Hirsutism Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Hirsutism from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis Diagnosis Diagnostic Criteria History and Symptoms Physical Examination Laboratory Findings MRI Echocardiography or Ultrasonography Treatment Medical Therapy Pharmacological therapy Non-pharmacological therapy Surgery Primary Prevention Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Hirsutism history and symptoms On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images Ongoing Trials at Clinical Trials.gov US National Guidelines Clearinghouse NICE Guidance FDA on Hirsutism history and symptoms CDC on Hirsutism history and symptoms Hirsutism history and symptoms in the news Blogs on Hirsutism history and symptoms Directions to Hospitals Treating Hirsutism history and symptoms Risk calculators and risk factors for Hirsutism history and symptoms Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2] Rasam Hajiannasab M.D.[3], Ahmed Younes M.B.B.CH [4] ## Overview[edit | edit source] The hallmark of hirsutism is excessive facial hair growth. A positive history of virilizing symptoms is suggestive of an underlying hormonal imbalance. The most important points in history taking regarding hirsutism in patients include: Age of onset, family history, and severity/progression. ## History and Symptoms[edit | edit source] ### History[edit | edit source] * A good and accurate history of the onset and developmental milestones are important and useful in making a diagnosis of hirsutism.[1] #### Age of Onset[edit | edit source] * During puberty * Mainly due to idiopathic hirsutism and other less serious causes of hirsutism * Hirsutism in middle-aged or older women * May suggest an adrenal or ovarian tumor #### Family History[edit | edit source] * Congenital adrenal hyperplasia (CAH) in a patient with a family history of hirsutism is consistent with the diagnosis. Idiopathic hirsutism and polycystic ovary syndrome (PCOS) could also be familial and may be suggestive in making a diagnosis. #### Hirsutism severity and rate of progression[edit | edit source] * A benign form of hirsutism is usually characterized by pubertal onset with slow progression over many years. This is often true of hirsutism with PCOS. * An androgen-secreting tumor is a possibility with a history of rapid severe hirsutism or other signs of virilization. * Adrenarche and Puberty: Early development of pubic hair is a pointer towards CAH. ### Common Symptoms[edit | edit source] * Patients must be assessed regarding the presence or lack of virilizing signs such as:[2] * Change in the voice or deepening voice * Male pattern baldness * Excess facial and body hair * Clitoromegaly (enlargement of the clitoris) * Increased muscle mass * Acne * Decreased breast size * Amenorrhea * Increased libido * Signs of insulin resistance (eg, acanthosis nigricans, abdominal obesity) ### Less Common Symptoms[edit | edit source] ## References[edit | edit source] 1. ↑ Ruutiainen K, Erkkola R, Grönroos MA, Irjala K (1988). "Influence of body mass index and age on the grade of hair growth in hirsute women of reproductive ages". Fertil. Steril. 50 (2): 260–5. PMID 3396696. 2. ↑ Sachdeva S (2010). "Hirsutism: evaluation and treatment". Indian J Dermatol. 55 (1): 3–7. doi:10.4103/0019-5154.60342. PMC 2856356. PMID 20418968.