Cause Of Hirsutism Research Articles

Is There Any Association Between Hirsutism and Serum Zinc Levels in Adolescents?

Zinc has shown to have an anti-androgenic effect through 5 alpha-reductase enzyme activity inhibition in skin. However, there are contradicting findings concerning the effect of zinc on hirsutism mainly from studies including adult women with polycystic ovary syndrome (PCOS). The aim of our study was to investigate the association between serum zinc levels and hirsutism in adolescents. Between October 2017 and June 2018, 51 female adolescents with hirsutism (mean age: 16.11 ± 1.47years) and 51 healthy female controls were included in the study (mean age: 15.5 ± 1.40years). Adolescents with hirsutism were classified under two groups; PCOS (n = 34, 66.7%) and idiopathic causes of hirsutism (idiopathic hirsutism (n = 9, 17.6%) and idiopathic hyperandrogenemia (n = 8, 15.7%)). The serum zinc levels were measured via atomic absorption spectrophotometry. The mean zinc levels of adolescents with hirsutism (102.02 ± 11.64μg/dl) and the control group (101.72 ± 16.71μg/dl) were similar (p = 0.915). Additionally, there was no significant difference among the mean zinc levels of the hirsutism sub-groups and the control group (p = 0.979). While some studies demonstrated low zinc levels in women with hirsutism, some studies similar to ours showed no association. Adolescence is a developmental phase where generally isolated mild hirsutism is not associated with hyperandrogenism and more studies are needed to evaluate the effect of zinc on hirsutism in this age group.

Assessment of Anti-Mullerian Hormone and Anti Ovarian Antibody in the Sera of Patients with Polycystic Ovarian Syndrome in AL-Najaf Al-Ashraf Province

Polycystic ovarian syndrome(PCOS)is the most common endocrinopathy,that affects 5 to 20% of women in age of(12-45year)and cause a widespread of reproductive disorder in women and it is a major cause of hirsutism,acne,hormonal disturbance and infertility. Women with PCOS may associated with health conditions obesity,amenorrhea, oligomenorrhea,hyperandrogenemia and insulin resistance.The PCOS patients are with increased risk for type 2diabetes mellitus,diabetic complications,dyslipidemia and cardiovascular disease .Objective: Aim of the study to investigate the pathogenicity,disease severity and early diagnosis roles anti-Mullerian hormone and anti-ovarian antibody in ladies with PCOS.Conclusion: Polycystic ovarian syndrome was related to the increase level of AMH in different age of PCOS patients,which comprised 55.0% in PCOS patients that cause defect in ovulation and resulting fertility problem,while no relationship between anti-ovarian antibody and patients with PCOS.

Assessment of obesity, dyslipidemia, and insulin resistance in idiopathic hirsutism: a case–control study

Background Polycystic ovary syndrome (PCOS) and idiopathic hirsutism (IH) are the most common causes of hirsutism. Obesity, dyslipidemia, and insulin resistance are common findings in PCOS. It is not confirmed whether patients with IH also have similar metabolic consequences or not. Objective To investigate and assess obesity, dyslipidemia, and insulin resistance in women with IH. Patients and methods A total of 75 women were enrolled in three groups: group A included 25 PCOS cases, group B included 25 IH cases, and group C included 25 healthy, age-matched women who are unrelated to groups A and B. Height, body weight, BMI, and waist circumference were measured. Serum cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, fasting blood sugar, and fasting serum insulin were assessed. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and the presence of metabolic syndrome were evaluated. Results Hirsutism score, body weight, BMI, waist circumference, serum cholesterol, triglycerides, and low-density lipoprotein were significantly higher in IH and PCOS cases compared with controls (P 0.05). Hirsutism score, fasting blood sugar, and HOMA-IR were significantly higher in PCOS cases compared with IH cases (P Conclusion IH is associated with obesity, dyslipidemia, and insulin resistance, with the risk of development of cardiovascular disease.

