Bulent O Yildiz
Hirsutism, defined as excessive male-pattern terminal hair growth in females, affects about 510% of the women of reproductive age depending on the population studied and the method used to determine its presence. Hirsutism is the primary clinical diagnostic criterion of hyperandrogenism. Hyperandrogenism can result from increased androgen production and/or increased sensitivity of hair follicles to androgens. The presence of hirsutism in women can lead to significant psychologic morbidity and can negatively influence the quality of life. The Ferriman-Gallwey scoring system is the preferred method today for the assessment of hirsutism. However, this system is semiquantitative at best, and is subject to inherent problems, particularly because of the inter-observer variability in results. The evaluation of a hirsute patient includes a thorough history, a careful physical examination and a focused laboratory work-up. Most patients with hirsutism will have an underlying endocrine abnormality with androgen excess, the most common of which being the polycystic ovary syndrome. Management of hirsutism generally includes the pharmacological approaches for the suppression of androgens and the reduction of their end-organ effects, combined with appropriate mechanical/cosmetic treatments.