Hirsutism: Diagnosis and management

Gend Med. 2010 Apr;7(2):79-87. doi: 10.1016/j.genm.2010.04.002.


Background: Hirsutism is defined as excess hair growth in androgen-dependent areas of the body in women.

Objective: This article provides an updated review of hirsutism, focusing on the etiologies, clinical features, approach to diagnostic evaluation, and treatment options.

Methods: The PubMed database was searched for English-language articles published from 1981 to the present, using the terms hirsutism, polycystic ovarian syndrome, congenital adrenal hyperplasia, hirsutism diagnosis, and hirsutism treatment. Reference lists from review articles on hirsutism during this time period were also examined.

Results: While there are many causes of hirsutism, the majority of patients have a benign process that may be idiopathic. In some circumstances, hirsutism is a sign of functional ovarian hyperandrogenism or congenital adrenal hyperplasia. Even more rarely, it is the presenting sign of an internal malignancy.

Conclusions: Hirsutism clinically presents in women as excessive hair growth in androgen-dependent areas. It is a particularly important diagnosis to make, because it often significantly affects a woman's perception of her femininity and less commonly can be a sign of an underlying malignancy or a cutaneous manifestation of a condition with significant cardiovascular or other morbidity. A variety of treatments exist to help minimize the appearance of unwanted hair.

Publication types

  • Review

MeSH terms

  • 5-alpha Reductase Inhibitors
  • Adrenal Hyperplasia, Congenital / complications
  • Causality
  • Contraceptives, Oral / therapeutic use
  • Diagnosis, Differential
  • Eflornithine / therapeutic use
  • Female
  • Finasteride / therapeutic use
  • Hair Removal / methods
  • Hirsutism / diagnosis*
  • Hirsutism / epidemiology
  • Hirsutism / etiology
  • Hirsutism / therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Laser Therapy / methods
  • Metformin / therapeutic use
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Neoplasms / complications
  • Ornithine Decarboxylase Inhibitors
  • Polycystic Ovary Syndrome / complications
  • Spironolactone / therapeutic use


  • 5-alpha Reductase Inhibitors
  • Contraceptives, Oral
  • Hypoglycemic Agents
  • Mineralocorticoid Receptor Antagonists
  • Ornithine Decarboxylase Inhibitors
  • Spironolactone
  • Finasteride
  • Metformin
  • Eflornithine