Hirsutism natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hirsutism}} | {{Hirsutism}} | ||
{{CMG}} {{AE}} | {{CMG}}: {{AE}}; {{Ochuko}}; {{RHN}} | ||
==Overview== | ==Overview== | ||
[[Pubertal]] onset hirsutism specially when it is mild ,points toward [[PCOS]] or idiopathic hirsutism but sever late onset hirsutim with other virlization signs can be due to [[ovarian]] or [[adrenal]] [[tumor]]<nowiki/>s. Hirsutism can lead to significant [[psychological]] distress for women and even [[depression]] if left untreated and based on the underlying cause other medical complications can occur (e.g. in cases of hirsutism due to [[PCOS]] , if the treatment doesn't address PCOS , it can lead to [[infertility]].) [[Prognosis]] depend on underlying [[etiology]] . | |||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
The patient's age of onset of hirsutism can be helpful in the [[etiologic]] diagnosis. | |||
* [[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|mense]]<nowiki/>s would be expected.<ref name="pmid19567450">{{cite journal |vauthors=Yildiz BO, Bolour S, Woods K, Moore A, Azziz R |title=Visually scoring hirsutism |journal=Hum. Reprod. Update |volume=16 |issue=1 |pages=51–64 |year=2010 |pmid=19567450 |pmc=2792145 |doi=10.1093/humupd/dmp024 |url=}}</ref> | |||
===Complications=== | ===Complications=== | ||
Hirsutism sometimes can lead to significant [[psychological]] distress in patients.<ref name="pmid16880018">{{cite journal |vauthors=Lipton MG, Sherr L, Elford J, Rustin MH, Clayton WJ |title=Women living with facial hair: the psychological and behavioral burden |journal=J Psychosom Res |volume=61 |issue=2 |pages=161–8 |year=2006 |pmid=16880018 |doi=10.1016/j.jpsychores.2006.01.016 |url=}}</ref> 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=== | ||
[[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.<ref name="pmid19567450">{{cite journal |vauthors=Yildiz BO, Bolour S, Woods K, Moore A, Azziz R |title=Visually scoring hirsutism |journal=Hum. Reprod. Update |volume=16 |issue=1 |pages=51–64 |year=2010 |pmid=19567450 |pmc=2792145 |doi=10.1093/humupd/dmp024 |url=}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 19:58, 13 October 2017
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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]
Overview
Pubertal onset hirsutism specially when it is mild ,points toward PCOS or idiopathic hirsutism but sever late onset hirsutim with other virlization signs can be due to ovarian or adrenal tumors. Hirsutism can lead to significant psychological distress for women and even depression if left untreated and based on the underlying cause other medical complications can occur (e.g. in cases of hirsutism due to PCOS , if the treatment doesn't address PCOS , it can lead to infertility.) Prognosis depend on underlying etiology .
Natural History, Complications and Prognosis
Natural History
The patient's age of onset of hirsutism can be helpful in the etiologic diagnosis.
- 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.[1]
Complications
Hirsutism sometimes can lead to significant psychological distress in patients.[2] 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.[1]
References
- ↑ 1.0 1.1 Yildiz BO, Bolour S, Woods K, Moore A, Azziz R (2010). "Visually scoring hirsutism". Hum. Reprod. Update. 16 (1): 51–64. doi:10.1093/humupd/dmp024. PMC 2792145. PMID 19567450.
- ↑ Lipton MG, Sherr L, Elford J, Rustin MH, Clayton WJ (2006). "Women living with facial hair: the psychological and behavioral burden". J Psychosom Res. 61 (2): 161–8. doi:10.1016/j.jpsychores.2006.01.016. PMID 16880018.