[Etiological diagnosis of hirsutism in premenopausal Iranian women]

ABSTRACT

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. 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. 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%]. 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