Investigation of body mass index, insulin resistance and diabetes in patients with hirsutism.

IntroductionObese woman with hirsutism have increased risk for developing insulin resistance and diabetes mellitus.AimTo evaluate patients with hirsutism, report the hormone levels, body mass index (BMI), insulin resistance and diabetes in our study population and compare our results with those of similar research conducted in other countries.Material and methodsHormones were measured with radioimmunoassay/immunoradiometric assay methods. Oral glucose tolerance test was done only in a selected group of women (with positive anamnesis for diabetes, women with polycystic ovary syndrome (PCOS) and overweight/obese women). The level of blood glucose was measured after drinking the liquid containing 75 g glucose. Blood was taken to measure glucose, insulin and C-peptide levels after 30 min, 60 min and 3 h.ResultsWomen with PCOS (27.4%) had higher BMI than women with other causes of hirsutism. Among 135 of the women with hirsutism, 9.6% were underweight, 60% were with normal weight, 20.7% were overweight and 9.6% were obese. Obesity was more frequent in PCOS and hyperandrogenism groups. Women with hirsutism had higher levels of androstenedione, dehydroepiandrosterone sulfate (DHEAS), total testosterone, free testosterone, lower levels of sex hormone-binding globulin (SHBG). Insulin resistance was present in 20 (14.8%) women and diabetes in 2 (1.4%) women.ConclusionsObesity was associated with increased hirsutism. In our study we found that insulin resistance should be assessed in hirsute women with PCOS regardless of their BMI as insulin resistance was found in hirsute women irrespective of whether they were overweight, obese, of normal weight or underweight. Groups at risk (hirsute, obese, diabetes) should be identified and treated.

A study of clinical and investigational profile of hirsute women at a tertiary care center in Western India

Background: Hirsutism is defined as a male pattern of hair distribution in a female. The interplay of androgens as well as other non androgenic hormones has an important role in the causation of hirsutism. Objectives: The objective of this study was to investigate the prevalent causes for hirsutism and to study the clinical profile of patients presenting with hirsutism. Methodology: Patients who came with features of hirsutism were screened by the modified Ferriman–Gallwey (mFG) scale and those with mFG ≥8 were included in the study. Patient's clinical history, family history, body mass index, general examination, dermatological examination, and systemic examination were carried out. Serum total testosterone, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH: FSH ratio, dehydroepiandrosterone sulfate (DHEAS), thyroid-stimulating hormone, blood sugar levels (fasting and postprandial), and abdomino-pelvic ultrasound were performed for all patients. Serum prolactin, free testosterone, 17 hydroxyprogesterone, T3level, T4level, serum cortisol level, and serum fasting insulin levels were performed in selected patients depending on the clinical scenario. Results: A total of 44 patients were studied during the study. About 95.45% of patients were categorized under mild mFG, whereas 4.55% of patients had moderate mFG score. Idiopathic hirsutism (IH) was the most common cause in our patients which accounted for 43.18% of patients followed by polycystic ovarian syndrome (PCOS) which was the reason for hirsutism in 38.64% of patients. Total testosterone was raised in 25% of patients. Free testosterone levels were performed for 25 patients and found to be raised in six patients. Five patients had elevated DHEAS levels of which four had PCOS and one had late-onset congenital adrenal hyperplasia. Conclusion: IH was the most common cause of hirsutism in our patients which was followed by PCOS.

