Hirsutism in Women

CLINICAL DIAGNOSTIC MANUAL

Hirsutism in women refers to the excessive growth of terminal hair in areas where it is normally minimal or non-existent, such as the face, chest, abdomen, and back. This thick, dark hair can cause considerable emotional distress and affect the quality of life of the patients.

Hirsutism may be due to increased levels of androgens or increased sensitivity of the hair follicles to these hormones.

It is essential to identify the underlying cause of hirsutism in order to provide appropriate treatment and improve the quality of life of the patients.

Pathology	Clinical Symptoms and Signs	Suspicion Diagnosis	Confirmation Diagnosis
Racial Cutaneous Sensitivity	Excessive hair growth in patterns specific to certain ethnicities. No other signs of virilization or endocrine dysfunction.	Clinical history and physical examination. Evaluation of family and ethnic patterns.	Clinical diagnosis based on the evaluation of hair distribution.
Polycystic Ovary Syndrome (PCOS)	Menstrual irregularities, acne, androgenic alopecia, obesity. Excessive hair in typically male areas.	Clinical history and physical examination. Pelvic ultrasound (ovarian cysts).	Elevated testosterone levels, altered LH/FSH ratio.
Ovarian or Adrenal Carcinoma	Virilization, deep voice, increased muscle mass, clitoromegaly. Excessive hair in typically male areas.	Clinical history and physical examination. Abdominal CT or MRI.	Elevated androgen levels. Confirmatory biopsy.
Cushing’s Syndrome	Weight gain, moon face, purple striae, hypertension, osteoporosis. Excessive hair in typically male areas.	Clinical history and physical examination. Dexamethasone suppression test.	Elevated cortisol levels. Imaging of adrenal glands.