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.