Hirsutism and Virilism

  • Ian S. Tummon


Hirsutism is increased terminal hair growth in normal and abnormal areas that is considered to be excessive in that individual’s racial and cultural setting (Fig. 24.1). A common but distressing benign condition, hirsutism is most often caused by an increase in androgen production from the adrenal cortex or overies or by increased peripheral conversion to androgen. A predisposition may also be present, with increased sensitivity of the follicles to normal levels of circulating androgens.


Luteinizing Hormone Congenital Adrenal Hyperplasia Hair Growth Ethinyl Estradiol Cyproterone Acetate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Judd SJ, Carter JN. The changing face of hirsutism. Med J Aust. 1992; 156: 148.PubMedGoogle Scholar
  2. 2.
    Min DI, Monaco AP. Complications associated with immunosuppressive therapy and their management. Pharmacotherapy. 1991;11:119S- 125S.PubMedGoogle Scholar
  3. 3.
    Parker LU, Bergfeld WF. Virilization secondary to topical testosterone. Cleve Clin J Med. 1991; 58: 43–46.PubMedGoogle Scholar
  4. 4.
    DeFreitas A, Dudzinski MR, LaRocque JC, Coddington CC. Ovarian vein sampling in rapidly progressing virilization: a case report. J ReprodMed. 1991; 36: 546–548.Google Scholar
  5. 5.
    Abdel-Gadir A, Khatim MS, Mowafi RS, Alnaser HM, Alzaid HG, Shaw RW. Polycystic ovaries: do these represent a specific endocrino-pathy? Br J Obstet Gynaecol. 1991; 98: 300–305.PubMedCrossRefGoogle Scholar
  6. 6.
    Pugeat M, Crave JC, Elmidani M, et al. Pathophysiology of sex hormone binding globulin (SHBG): relation to insulin. J Steroid Biochem Mol Biol. 1991; 40: 841–849.PubMedCrossRefGoogle Scholar
  7. 7.
    Sharp PS, Kiddy DS, Reed MJ, Anyaoku V, Johnston DG, Franks S. Correlation of plasma insulin and insulin-like growth factor-I with indices of androgen transport and metabolism in women with polycystic ovary syndrome. Clin Endocrinol Oxf. 1991; 35: 253–257.PubMedCrossRefGoogle Scholar
  8. 8.
    Wild RA, Grubb B, Hartz A, Van Nort JJ, Bachman W, Bartholomew M. Clinical signs of androgen excess as risk factors for coronary artery disease. Fertil Steril. 1990; 54: 255–259.PubMedGoogle Scholar
  9. 9.
    Conway GS, Jacobs HS. Hirsutism BMJ. 1990; 301: 619–620.PubMedCrossRefGoogle Scholar
  10. 10.
    Rittmaster RS, Thompson DL. Effect of leupro-lide and dexamethasone on hair growth and hormone levels in hirsute women: the relative importance of the ovary and the adrenal in the pathogenesis of hirsutism. J Clin Endocrinol Metab. 1990; 70: 1096–1102.PubMedCrossRefGoogle Scholar
  11. 11.
    Hassiakos DK, Toner JP, Jones GS, Jones HW Jr. Late-onset congenital adrenal hyperplasia in a group of hyperandrogenic women. Arch Gynecol Obstet. 1991; 249: 165–171.PubMedCrossRefGoogle Scholar
  12. 12.
    Azziz R, Boots LR, Parker CR Jr, Bradley E Jr, Zacur HA. 11 betahydroxylase deficiency in hyperandrogenism. Fertil Steril. 1991; 55: 733–741.PubMedGoogle Scholar
  13. 13.
    Siegel SF, Finegold DN, Lanes R, Lee PA. ACTH stimulation tests and plasma dehydro-epiandrosterone sulfate levels in women with hirsutism. N Engl J Med. 1990; 323: 849–854.PubMedCrossRefGoogle Scholar
  14. 14.
    Franks S, Kiddy D, Sharp P, et al. Obesity and polycystic ovary syndrome. Ann N Y Acad Sei. 1991; 626: 201–206.CrossRefGoogle Scholar
  15. 15.
    Wagner FR Jr. Physical methods for the management of hirsutism. Cutis. 1990;45:319–321, 325–326.Google Scholar
  16. 16.
    Ehrmann DA, Rosenfield RL. Clinical review 10: an endocrinologic approach to the patient with hirsutism. J Clin Endocrinol Metab. 1990; 71: 1–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Porcile A, Gallardo E. Oral contraceptive containing desogestrel in the maintenance of the remission of hirsutism: monthly versus bimonthly treatment. Contraception. 1991; 44: 533–540.PubMedCrossRefGoogle Scholar
  18. 18.
    Porcile A, Gallardo E. Long-term treatment of hirsutism: desogestrel compared with cypro-terone acetate in orald contraceptives. Fertil Steril. 1991; 55: 877–881.PubMedGoogle Scholar
  19. 19.
