Hirsutism history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hirsutism}} | {{Hirsutism}} | ||
{{CMG}} {{AE}} | {{CMG}} {{AE}} {{Ochuko}} {{RHN}}, {{AY}} | ||
==Overview== | ==Overview== | ||
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== | ==History and Symptoms== | ||
===History=== | ===History=== | ||
A good and accurate history of the onset and developmental [[milestones]] are important and useful in making a diagnosis of hirsutism. | * A good and accurate history of the onset and developmental [[milestones]] are important and useful in making a diagnosis of hirsutism.<ref name="pmid3396696">{{cite journal |vauthors=Ruutiainen K, Erkkola R, Grönroos MA, Irjala K |title=Influence of body mass index and age on the grade of hair growth in hirsute women of reproductive ages |journal=Fertil. Steril. |volume=50 |issue=2 |pages=260–5 |year=1988 |pmid=3396696 |doi= |url=}}</ref> | ||
==== '''Age of Onset''' ==== | |||
*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''' ==== | |||
* | * [[Congenital adrenal hyperplasia (CAH)]] in a patient with a family history of hirsutism is consistent with the diagnosis. [[Idiopathic]] hirsutism and [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] could also be familial and may be suggestive in making a diagnosis. | ||
==== '''Hirsutism severity and rate of progression''' ==== | |||
*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]]. | *'''[[Adrenarche]] and [[Puberty]]''': Early development of pubic hair is a pointer towards [[CAH]]. | ||
===Common Symptoms=== | |||
===Symptoms=== | *Patients must be assessed regarding the presence or lack of [[virilizing]] signs such as:<ref name="pmid20418968">{{cite journal |vauthors=Sachdeva S |title=Hirsutism: evaluation and treatment |journal=Indian J Dermatol |volume=55 |issue=1 |pages=3–7 |year=2010 |pmid=20418968 |pmc=2856356 |doi=10.4103/0019-5154.60342 |url=}}</ref> | ||
*[[ | **Change in the voice or deepening voice | ||
**Change in voice or deepening voice | |||
**[[Male pattern baldness]] | **[[Male pattern baldness]] | ||
**Excess facial and body hair | **Excess facial and body hair | ||
| Line 29: | Line 31: | ||
**Increased muscle mass | **Increased muscle mass | ||
**[[Acne]] | **[[Acne]] | ||
**Decreased breast size | **Decreased breast size | ||
*[[Amenorrhea]] | *[[Amenorrhea]] | ||
* | *Increased [[libido]] | ||
*Signs of [[insulin]] resistance (eg | *Signs of [[insulin]] resistance (eg, [[acanthosis nigricans]], abdominal obesity) | ||
=== Less Common Symptoms === | |||
* | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 15:22, 8 December 2020
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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
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
History
- 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
- 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
- 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
- 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
- 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
References
- ↑ 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.
- ↑ Sachdeva S (2010). "Hirsutism: evaluation and treatment". Indian J Dermatol. 55 (1): 3–7. doi:10.4103/0019-5154.60342. PMC 2856356. PMID 20418968.