Hirsutism natural history, complications and prognosis

Hirsutism Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Hirsutism from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Echocardiography or Ultrasonography
Treatment
Medical Therapy Pharmacological therapy Non-pharmacological therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hirsutism natural history, complications and prognosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hirsutism natural history, complications and prognosis
CDC on Hirsutism natural history, complications and prognosis
Hirsutism natural history, complications and prognosis in the news
Blogs on Hirsutism natural history, complications and prognosis
Directions to Hospitals Treating Hirsutism natural history, complications and prognosis
Risk calculators and risk factors for Hirsutism natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rasam Hajiannasab M.D.[2]

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

Natural History, Complications and Prognosis

Natural History

The patient's age of onset of hirsutism can be helpful in the etiologic diagnosis.

• Age of onset
  • Idiopathic hirsutism and hirsutism with benign causes usually begin at puberty.
  • Hirsutism due to adrenal or ovarian tumors usually occurs in middle-aged and older women.
• Family history: A positive family history of hirsutism is consistent with congenital adrenal hyperplasia (CAH); however, idiopathic hirsutism and polycystic ovary syndrome (PCOS) can also be familial.
• Hirsutism severity and rate of progression
  • The benign forms of hirsutism such as hirsutism due to PCOS and idiopathic hirsutism are usually characterized by pubertal onset with slow progression over many years.
  • In patients with rapid and severe hirsutism or other signs of virilization, ovarian or adrenal tumors should be considered.
• Adrenarche and puberty
  • Early development of pubic hair points toward CAH, because the development of pubic hair depends on adrenal androgens
  • In patients with ovarian hyperandrogenism normal adrenarche and delayed menarche or irregular menses would be expected.

Complications

Hirsutism sometimes can lead to significant psychological distress in patients. As well as the physical signs of excess hair, hirsutism can affect patients psychologically (mentally). It can cause embarrassment and affect patient's self-confidence, and therefore the quality of life.Some women feel self-conscious about having unwanted body hair or even may develop depression. Also, although hirsutism doesn't cause physical complications, the underlying cause of a hormonal imbalance can. For example if hirsutism is due to PCOS , it can lead to infertility.

Prognosis

Prognosis depends on the underlying cause.

Pubertal onset hirsutism, mild hirsutism with slow progression are usually due to benign causes .

In cases of late onset hirsutism (in older women) , rapid and severe hirsutism with other signs of virilization ( including frontal balding, clitoromegaly, increased muscle mass, or deepening of the voice)  , adrenal or ovarian tumors should be considered.