Acromegaly: ominous cause of hirsutism

Acromegaly: ominous cause of hirsutism

Clinical profile of 50 premenopausal women with hirsutism

<p class="abstract"><strong>Background:</strong> Hirsutism is a common condition, affecting up to 10% of women and may be associated with signs and symptoms of hyperandrogenism. The aim of this study was to study the clinical characteristics of patients presenting with hirsutism and to correlate the severity of hirsutism with the presence of these features.</p><p class="abstract"><strong>Methods:</strong> A hospital based, cross sectional prospective study was conducted on 50 patients with clinically diagnosed hirsutism. Scoring of hirsutism was done using modified Ferriman –Gallwey scoring system following which a complete history was taken and thorough examination of all patients in the study group was carried out for features associated with hirsutism.<strong></strong></p><p class="abstract"><strong>Results:</strong> Maximum (60%) patients had mild hirsutism, 30% had moderate hirsutism and 10% patients had severe hirsutism. Acne was the most commonly occurring clinical feature, occurring in 50% of the patients followed by menstrual irregularities in 46%, striae and obesity in 42% and acanthosis nigricans in 40% of the patients. Other features seen were androgenic alopecia in 26%, infertility in 16.67% and deepening of voice in 4% of participants.</p><p><strong>Conclusions:</strong> Hirsutism is a multifaceted condition and this study highlights the need for a thorough clinical examination in order to identify possible associated conditions which may provide significant clues for the underlying cause of hirsutism.</p>

MON-LB044 Bilateral Ovarian Hyperthecosis: A Benign and Unusual Cause of Postmenopausal Hirsutism

Introduction-: Postmenopausal hirsutism is a rare presentation. The presentation of clinical hyperandrogenism , its severity and the pace of presentation along with the hormonal profiles help in determining the cause. Once iatrogenic cause is ruled out, one has to assess for the endocrine causes of postmenopausal hirsutism. There are various benign and malignant causes of ovarian hyperandrogenism. Case Presentation- A 62 years post menopausal lady came with complaints of increasing facial hair, coarseness of facial skin and alopecia for two years. She had no significant medical illness and had not received androgens in any form. She had a normal menstrual history during her reproductive years and has two children born of natural conception. Clinically there was no evidence of other endocrine causes of hyperandrogenism like Acromegaly, Cushing’s syndrome, Late onset CAH. Her hormonal profile showed significantly elevated testosterone levels with normal DHEAS levels. Investigations - TSH 1.898 uIu/ml (NR 0.5-5.0); Testosterone 216.10 ng/dl ( NR 20-90); DHEAS 40 mcg/dl ( NR 17-90); USG abdomen and pelvis showed thickened endometrium 8 mms in size and submucosal fibroid. Further investigations-Serum Testosterone 145 ng/dl (NR 20-90); DHEAS 23.8 mcg/dl ( NR 17-90); 17 OH Progesterone 0.86 ng/ml ( NR 0.2- 0.5); Post Dexamthasone 1 mg cortisol < 1.0 mcg/dl (normal response< 1.8- 2.0); Alpha Fetoprotein 2.08 ng/ml ( NR <10 ng); IGF1 71 ng/ml ( NR 70-140) ; Estradiol 10 pg/ml ( NR <30). Her assessment for other causes of hirsutism ruled out Acromegaly, Late onset CAH and Cushing syndrome. MRI abdomen and pelvis revealed normal ovaries and uterus for her menopausal status. In view of persistent symptoms and very high levels of testosterone along with endometrial hyperplasia, patient was counselled to get her ovaries and uterus removed.She underwent a total hysterectomy with bilateral oophorectomy. Postoperatively the patients symptoms have improved, her skin hue is better and the facial hair growth has significantly reduced. The testosterone levels have returned to normal. Postoperative Total Testosterone 16.12 ng/dl ( NR 20-90) and Free Testosterone 1.63pg/ml ( NR 0.3-2). The histopathology showed bilateral ovarian hyperthecosis along with benign endometrial hyperplasia. Conclusion: Polycystic ovaries is a common cause of hirsutism in young women of reproductive age group. It is not commonly seen in the post menopausal state. Even though the hormonal profile points towards an ovarian cause, localisation of an ovarian pathology is sometimes difficult. Diagnostic and therapeutic bilateral oophorectomy points towards the diagnosis which can be unusual and curable like bilateral ovarian hyperthecosis. This was an unusual , curable and rewarding case of postmenopausal hirsutism. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Current aspects of polycystic ovary syndrome I: definition, pathophysiology, clinical manifestations, diagnosis and complications

