Hirsutism may be the expression of hyperandrogenia of ovarian or adrenal origin, iatrogenic or idiopathic/familial. Regardless of the etiology, there is a negative impact of body hair excess on the self-image, the self-esteem and the sexual satisfaction of subjects. The present study aimed to evaluate 60 women, aged 26.3 years, with hirsutism as the primary symptom. At presentation, basal FSH, LH and testosterone levels, urinary 24-hours 17-ketosteroids and DHEA, and an abdominal ultrasound evaluation were performed. In subjects in whom abnormal results were obtained, the diagnostic evaluation continued. Records of clinical data showed that 75% of women were obese and in 53% of women other signs of hyperandrogenia were noticed. Amenorrhea was recorded in 62.5% of cases. Of the 60 patients, a tumor (ovarian, adrenal or pituitary) was found in 11 women (18.3%), 23 were diagnosed with polycystic ovary disease (38.3%) and 12 (20%) had laboratory data suggesting an adrenal enzymatic defect. Of the 60 patients, 10 (16.6%) women with hirsutism and clinical signs of metabolic syndrome had slightly increased basal testosterone levels but normal day 3 FSH, LH levels, FSH/LH ratio and ultrasound evaluation. Only 4 (6.6%) of women were diagnosed with idiopathic hirsutism. Mean levels of testosterone, 17-ketosteroids and urinary DHEA were above the upper range in the studied group; mean testosterone concentration was significantly higher in women suffering from virilizing syndrome as compared to women with hirsutism as the solely complaint (2.3±0.7 ng/ml vs 1.7±0.5 ng/ml, P<0.01) but no difference was seen with regard to urinary 17-ketosteroids levels (17.7±4.1 mg/24 h vs 16.5±3.1 mg/24 h, P>0.05) or urinary DHEA levels (1.9±0.8 mg/24 h vs 1.9±0.6 mg/24 h, P>0.05). In conclusion, in most cases hirsutism is the expression of a dysfunctional hormonal state. There is a significant correlation between testosterone levels and clinical characteristics.
01 - 05 Apr 2006
European Society of Endocrinology