Hirsutism is the term used for women with excess growth of terminal hair in a male pattern. It is an endocrine disorder affecting about 10% of women. Excess hairness implies abnormal androgen activity which may present a serious or non serious medical problem. This hairness can produce extreme mental and emotional anguish in the affected women as it is presumed a cosmetic problem.
Adrenal tumors. Adrenocortical tumors are almost always malignant in patients with hirsutism. The tumors are usually large and are associated with poor prognosis.
Cushing syndrome. This syndrome is mostly caused by glucocorticoid therapy. There is excess hair growth on the face. Pituitary tumor is the most common cause of cushing syndrome.
Ovarian tumors. ovarian tumors can be either benign or malignant. Arrhenoblastoma is an androgen secreting tumor and they are a less serious threat. Patients with this tumor have high testosterone levels in blood and a palpable ovarian mass.
Gonadoblastomas. these are common in younger people who are genetic males with external female genitalia. Almost half of these tumors are malignant and are bilateral. Internal female organs are usually absent.
Lipoid cell tumors. they are usually malignant tumors.
Polycystic ovarian syndrome. This is the most common ovarian disorder associated with hirsutism which begins at puberty The cause of polycystic ovarian syndrome is not known but it is assumed to be multifactorial. Many women with PCOS have insulin resistance which is manifested by acanthosis nigricans and elevated plasma insulin levels. Increased insulin levels stimulate production of androgen which causes hirsutism.
Idiopathic hirsutism. idiopathic hirsutism is a diagnosis of exclusion. The cause of hairness is not caused by any abnormalities or androgen secreting tumors. The hairness usually begins at puberty.
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