Hirsutism laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
It is important to carry out various biochemical tests to determine the cause of hirsutism that is necessary to make an informed decision for the best options for treatment.
Laboratory Finding
- Testosterone - Serum testosterone may be normal to increased in case of benign pathology as PCOS and CAH but would be definitely raised (>200 ng/ml) in case of malignant tumor of the adrenal or ovary.[11]
- Dehydroepiandrosterone sulfate (DHEAS) - Raised DHEAS (>700 μg/dl) always indicates an adrenal cause, benign or malignant.
- 17 Hydroxy progesterone - This serum marker is unique for congenital adrenal hyperplasia. The measurement should be done between 0700 and 0900 hours in the early follicular phase of the menstrual cycle. Levels less than 200 ng/dl excludes the disease. Mildly increased levels between 300 and 1,000 ng/dl require an ACTH stimulation test. Cosyntropin (synthetic ACTH), 250 μg, is administered intravenously, and levels of 17-hydroxyprogesterone are measured before and one hour after the injection. Post-stimulation values (>1,000 ng/dl) constitute a positive test.[11]
- Twenty four hour urine free cortisol should be measured in women with signs and symptoms of Cushing's syndrome.
- LH/FSH greater than 3 is indicative of PCOS.[12]
- Prolactin would be raised in hyperprolactinemia due to hypothalamic disease or a pituitary tumor.
- Serum TSH: Hypophyseal hypothyroidism[13] can act as a cofactor in hirsutism causing raised TSH