hirstuism Flashcards
(21 cards)
What is hirsutism?
Excess terminal hair growth in women in an androgen-dependent distribution (face, chest, back, abdomen)
Results from androgen excess or increased sensitivity of hair follicles to normal androgen levels.
What is the most common cause of hirsutism?
Polycystic Ovary Syndrome (PCOS)
Characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries.
What is idiopathic hirsutism?
Normal ovulation with no identifiable cause, often familial
A common type of hirsutism.
Name two other causes of hirsutism.
- Non-classic congenital adrenal hyperplasia (CAH)
- Cushing syndrome
- Androgen-secreting tumors
- Medications (e.g., danazol, anabolic steroids)
These can contribute to androgen excess or sensitivity.
What is the first step in the evaluation of hirsutism?
History & Physical examination
Assess onset, progression, menstrual pattern, and signs of virilization.
What lab test would indicate an ovarian tumor in hirsutism evaluation?
Total testosterone >200 ng/dL
Markedly elevated testosterone levels suggest potential ovarian tumor.
What DHEA-S level would suggest an adrenal tumor?
DHEA-S >700–800 mcg/dL
Indicates significantly high adrenal production.
What imaging test is used to assess for polycystic ovaries?
Pelvic ultrasound
Useful for evaluating ovarian morphology in suspected PCOS.
What is the first-line treatment for hirsutism?
Combined Oral Contraceptives (COCs)
Suppress ovarian androgen production and improve menstrual regularity.
What is a common add-on treatment for refractory hirsutism cases?
Anti-androgens
Used if there is no improvement with COCs alone.
Name an anti-androgen that is an androgen receptor blocker.
Spironolactone
May take 6–12 months for effect and must be used with contraception.
What is flutamide?
A nonsteroidal anti-androgen
Less commonly used due to hepatotoxicity.
What role does weight loss play in the management of hirsutism?
Improves insulin resistance and hyperandrogenism, especially in PCOS
Weight loss can significantly impact symptoms.
What are some hair removal methods for hirsutism?
- Shaving
- Waxing
- Laser therapy
- Electrolysis
These methods may be used concurrently with other treatments.
What should be done if an adrenal or ovarian tumor is suspected?
Imaging is warranted
Look for sudden onset and rapid progression of symptoms.
How is PCOS-related hirsutism typically managed?
With COCs ± anti-androgens and lifestyle changes
Focus on hormonal regulation and weight management.
What treatment is used for non-classic CAH?
Glucocorticoids (e.g., dexamethasone)
Helps to manage hormone levels effectively.
What are potential complications of hirsutism?
- Psychological distress
- Cosmetic concern
- Underlying untreated endocrine disorder
- Feminization of male fetus if pregnancy occurs while on anti-androgens
These complications highlight the importance of management.
How long may it take to see the full effect of treatment for hirsutism?
6–12 months
Patients should be informed about the timeline for treatment effectiveness.
True or False: All anti-androgens should be used with effective contraception.
True
Essential to prevent risks associated with pregnancy.
Fill in the blank: Hair removal methods may be used concurrently but do not treat the _______.
underlying cause
They provide temporary relief but do not address hormonal imbalances.
