In order to hopefully treat and prevent recurrence of hirsutism we need to understand and — if possible — remove the underlying causes and risk factors. We need to ask: "What else is going on inside the body that might allow hirsutism to develop?"
Accurate diagnosis of the factors behind hirsutism consists of three steps:
suspected adrenal insufficiency
recent onset vomiting
often/always feeling unusually cold
having hot flashes
tender muscles
sexual abuse during childhood
slow recovery from colds/flu
darker/redder skin color
unexplained missed periods
low systolic blood pressure
pre/menstrual depression
ovarian cysts| Cause | Probability | Status |
|---|---|---|
| Polycystic Ovary Syndrome | 91% | Confirm |
| Low Progesterone | 61% | Possible |
| Ovarian Cysts | 12% | Unlikely |
| Adrenal Fatigue | 2% | Ruled out |
| Cerebral Gland Dysfunction | 2% | Ruled out |
| High Female Testosterone | 2% | Ruled out |
|
Do you have any hair growth pattern that is usually seen in males? This means increased hair on the chest/nipples, above the pubic area toward the navel, or on the chin or upper lip.
Possible responses:
→ Don't know→ No → Very minor → Somewhat / one or two areas → Very noticeable / in several areas |
A study by the Royal College of Obstetricians and Gynaecologists, reported by the BBC in April of 2009, found that 70-80% of cases of female Hirsutism are caused by polycystic ovarian syndrome, an abnormality of the ovaries where many small cysts appear due to elevated testosterone levels.
It has been a tradition to divide patients with hirsutism into those with no elevation of serum androgen levels and no other clinical features ('idiopathic hirsutism') and those with an identifiable endocrine imbalance (most commonly PCOS or rarely other causes). However, in recent years it has become apparent that most patients with 'idiopathic hirsutism' have some radiological or biochemical evidence of PCOS on more detailed investigation.