Etiological review of hirsutism in 250 patients

RESUMO

Two hundred fifty women with hirsutism were studied, with a mean age of 25.5 years (ranging from 13 to 38 years). The evolution of hirsutism varied from 3 months to 13 years, being minimal in 82 patients (33 per cent), mild in 101 (40 per cent), moderate in 56 (23 per cent) and severe in the remaining 11 women (4 per cent). Polycystic ovary syndrome (PCOS) was diagnosed in 134 patients (53 per cent), overweight or obesity in 45 (18 per cent), late-onset adrenal hyperplasia in five (2 per cent), ovarian tumor in two (0.8 per cent), drug-induced hirsutism and Cushing's syndrome in one patient each (0.4 per cent), and idiopathic hirsutism in 62 cases (25 per cent). Among 67 patients with moderate or severe hirsutism, testosterone was elevated in 21 (31 per cent). In 117 out of 206 (57 per cent) cases polycystic ovaries were observed by ultrasound. Fifty-four patients were treated with a combination of 2 mg cyproterone acetate and 0.035 mg ethinyl estradiol, observing improvement of hirsutism in 32 patients (59 per cent). It is concluded that PCOS is the most frequent cause of hirsutism, but an important proportion of cases without evident etiology remain classified as idiopathic hirsutism