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Hirsutism and Virilization

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Endocrinology and Diabetes

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Abstract

Hirsutism is the medical term that refers to the presence of excessive terminal (coarse) hair in androgen-sensitive areas of the female body (upper lip, chin, chest, back, abdomen, arms, and thighs). Virilization is more extensive than hirsutism with additional evidence of masculinization. In particular, the term virilization refers to the concurrent presentation of hirsutism with a broad range of signs suggestive of androgen excess, varying with age, such as ambiguous external genitalia, increased muscle mass, acne, balding, deepening of the voice, breast atrophy, amenorrhea/oligomenorrhea, and increased libido.

Hirsutism and virilization usually have different underlying pathologic conditions, generally more severe in virilization that is frequently an expression of a life-threatening disorder such as malignancy (ovarian or adrenal tumors) (Bonfig et al., Eur J Pediatr 162:623–628, 2003) or classic congenital adrenal hyperplasia (CCAH) (White and Speiser, Endocr Rev. 21:245–291, 2000; New, Mol Cell Endocrinol 211:75–83, 2003). Hirsutism commonly results from relatively benign functional disorders. Sometimes, however, it is the presentation of a more severe disorder, and it may be the first manifestation of a condition that will ultimately lead to virilization, if untreated. Therefore, both hirsutism and virilization must be seriously considered by practitioners not only for the disorder that they express but also for the considerable psychological negative impact that they exert in the individual affected, especially among young women (Barth et al., J Psychosom Res 37:615–619, 1993; Sonino et al., Postgrad Med J 69:186–189, 1993; Assante et al., International workshop “disorders of sex development: new directions and persistent doubts”, 14–15 Nov 2011, Bologna, Italy, 2011; Guidi et al., Clin Endocrinol (Oxf) 83:872–878, 2015).

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Authors and Affiliations

  1. Division of Endocrinology, Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Alessandra Gambineri

  2. Pediatric Unit, Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Antonio Balsamo

  3. Department of Medicine, University of Bologna, Bologna, Italy

    Renato Pasquali

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  1. Alessandra Gambineri
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  2. Antonio Balsamo
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  3. Renato Pasquali
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Correspondence to Alessandra Gambineri .

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Editors and Affiliations

  1. Division of Endocrinology, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil

    Francisco Bandeira

  2. Division of Endocrinology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Hossein Gharib

  3. School of Medicine, University of Pernambuco, Recife, Brazil

    Luiz Griz

  4. School of Medicine, University of Maranhao, Sao Luis, Brazil

    Manuel Faria

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Gambineri, A., Balsamo, A., Pasquali, R. (2022). Hirsutism and Virilization. In: Bandeira, F., Gharib, H., Griz, L., Faria, M. (eds) Endocrinology and Diabetes. Springer, Cham. https://doi.org/10.1007/978-3-030-90684-9_12

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