961, 21, p. 1440.

6. Granger, LR., Roy, S., Mishell, DR. Jr. Changes in unbound sex steroids and sex hormone binding globulin-binding capacity during oral and vaginal progestogen administration. Am J Obstet Gynecol, 1982, 144, p. 578.

7. Heinemann, LA., Will-Shahab, L., van Kesteren, P., et al. Safety of cyproterone acetate: report of active surveillance. Pharmacoepidemiol Drug Saf, 1997, 6, p. 169.

8. Cheewadhanaraks, S., Peeyananjarassri, K., Choksuchat, C. Clinical diagnosis of hirsutism in Thai women. J Med Assoc Thai, 2004, 87, p. 459.

9, Knochenhauer, ES., Key, TJ., Kahsar-Miller, M., et al. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab, 1998, 83, p. 3078.

10. Knopp, RH., Broyles, FE., Cheung, M., et al. Comparison of the lipoprotein, carbohydrate, and hemostatic effects of phasic oral contraceptives containing desogestrel or levonorgestrel. Contraception, 2001, 63, p. 1.

11. Madden, JD., Milewich, L., Parker, CR. Jr., et al. The effect of oral contraceptive treatment on the serum concentration of dehydroisoandrosterone sulfate. Am J Obstet Gynecol, 1978, 132, p. 380.

12. Martin, KA., Chang, RJ., Ehrmann, DA., et al. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab, 2008, 93, p. 1105.

13. Porcile, A., Gallardo, E. Long-term treatment of hirsutism: desogestrel compared with cyproterone acetate in oral contraceptives. Fertil Steril, 1991, 55, p. 877.

14. Rosenfield, RL. Clinical practice. Hirsutism. N Engl J Med, 2005, 353, p. 2578.

15. Vrbíková, J., Fanta, M., Koryntová, D. Syndrom polycystických ovarií. Praha: Maxdorf, 2014.

16. Waggoner, W. Total testosterone and DHEAS levels as predictors of androgen-secreting neoplasms: a populational study. Gynecol Endocrinol, 1999, 13(6), p. 394–400.