Hirsutism causes

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Hirsutism Microchapters


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Historical Perspective




Differentiating Hirsutism from other Diseases

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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]


The cause of hirsutism can be either an increased level of androgens (male hormones) or an oversensitivity of hair follicles to androgens, and the most common cause is polycystic ovary syndrome. Male hormones such as testosterone stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass. Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

  • There are no known life threatening causes of hirsutism.

Common Causes

Causes by Organ System

Cardiovascular Insulin resistance syndrome
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Dermatomyositis
Drug Side Effect Aripiprazole, bimatoprost, bupropion, carbamazepine, clonazepam, corticosteroids, cyclosporine, danazol, dantrolene, desogestrel and ethinyl estradiol, dexamethasone, diazoxide, donepezil, estrogens, eszopiclone, ethosuximide, ethotoin, ethynodiol diacetate and ethinyl estradiol, fluoxetine, fluoxymesterone, gestrinone, interferon alfa, isotretinoin, lamotrigine, leuprolide, methyltestosterone, mycophenolate, olanzapine, oxandrolone, oxymetholone, paroxetine, phenytoin, prednisolone, pregabalin, progestin, selegiline, tacrolimus, testosterone, tiagabine, trazodone, valproic acid, vasodilators, venlafaxine, zonisamide
Ear Nose Throat No underlying causes
Endocrine Acromegaly, adrenal adenoma, adrenal carcinoma, adrenal tumor, arrhenoblastoma, congenital adrenal hyperplasia, Cushing syndrome, Cushing's disease, hyperprolactinemia, hypothyroidism, insulin resistance syndrome, luteoma, pituitary tumor, polycystic ovary syndrome, porphyria cutanea tarda, Stein-Leventhal syndrome, testosterone
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic 11β-hydroxylase deficiency, 21-hydroxylase deficiency, Achard-Thiers syndrome, alpha-L-iduronidase deficiency, Ambras syndrome, Coffin-Siris syndrome, congenital adrenal hyperplasia, Cornelia de Lange Syndrome, Hurler syndrome, hypertrichosis lanuginosa, Miller-Dieker syndrome, nodulosis-arthropathy-osteolysis syndrome, Turner syndrome
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Alpha-L-iduronidase deficiency, cortisone reductase deficiency, Hurler syndrome, i-cell disease, porphyria cutanea tarda
Obstetric/Gynecologic Ovarian cancer, ovarian hyperthecosis, ovarian tumor, polycystic ovary syndrome, Stein-Leventhal syndrome
Oncologic Adrenal adenoma, adrenal carcinoma, adrenal tumor, arrhenoblastoma, luteoma, ovarian cancer, ovarian tumor, pituitary tumor, testicular tumor
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Dermatomyositis, insulin resistance syndrome
Sexual Ovarian cancer, ovarian hyperthecosis, ovarian tumor, polycystic ovary syndrome
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Idiopathic hirsutism

Causes in Alphabetical Order


  1. 1.0 1.1 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.
  2. Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR (2004). "Androgen excess in women: experience with over 1000 consecutive patients". J. Clin. Endocrinol. Metab. 89 (2): 453–62. doi:10.1210/jc.2003-031122. PMID 14764747.
  3. Goldman JM, Kapadia LJ (1991). "Virilization in a postmenopausal woman due to ovarian stromal hyperthecosis". Postgrad Med J. 67 (785): 304–6. PMC 2399029. PMID 2062784.

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