Abstract Polycystic ovary syndrome (PCOS) is the most frequent endocrine disease among women with childbearing potential, the best-known cause of hirsutism, with a hypothesized prevalence of 8-22%. The first part of the paper discusses the conceptional evolution of the syndrome, from its description in 1935 by Stein and Leventhal till today. It describes the changes in the criteria systems, emphasizing that the Rotterdam criteria, proposed in 2003 by the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine, are still valid today. This system basically differs from earlier (1990) NIH-criteria in one aspect: it introduced two newer phenotypes, one without hyperandrogenism and the other with ovulatory cycles, so it distinguishes 4 phenotypes. The etiology and pathogenesis of PCOS is heterogeneous, multifactorial, poorly understood. We present the 3 leading hypotheses (1 - hypothalamo-hypophyseal disturbances, 2 – primary enzyme disorders in ovarian, or ovarian/adrenal steroidogenesis, resulting primarily in hyperactivity of 17alpha-hydroxylase/17,20-lyase, 3 – insulin resistance-hyperinsulinism and other metabolic dysfunctions). We emphasize the role of genetically determined hyperandrogenism, that of insulin resistance-hyperinsulinism and the importance of reinforcing each other. Subsequently, the aggravating aspects of the frequently associated metabolic syndrome are discussed, and then the effects of the mentioned pathological processes on the endocrine and other organ structures participating in the regulation of sexual functions. We stress the hypothetical role of perinatal and pubertal androgen exposition in the pathogenesis of PCOS. The mechanisms of anovulation and those of the endometrial lesions are discussed, too. The clinical manifestations, the paraclinical and laboratory examinations, the positive and differential diagnosis and the complications are also presented. We intend to deal with the therapeutic aspects of PCOS in an upcoming paper.

Long-Term Response of Hirsutism and Other Hyperandrogenic Symptoms to Combination Therapy in Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) affects 5%-15% of women and is the most common cause of hirsutism. Data on the time-course of improvement to suppressive therapy and predictors of that response in PCOS are lacking. The objectives of our study are to determine the long-term response and identify predictors of response in PCOS women treated with suppressive therapy, including spironolactone (SPL) + oral contraceptives (OCs). Retrospective cross-sectional analysis of 200 women with PCOS (1990 NIH criteria) treated with suppressive therapy in general, and a subgroup of 138 subjects treated with OCP+SPL who had been prospectively included in a biorepository. Main outcome measure included improvement rate per 100 person-month of follow-up for hirsutism, menstrual irregularity and acne measured qualitatively as "feeling better", and changes in the severity of hirsutism quantified by modified Ferriman-Gallwey [mF-G] score. During a mean follow-up of 34.2 months, 85.1%, 82.7%, and 79.3% of patients reported improvement in hirsutism, menstrual dysfunction, and acne, respectively. The modified Ferriman-Gallwey (mF-G) hirsutism score improved by 59.9%. The net reduction in mF-G score and the percent of patients reporting improvement in hirsutism were greater for OC+SPL than for either drug alone, with no difference in the percent of patients free of adverse effects. Among those treated with OC+SPL (n = 138), the initial mF-G and sex hormone-binding globulin (SHBG) independently predicted successful therapy for hirsutism. There is a high rate of patient satisfaction with suppressive therapy in PCOS. The efficacy of suppressive therapy for hirsutism was greater with OC+SPL than with either drug alone. Successful treatment of hirsutism with combination OC+SPL requires at least 6 months of therapy, with the proportion of satisfied patients continuing to increase with treatment duration. The probability of patient satisfaction with OC+SPL treatment for hirsutism can be predicted by her initial mF-G score or SHBG level.

