Hirsutism Max Brinsmead MB BS PhD July 2012
Definition of Hirsutism Terminal hairs in a female (or child) in a male pattern distribution and amount Hairs that are not regulated by androgens include: Scalp Eyebrows Eyelashes
Role of 5 -Reductase Converts Testosterone to Dihydrotestosterone in hair follicles Is increased in both idiopathic and other forms of hirsutism
Idiopathic Hirsuitism Hirsutism with normal menstrual cycles and serum androgens More common in Mediterranean, Middle Eastern and Southern Asian women This means that the incidence of hirsutism is culturally determined Up to 50% of Australian women complain of hirsutism
Medical Causes for Hirsutism PCO Disorder % Androgen-producing tumour Congenital Adrenal Hyperplasia Cushings Syndrome Drugs
The clinical evaluation of hirsutism When and where is the hair? Weight and menstrual history Family history Drugs Acne Symptoms or signs of virilisation Temporal hair loss Voice change Clitoral enlargement
Tests for a patient with hirsutism… Androgens i.e. TEST, SHBG & FAI HydroxyPROG DHEAS PROL & TSH Ovarian ultrasound
Treatment options for hirsutism… Counselling Cosmesis Combined Oral Contraceptive Cyproterone acetate With or without COC e.g. Diane Spironolactone Causes irregular periods Topical Eflornithine
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