Journal of

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Background and Aim: Hirsutism is defined as the presence of terminal hairs in androgen dependent areas in women. It is a common clinical condition and affects 5% to 10% of women of reproductive age. The aim of this study was to determine the clinical features and etiologic factors of hirsutism in premenopausal women.
Methods: In this cross-sectional study, 200 premenopausal women with hirsutism who were admitted at our dermatologic clinic during a 2-year period were nivestigated. After a careful history and physical examination, a transabdominal ultrasonography of the ovaries and laboratory evaluation including early morning total testosterone, prolactin, dehydroepiandrosterone sulfate (DHEA-S) and 17-hydroxyprogestron in all patients and thyroid stimulating hormone (TSH) in 10 patients were performed.
Results: Polycystic ovary syndrome (PCOS) was the most common cause of the hirsutism (54.5%) followed by idiopathic hirsutism (40%). Other causes of hirsutism were prolactinoma (2%), hypothyroidism (1%) and drugs intake (2.5%). Hirsutism was mild in 109 patients (54.5%), moderate in 85 patients (42.5%) and severe in 6 patients (3%). Family history of hirsutism was present in 105 (52.5%) patients. Clinical conditions associated with hirsutism were: acne (52.5%), menstrual irregularity (35%), androgenetic alopecia (15%), acanthosis negricans (7.5%) and obesity (37.5%).
Conclusion: PCOS and idiopathic hirsutism are the most common cause of the hirsutism in premenopausal women. A detailed history and physical exam often provide enough information to determine the etiology of hirsutism.

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Background and Aim: Adolescents with polycystic ovary syndrome concern about weight gain, menstrual irregularities, acne and hirsutism. The aim of this study was to determine the frequency of facial and trunkal lesions of acne in 14- to 18-year-old high school students with polycystic ovary syndrome in Shiraz in 2009.
Methods: In this cross-sectional study, 3189 14- to 18-year-old female students were enrolled.  Using questionnaires, data on personal information, clinical features and laboratory findings of hyperandrogenism and results of ultrasound examination were collected. Severity of acne was classified as mild, moderate and severe, based on the type and number of the lesions. Chi-squared and independent t tests were used for comparing proportions and means, respectively.
Results: The prevalence of severe acne was 5%. Mean total testosterone in individuals with severe acne was higher in comparison with those without acne. Severity of facial and trunkal acne were associated with polycystic ovaries (P<0.05). Mean level of luteinizing hormone (LH) was higher in those without acne than in those with severe acne (P >0.05).
Conclusion: Associations between severity of facial and trunkal acne lesions and polycystic ovaries were observed. Considering the undesirbale effects of acne on quality of life, hormonal screening and ultrasound examination in girls with moderate acne is recommended.

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Despite the large number of patients presenting with hirsutism and high prevalence of polycystic ovary syndrome, for which hirsutism is an important sign, no national guidelines are currently available to Iranian primary-care and family physicians for its diagnosis and management. We have integrated highest levels of evidence and expert consensus to provide a national guideline to standardize and unify the Iranian primary-care and family physician’s approach to hirsutism.

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Background and Aim: Hirsutism is defined as the presence of terminal hairs in androgen dependent areas like upper lip, cheeks, chin, breasts, lower area of abdomen and thigh in women. The aim of this study was to determine the etiologic factors and clinical features of hirsutism in premenopausal women.

Methods: In this cross-sectional study, 180 premenopausal women with hirsutism who were admitted at a referral dermatologic clinic in a 1-year period were investigated. After taking full medical history and performing physical examinations, a transabdominal ultrasonography of the ovaries, and laboratory evaluation including early morning total and free serum testosterone, prolactin, dehydroepiandrosterone sulfate, FSH, LH and 17-hydroxyprogestron in all patients were performed.

Results: The most common causes of hirsutism were idiopathic (51.1%), polycystic ovarian syndrome (37.7%), hyperprolactinemia (4.4%), adrenal hyperplasia (3.8%), and drug-induced (2.8%). Hirsutism was mild in 93 (51.6%) patients, moderate in 78 (43.3%) patients and severe in 9  (5%) patients. Family history of hirsutism was present in 100 patients. Clinical conditions associated with hirsutism were: acne (58.3%), obesity (55.5%), menstrual irregularity (38.8%), androgenic alopecia (17.7%) and acanthosis negricans (8.4%).

Conclusion: Idiopathic hirsutism and polycystic ovary syndrome were the most common causes of the hirsutism in premenopausal women. Obesity also had a significant role in hirsutism occurrence.