Clinical and Biochemical Profile of Women Presenting with Hirsutism and It’s Treatment Outcome-A Prospective Study

INTRODUCTION: Hirsutism is a disorder which affects about 10 to 15 percent of women. Hirsutism is the most frequent androgen excess disorder in women1. Hirsutism is defined as the excessive growth of terminal hair in androgen dependent areas of a woman’s body. The sites affected include; The upper lip, Chin, Chest, Upper abdomen, Lower abdomen, Upper back, Lower back, Upper Arm, Thighs. Each of the nine areas is given a score of 0 to 4 depending upon the grade 1 –mild, 2-moderate, 3-complete light coverage and 4 for complete heavy coverage. A score of more than 15 is considered as severe hirsutism2. Occasionally, hirsutism may signal more serious pathology. Therefore, clinical evaluation should differentiate benign causes from tumours and other conditions that require specific treatment. Hirsutism should be differentiated from hypertrichosis. Hypertrichosis is defined as a diffuse increase in vellus hair growth and is not androgen dependent. The congenital causes of hypertrichosis include Hurlers syndrome, trisomy 18, fetal alcohol syndrome etc. The other causes include hypothyroidism, porphyrias, epidermolysis bullosa, anorexia nervosa, malnutrition, dermatomyositis, severe head injury and trauma. AIM OF THE STUDY: There are not many studies that look at the causes of hirsutism, their clinical profile and hormonal changes .Therefore, this study was undertaken to analyse the clinical profile, biochemical profile, various causes of hirsutism and the response to treatment. MATERIALS AND METHODS: Study Design: This is a prospective study. Period of Study: The period of study was from August 2010 to September 2011. Place of Study: Subjects were taken from Endocrinology clinic and Fertility Research centre, Institute of Obstetrics and Gynaecology, Govt Hospital for Women and Children, Egmore. Inclusion Criteria: Females with modified Ferriman-Gallwey scoring >8 were included in the study. After getting an informed consent from the subjects, they were subjected to clinical and biochemical evaluation after history taking. Exclusion Criteria: Women who were 60 years and above and pregnant women were excluded from the study. SUMMARY: In this study, 52 had ovarian causes, (46 – PCOS, 4- ovarian tumour, 2- premature ovarian failure), one had adrenal cause (late onset CAH), systemic cause (hypothyroid -6) for hirsutism.• Majority of cases of hirsutism in this study fall in the 21 – 30 years age group. • In addition to hirsutism, menstrual irregularity is the chief complaint. • Majority had hirsutism scoring of 9 to 11. Severe hirsutism (Scoring more than > 15) was seen in androgen secreting ovarian tumour and PCOS (4 cases). • Virilization features commonly were seen in all the 4 ovarian tumors and late onset CAH . Highly elevated free testosterone levels were seen in androgen secreting ovarian tumours and late onset congenital adrenal hyperplasia. • Subjects with hirsutism were either overweight or obese except ovarian tumours and CAH. • Co morbid conditions like hyperlipidemia, diabetes mellitus, hypertension were seen in few PCOS and few non PCOS subjects. • Level of the testosterone did not correlate with the severity of hirsutism in the PCOS group. CONCLUSION: This study evaluates the various causes of hirsutism, their clinical and biochemical profile and their outcome after treatment. Although PCOS is the most common cause for hirsutism, other causes should also be thought of. The treatment should be individualised depending upon the cause of hirsutism. We should have a high suspicion of virilizing tumours if features of virilization are present. Hirsutism has a response to OCP containing cyproterone acetate but the reduction in severity of hirsutism is mild. They might need increase in the duration of treatment and dosage of cyproterone acetate. Free testosterone and DHEAS may or may not be elevated in PCOS. Majority have normal levels. Free testosterone is highly elevated in androgen secreting ovarian tumours. This study has highlighted the importance of evaluating the other causes of hirsutism such as androgen secreting ovarian tumours and adrenal hyperplasia. Hirsutism causes cosmetic problem and psychological upset on a woman. It can also be a manifestation of an underlying health problem. Hence it should be properly treated so that a favourable outcome can be obtained.

