Hirsutism medical therapy: Difference between revisions
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* [[Gonadotropin-releasing hormone agonist]]<nowiki/>s :An alternative to [[oral contraceptives]]<ref name="Rosenfield2005">{{cite journal|last1=Rosenfield|first1=Robert L.|title=Hirsutism|journal=New England Journal of Medicine|volume=353|issue=24|year=2005|pages=2578–2588|issn=0028-4793|doi=10.1056/NEJMcp033496}}</ref> | * [[Gonadotropin-releasing hormone agonist]]<nowiki/>s :An alternative to [[oral contraceptives]]<ref name="Rosenfield2005">{{cite journal|last1=Rosenfield|first1=Robert L.|title=Hirsutism|journal=New England Journal of Medicine|volume=353|issue=24|year=2005|pages=2578–2588|issn=0028-4793|doi=10.1056/NEJMcp033496}}</ref> | ||
If a [[tumor]] of [[ovaries]] or [[adrenal gland]]<nowiki/>s is the underlying cause of hirsutism, surgery may be the treatment option. | If a [[tumor]] of [[ovaries]] or [[adrenal gland]]<nowiki/>s is the underlying cause of hirsutism, surgery may be the treatment option. | ||
* Parenteral long acting gonadotropin-releasing hormone analogues combined with OCPs containing estrogen and progestin for severe hirsutism not respinding to OCPs and antiandrogen e.g Leuprolide. | * Parenteral long acting gonadotropin-releasing hormone analogues <ref name="pmid20198556">{{cite journal| author=Klotz RK, Müller-Holzner E, Fessler S, Reimer DU, Zervomanolakis I, Seeber B et al.| title=Leydig-cell-tumor of the ovary that responded to GnRH-analogue administration - case report and review of the literature. | journal=Exp Clin Endocrinol Diabetes | year= 2010 | volume= 118 | issue= 5 | pages= 291-7 | pmid=20198556 | doi=10.1055/s-0029-1225351 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20198556 }} </ref> combined with OCPs containing estrogen and progestin for severe hirsutism not respinding to OCPs and antiandrogen e.g Leuprolide. | ||
====Adrenal Suppression==== | ====Adrenal Suppression==== | ||
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====Antiandrogens==== | ====Antiandrogens==== | ||
* Finestride: A 5α-reductase inhibitor, 2.5mg daily. (this is rarely used because it causes fatal hepatitis with a high risk of being teratogenic. | * Finestride: A 5α-reductase inhibitor, 2.5mg daily. (this is rarely used because it causes fatal hepatitis with a high risk of being teratogenic. | ||
* Eflornithine hydrochloride cream (Vaniqa): Applied twice daily to the face. | * Eflornithine hydrochloride cream (Vaniqa): Applied twice daily to the face. | ||
===Non-Pharmacologic Treatment=== | ===Non-Pharmacologic Treatment=== | ||
Revision as of 17:43, 22 September 2017
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Hirsutism Microchapters |
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Diagnosis |
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Treatment |
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Medical Therapy |
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Case Studies |
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Hirsutism medical therapy On the Web |
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Risk calculators and risk factors for Hirsutism medical therapy |
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]
Overview
Many women with unwanted hair seek methods of hair removal to control the appearance of hirsutism. But the actual causes should be evaluated by physicians, who can conduct blood tests, pinpoint the specific origin of the abnormal hair growth, and advise on the best course of treatment.
Medical Therapy
Pharmacologic Treatment
Hormonal Therapy
- Oral contraceptives : Suppresses free testosterone level eg Yasmin which contains 30 microgram of estradiol and 3mg of drospirenone or Yaz (20microgram of estradiol and 3mg of drospirenone).
- Gonadotropin-releasing hormone agonists :An alternative to oral contraceptives[1]
If a tumor of ovaries or adrenal glands is the underlying cause of hirsutism, surgery may be the treatment option.
- Parenteral long acting gonadotropin-releasing hormone analogues [2] combined with OCPs containing estrogen and progestin for severe hirsutism not respinding to OCPs and antiandrogen e.g Leuprolide.
Adrenal Suppression
- Oral glucocorticoids : In patients with CAH eg Prednisone or Dexamethasone.
- Metformin for infertile women with PCOS.
Antiandrogens
- Finestride: A 5α-reductase inhibitor, 2.5mg daily. (this is rarely used because it causes fatal hepatitis with a high risk of being teratogenic.
- Eflornithine hydrochloride cream (Vaniqa): Applied twice daily to the face.
Non-Pharmacologic Treatment
- Cosmetic therapy : Bleaching, shaving, depilating agents, plucking, waxing treatments.
- Electrosurgical methods include electrosurgical epilation and Laser therapy which can remove unwanted hair for some women specially for women with dark hair and light skin.[3]
References
- ↑ Rosenfield, Robert L. (2005). "Hirsutism". New England Journal of Medicine. 353 (24): 2578–2588. doi:10.1056/NEJMcp033496. ISSN 0028-4793.
- ↑ Klotz RK, Müller-Holzner E, Fessler S, Reimer DU, Zervomanolakis I, Seeber B; et al. (2010). "Leydig-cell-tumor of the ovary that responded to GnRH-analogue administration - case report and review of the literature". Exp Clin Endocrinol Diabetes. 118 (5): 291–7. doi:10.1055/s-0029-1225351. PMID 20198556.
- ↑ Franks, Stephen (2012). "The investigation and management of hirsutism". Journal of Family Planning and Reproductive Health Care. 38 (3): 182–186. doi:10.1136/jfprhc-2011-100175. ISSN 1471-1893.