Hirsutism natural history, complications and prognosis: Difference between revisions
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===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. | 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=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
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.[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 begnin 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.