HIRSUTISM

elf-esteem, psychological distress and cosmetic embarrassment. Objective: Tostudy the clinical, biochemical and etiological profile of patients with hirsutism in Abbottabad,Pakistan. Duration and place: This descriptive study was performed in Frontier Medical &amp; DentalCollege, Abbottabad from January, 2015 to December, 2015. Methods: Fifty patients wereincluded in the study. Complete clinical assessment and abdominal and pelvic ultrasonographywas carried out. Ferriman and Gallwey score was used to assess the extent and pattern ofhirsutism. Endocrinological investigations performed in these patients included prolactin,testosterone, luteinizing and follicular stimulating hormone (LH, FSH), thyroid function testsand cortisol. Results: Fifty patients were included in the study. Their mean age was 28.30±5.83years. About 88% of the women were married and 70% were obese. The polycystic ovariansyndrome (58%) was diagnosed as the main cause of hirsutism followed by idiopathic hirsutism(38%) and drug-induced hirsutism (4%). Majority of patients, 50%, had hirsutism for 1-5 yearswhile 22% and 20% had hirsutism for 6-10 years and &gt; 10 years respectively. The rate of infertilityamong hirsute women was 70% (35 cases), out of which, 24 (48%) cases had primary infertilitywhile 11 (22%) had secondary infertility. Most of the hirsuite patients, 26 (52%), presented withthe complaints of infertility and menstrual disturbances followed by infertility alone in 9 (18%)cases, hirsutism in 6 (12%) cases and menstrual irregularities in 5 (10%). The 60% of patientsbelonged to moderate category according to FG score, (FG score 17-24). The 26% belonged tomild category (FG score 8-16) and 14% belonged to severe category (FG score 25-30). About72% of our patients used treatment of any kind for their disease. The common hair removingpractices used by these patients included bleaching (22%), waxing (20%), epilation (20%),electrolysis (6%) and shaving (4%). Serum free testosterone levels were elevated in 44% of ourpatients, LH/FSH ratio was more than 2 in 42.1% patients and prolactin levels were raised in10% of the patients. Conclusion: Hirsutism is not uncommon in Pakistan. The most commoncause of hirsutism was polycystic ovarian syndrome and idiopathic hirsutism. There is a need toconduct large scale studies to determine the true prevalence and etiological profile of patientswith hirsutism.

Polycystic Ovarian Syndrome and Hirsutism

Polycystic Ovarian Syndrome(PCOS) affected 5-15% of women and is the commonest cause of hirsutism in women. The prevalence of hirsutism in PCOS patients is 70-80% compared with 4%-11% in women in the general population.Methods: A search in the Medline, Pub Med, Cochrane library database and Embase was made. Prospective randomized trials, systematic reviews,meta-analysis and retrospective studies on hirsutism and PCOS were extracted and reviewed. Evidence for the different outcomes and recommendations for interventions were used on the best available data.Review of Evidence: Evidence revealed that there is no universal agreement on the definition of PCOS. The NIH, ESHRE and ASRM and Androgen Excess and PCOS Society use different definitions based on the three criteria of Oligo anovulation (OA), biochemical or clinical hyperandrogenamia (HA) and polycystic ovarian morphology (PCOM). Moleular pathways modulating androgen biosynthesis and their relationship to insulin metabolism have enhanced our understanding of the pathophysiology of PCOS and its therapy. Hirsutism in PCOS is due to excess production of ovarian androgen driven by high level of LH.Life style modification and loss of body weight in PCOS patient complaining of hirsutism should be advised. Effective medical treatment includes, combined hormonal contraceptives (CHCs), antiandrogens or combined CHCs and antiandrogens. Insulin sentizers are also useful when there is associated hyperinsulinaemia.Short term and long term effective methods for treatment of hirsutism are also available and effective.Conclusion: The strategy for management of PCOS patients with hirsutism should be patient centered. Medical treatment and cosmetic treatment are effective. Long term sequela of PCOS should not be overlooked..

