E J van Zuuren, H Pijl
Nederlands Tijdschrift Voor Geneeskunde 2007 October 20, 151 (42): 2313-8
--Hirsutism, defined as excessive growth of terminal hair in a male-type pattern, is prevalent in women and is most often a feature of androgen excess, associated with polycystic ovary syndrome (PCOS). Idiopathic hirsutism is the second most common cause. In a small minority of cases, hirsutism is the result of a serious adrenal or ovarian disorder. --The primary aim of diagnostic procedures is to establish or exclude underlying pathology. In the case ofhirsutism, i.e. a modified Ferriman and Gallwey score > 6, analysis of circulating androgen levels and other relevant endocrine parameters is indicated. --Adrenal or ovarian pathologies require primary therapy. --Hirsutism in women with PCOS, or without measurable changes in plasma androgen levels, can be treated with drugs either inhibiting ovarian or adrenal androgen production, blocking androgen receptors or inhibiting 5alpha-reductase in the hair follicle. --Spironolactone or cyproterone acetate combined with an oral contraceptive is the safest and most effective therapeutic approach. --Weight loss is an important part of the treatment of obese, hirsute women with PCOS.

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