    Prelevic GM, Würzburger MI, Balint-Peric L, Puzigaca Z. Effects of a low-dose estrogen-antiandrogen combination (Diane-35) on clinical signs of androgenization, hormone profile and ovarian size in patients with polycystic ovary syndrome. Gynecol Endocrinol1989; 3: 269–280.PubMedCrossRefGoogle Scholar
  20. 20.
    Crosby PD, Rittmaster RS. Predictors of clinical response in hirsute women treated with spironolactone. Fertil Steril1991; 55: 1076–1081.PubMedGoogle Scholar
  21. 21.
    O’Brien RC, Cooper ME, Murray RM, Seeman E, Thomas AK, Jerums G. Comparison of sequential cyproterone acetate/estrogen versus spironolactone/oral contraceptive in the treatment of hirsutism. J Clin Endocrinol Metab. 1991; 72: 1008–1013.PubMedCrossRefGoogle Scholar
  22. 22.
    Prezelj J, Kocijancic A, Andolsek L. Dexa-methasone and spironolactone in the treatment of non-tumorous hyperandrogenism. Gynecol Endocrinol1989; 3: 281–288.PubMedCrossRefGoogle Scholar
  23. 23.
    McLellan AR, Rentoul J, MacKie R, Mclnnes GT. Lack of effect of spironolactone on hair shaft diameter in hirsute females. Postgrad Med J. 1989; 65: 459–462.PubMedCrossRefGoogle Scholar
  24. 24.
    Lissak A, Sorokin Y, Calderon I, Dirnfeld M, Lioz H, Abramovici H. Treatment of hirsutism with Cimetidine: a prospective randomized controlled trial. Fertil Steril1989; 51: 247–250.PubMedGoogle Scholar
  25. 25.
    McKenna TJ. The use of anti-androgens in the treatment of hirsutism. Clin Endocrinol Oxf. 1991; 35: 1–3.PubMedCrossRefGoogle Scholar
  26. 26.
    Barth JH, Cherry CA, Wojnarowska F, Daw-ber RP. Cyproterone acetate for severe hirsutism: results of a double-blind dose ranging study. Clin-Endocrinol Oxf. 1991; 35: 5–10.PubMedCrossRefGoogle Scholar
  27. 27.
    Marcondes JA, Minnani SL, Luthold WW, Wa-jchenberg BL, Samojlik E, Kirschner MA. Treatment of hirsutism in women with fluta-mide. Fertil Steril. 1992; 57: 543–547.PubMedGoogle Scholar
  28. 28.
    Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Endocrinol Metab. 1961; 21: 1440.CrossRefGoogle Scholar
  29. 29.
    Akalin S. Effects of ketoconazole in hirsute women. Acta Endocrinol Copenh. 1991; 124; 19–22.PubMedGoogle Scholar
  30. 30.
    Venturoli S, Fabbri R, Dal-Prato L, et al. Ketoconazole therapy for women with acne and/or hirsutism. J Clin Endocrinol Metab. 1990; 71: 335–339.PubMedCrossRefGoogle Scholar
  31. 31.
    Cassidenti DL, Paulson RJ, Serafini P, Stanczyk FZ, Lobo RA. Effects of sex steroids on skin 5 alpha-reductase activity in vitro. Obstet Gynecol 1991;78;103–107.PubMedGoogle Scholar
  32. 32.
    Dewailly D. ACTH stimulation tests in women with hirsutism. N Engl J Med. 1991; 324; 564–565.PubMedCrossRefGoogle Scholar
  33. 33.
    Andreyko JL, Monroe SE, Jaffe RB. Treatment of hirsutism with a gonadotrophin releasing hormone agonist (naferelin). J Clin Endocrinol Metab. 1986; 63: 1031–1035.CrossRefGoogle Scholar
  34. 34.
    Tummon IS, Pepping ME, Binor Z, Radwanska E, Dmowski WP. Unchanged bone mineral density during ovarian suppression with GnRH-a or danazol for endometriosis. Fertil Steril1988; 49: 792–796.PubMedGoogle Scholar
  35. 35.
    Adashi EY. Potential utility of gonadotropin-releasing hormone agonists in the management of ovarian hyperandrogenism. Fertil Steril1990; 53: 765–779.PubMedGoogle Scholar
  36. 36.
    Sugimoto AK, Nisker JA, Hodsman AB. Long-term gonadotropin-releasing hormone agonist with standard postmenopausal estrogen replacement failed to prevent vertebral bone loss in premenopausal women. Fertil Steril In press.Google Scholar
  37. 37.
    Shaw RW. Use of nafarelin to investigate the pathophysiology of the polycystic ovarian syndrome. J Reprod Med. 1989; 34 (suppl 12): 1039–1043.PubMedGoogle Scholar
  38. 38.
    Helfer EL, Miller JL, Rose LI. Cost effectiveness of routine gonadotropin and androgen measurements in hirsute women. Am J Med Sei. 1990; 299: 94–97.CrossRefGoogle Scholar
  39. 39.
    Ehrmann DA, Rosenfield RL. Hirsutism: beyond the steroidogenic block. N Engl J Med. 1990; 323: 909–911.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 1993

Authors and Affiliations

  • Ian S. Tummon

There are no affiliations available

Personalised recommendations