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Idiopathic hirsutism: an uncommon cause of hirsutism in Alabama

1998; Elsevier BV; Volume: 70; Issue: 2 Linguagem: Inglês

10.1016/s0015-0282(98)00141-1

1556-5653

Ricardo Azziz, W. Waggoner, Theresa J. Ochoa, Eric S. Knochenhauer, Larry R. Boots,

Ovarian cancer diagnosis and treatment

Abstract Objective: To determine the prevalence of idiopathic hirsutism among a population of consecutive hirsute patients. Design: Prospective cohort study. Setting: University-based clinic. Patient(s): Premenopausal women with a complaint of hirsutism who were not receiving hormonal therapy. Intervention(s): Evaluations for total and free testosterone, (T), 17-hydroxyprogesterone (17-HP), and DHEAS serum levels. Main Outcome Measure(s): Ovulatory function in women with cycles of ≤35 days in length was assessed with a basal body temperature (BBT) calendar and day 22–24 progesterone levels. Result(s): Of 132 consecutive hirsute women studied, 68 had cycles of >35 days in length. Of the remaining 64 patients, 25 also had oligo/anovulation by BBT and day 22–24 progesterone level. Of the 39 patients with hirsutism and regular ovulatory function, 22 had total and free T and DHEAS levels within normal limits. Conclusion(s): If idiopathic hirsutism is defined by the presence of hirsutism, regular ovulation, and normal androgen levels, only 17% of consecutive hirsute patients can be diagnosed with the disorder. Alternatively, if idiopathic hirsutism is based solely on the presence of hirsutism and regular ovulation, regardless of androgen levels, then 29% of the total hirsute population can be considered as having idiopathic hirsutism. Importantly, 40% of hirsute patients with a history of "regular cycles" were actually oligo/anovulatory, indicating the need to objectively assess ovulatory function in such patients.