Laboratory parameters of the 1st order – obligatory laboratory tests. Luteinizing hormone (LH). Testosterone* Androstenedione* Dehydroepiandrostenedione (DHEA) or dehydroepiandrostenedione sulfate (DHEAS). Sex hormone binding globulin (SHBG) Dihydrotestosterone Note: From the testosterone and SHBG serum concentration, the free androgen index (FAI) can be determined. The FAI is the measure of the proportion of free and therefore … Hirsutism: Test and Diagnosis
Therapeutic target Improvement of the symptomatology Therapy recommendations The therapeutic recommendations listed here refer only to idiopathic hirsutism. The type of therapy, whether local or systemic, depends on the severity and the patient’s situation (premenopausal, with or without a desire for children or contraception (birth control pills), or postmenopausal). Systemic endocrine therapies (hormone therapies) are … Hirsutism: Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – to examine the adrenal glands and ovaries (ovaries). Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Computed tomography (CT) of the abdomen (abdominal CT)/pelvis (pelvic CT) – … Hirsutism: Diagnostic Tests
To prevent hirsutism, attention must be paid to reducing individual risk factors. Behavioral risk factors Overweight (BMI ≥ 25, obesity).
The following symptoms and complaints may indicate hirsutism: Leading symptoms Increased hairiness of the terminal hairs (long hairs) of the female according to a male distribution pattern in the following areas: Of the sideburns (of the jaw area near the ear), the upper lip and on the chin. Of the upper sternum area, around the … Hirsutism: Symptoms, Complaints, Signs
Pathogenesis (development of disease) As a rule, hirsutism occurs idiopathically. In southern women, there is mainly familial idiopathic hirsutism. Idiopathic hirsutism is due to increased endoorgan responsiveness to normal serum androgen levels. Etiology (Causes) Biographic causes Hormonal factors – menopause (female menopause): idiopathic hirsutism. Behavioral causes Overweight (BMI ≥ 25, obesity). Disease-related causes Congenital malformations, … Hirsutism: Causes
General measures Bleaching the hair Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight. Review of permanent medication due topossible effect on the existing disease. Epilation therapy … Hirsutism: Therapy
Medical history (history of the patient) represents an important component in the diagnosis of hirsutism. Family history Are there any conditions in your family that are common? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). In which parts of the body is there increased hairiness? Sideburns (of the jaw area near the ear), … Hirsutism: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Hermaphroditism verus (hermaphroditism). Endocrine, nutritional, and metabolic diseases (E00-E90). Abnormal cortisol metabolism Adrenogenital syndrome (AGS) – autosomal recessive inherited metabolic disorder characterized by disorders of hormone synthesis in the adrenal cortex; these disorders result in deficiency of aldosterone and cortisol; in girls, virilization (masculinization) and pubertas praecox (premature … Hirsutism: Or something else? Differential Diagnosis
Severity hirsutism For objectification, the Baron assessment or the Ferriman-Gallwey score have proven useful. Assessment according to Baron Grade Description Grade I (light) Hairline from the genital area to the navel, Hairiness upper lip, perimamillary Grade II (intermediate) Same as Grade I, plus: Hairiness chin, inner thighs. Grade III (strong) Same as grade II, plus: … Hirsutism: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Abdominal wall and inguinal region (groin area) [objective evaluation of distribution/quantity of hair: increased hairiness of the terminal hair (long hair) of the female according … Hirsutism: Examination