The Metabolic Syndrome in Polycystic Ovarian Disease

Polycystic ovarian disease (PCOS) is the most common endocrine disorder among women in genital activity (prevalence: 5 and 10%). It is a frequent cause of hirsutism and infertility in women and affects 3-10% of women overall population. Whatever the age of onset, PCOS predisposes to metabolic and early cardiovascular complications. The PCOS is frequently associated with obesity, insulin resistance and hyperinsulinemia. There is a greater risk of glucose intolerance, diabetes mellitus (10%) and hyperlipidemia (more than half of women). The aim of our study was to report the frequency of metabolic syndrome (MS) in PCOS and specify its clinical and biological characteristics. This is a prospective, descriptive study which concerned 66 primary PCOS patients. The frequency of metabolic syndrome was 48.5%. The average age was 33.9 ± 9.22 years (16 – 45) Just under half of the patients (42.4%) were obese at diagnosis. The mean BMI was 32.4 kg / m2 ± 0.3. A slightly more than 2/3 of PCOS patients (72.6%) have a and roidobesity. The average waist circumference PCOS patients was 87.5 ± 0.1 cm. Nearly a third of patients have abnormal glucose tolerance. They have an average triglycerides, mean arterial pressure, mean blood glucose, insulin and an average index HOMA significantly higher (p: 10- 3). Their HDL level is significantly reduced (p <10-3). A little over a quarter of PCOS patients with metabolic syndrome: 37.5%) have all of the risk factors for MS at diagnosis.

Hyperprolactinemia and Hirsutism in Patients Without Polycystic Ovary Syndrome.

Background:Hirsutism is one of the most important diseases that lead women to refer to dermatology clinic. Hyperprolactinemia is one of the causes of hirsutism. The aim of this study was to determine prolactin (PRL) levels in hirsute women.Materials and Methods:In this cross-sectional study, hirsute patients were evaluated. For all of the patients, 2 or 3 days after mense starting, hormone level tests were performed, and 200 patients that had not polycystic ovary syndrome enrolled to the study. A questionnaire of history and physical examination were performed. Data have been analyzed with SPSS version 21.Results:Hyperprolactinemia were seen in 25 patients (12.5%). There was no significant relation between marital statuses, galactorrhoea, positive family history, and infertility with hyperprolactinemia. But significant relation was seen between irregular mense and hyperprolactinemia.Conclusion:Although hyperprolactinemia is the rare cause of hirsutism, the prevalence of hyperprolactinemia was high in our study. Thus, PRL level in hirsute patients should be evaluate.

Is idiopathic hirsutism (IH) really idiopathic? mRNA expressions of skin steroidogenic enzymes in women with IH.

Hirsutism results from hyperandrogenemia and/or exaggerated androgen responsiveness. Among various causes of hirsutism, some patients do not exhibit androgen excess which is called idiopathic hirsutism (IH). The pathogenesis of IH could not so far be clearly established. To investigate the mRNA expression of aromatase enzyme and the other enzymes having functional roles in the steroidogenic pathway, in freshly obtained skin tissue from subumbilical skin and the arm of the patients with IH and healthy women. Twenty-one women with IH and 15 healthy women were included in the study. We aimed to determine mRNA expressions of genes associated with local androgen synthesis and metabolism (CYP11A1, STS, CYP19A1, SRD5A1, SRD5A2, HSD3B1, AR, COMT, ESR1, ESR2, HSD3B2, CYP17A1, SULT2A1, SULT1E1, HSD17B2, IL6, TGFB1, TNFA) from skin biopsy and blood samples of patients with IH and the data compared with healthy subjects. Patients with IH exhibit significantly lower interleukin 6 (IL6) mRNA expression and higher steroid sulphatase (STS) and hydroxysteroid (17beta) dehydrogenase 2 (HSD17B2), gene mRNA expression, respectively, in the subumbilical region skin biopsies. Similarly, patients with IH exhibit significantly lower IL6 mRNA expression and higher STS and HSD17B2 gene mRNA expression, respectively, in the arm skin compared to healthy women's subumbilical region. In both arm and subumbilical skin biopsy of patients with IH, we observed an up-regulation of HSD17B2 and STS, decreased IL6 mRNA expression, probably determining an increase in the local amount of active androgens, which could then be used as substrate for other androgen metabolic routes.

