Hirsutism

This review article examines the aetiology, physical assessment, treatment and pharmacological therapies for hirsutism. Hirsutism is defined as the presence in a female of terminal hair in a distribution more typically associated with the adult male. The condition can have a significant negative psychosocial impact on an individual as well as being a sign of underlying endocrine abnormality. Hirsutism develops as the result of the sensitisation of androgen-dependent hair follicles converting vellus hair to darker and thicker terminal hair. Over seventy percent of women with androgen excess demonstrate hirsutism, however, not all women with hirsutism will have detectable androgen excess. In these cases increased end-organ sensitivity to androgen plays an important role. Future developments for assessing and treating hirsutism are discussed.