Idiopathic hirsutism – medical and psychological aspects

Introduction. Hirsutism is a condition which results in excess of male pattern hair growth - the androgen dependent hair in females. Excessive hair growth usually starts around puberty. The aim of this study was to show the significance of hormonal diagnosis in female adolescent hirsute patients.Material and methods. The material consisted of medical documentation of 128 female adolescent patients aged 13–22 years who came for a consultation because of excessive male pattern hair growth (second degree of hirsutism according to the Ferriman-Gallwey scale) which they considered unacceptable. The history was indicative of considerable discomfort, decreased mood in subjects and low self-esteem (especially regarding patient’s femininity).Results. Results of the analysis were confronted with the results of a group of an equal number of participants.Conclusions. Hormonal tests in female patients with hirsutism were proven to constitute a major diagnostic element allowing for correct diagnosis of the cause of hirsutism, planning further tests and treatment methods.Considering its causes and effects, hirsutism in adolescent patients is a serious concern for developmental gynecology. This disorder is a endocrinological or gynecological problem, which influences patient's well-being.

Identify underlying cause of hirsutism and individualize treatment as required

Diagnostic evaluation of women with hirsutism is essential to identify and manage the underlying cause of the condition, which is often an endocrine disorder. Physical and pharmacological treatments for hirsutism are available, and should be individualized according to the needs and preferences of the patient, the severity and extent of hirsutism, and the potential benefits and harms of therapy.

Hyperinsulinaemic androgen excess in adolescent girls.

Hyperinsulinaemic androgen excess is the most common cause of hirsutism, acne and menstrual irregularity in adolescent girls. Here, we propose that the disorder frequently originates from an absolute or relative excess of lipids in adipose tissue, and from associated changes in insulin sensitivity, gonadotropin secretion and ovarian androgen release. Girls from populations with genotypes attuned to nutritionally harsh conditions seem to be particularly vulnerable to the development of hyperinsulinaemic androgen excess in today's obesogenic environment. We propose that hirsutism, hyperandrogenaemia and menstrual irregularity (≥2 years after menarche) is used as a diagnostic triad for the disorder. No pharmacological therapy has been approved for girls with androgen excess; however, lifestyle intervention is essential to reduce adiposity. In girls without obesity who are not sexually active, insulin sensitization has more broadly normalizing effects than estradiol-progestogen combinations. The early recognition of girls at risk of developing hyperinsulinaemic androgen excess might enable prevention in childhood.

Diagnostic evaluation of patients presenting with hirsutism

Objective: Hirsutism, similar to men, is the presence of terminal hairs in androgen-to sensitive areas in women. The present report aimed to study etiology and determine the prevalence of the diseases that causes hirsutism in these patients. Methods: In this study, total number of 40 patients who admitted because of hirsutism to Department of Endocrinology and Metabolism clinic was enrolled. Demographic, clinical and laboratory parameters of the patients were evaluated. Results: Result of the study showed that polycystic ovary syndrome is the most common cause of hirsutism. The second most common cause was found as idiopathic hirsutism. Conclusion: By the present study, etiologic factors of hirsutism were examined firstly in our region in which Ethnic and cultural diversity is concentrated. In rare cases like Cushing's syndrome, hyperprolactinemia, non-classic adrenal hyperplasia, androgen-secreting tumors should be considered in the differential diagnosis of hirsutism.