ABSTRACT Objective The aim of this study was to evaluate the efficacy of a self-assessment questionnaire for hirsutism using the latest cutoff values recommended by the Endocrine Society (ES) for Latin-American women and by the European Society for Human Reproduction and Embryology (ESHRE). Subject and methods Female premenopausal outpatients (n = 188) completed a self-assessment questionnaire, scoring hair presence across the nine areas evaluated by the modified Ferriman-Gallwey (mFG) scale. The results were compared with clinician-assessed scores rated independently by […]

Hirsutism is defined as excessive terminal hair growth in androgen-dependent areas of the body in women, which grows in a typical male distribution pattern. Hirsutism is a common clinical problem in women, and the treatment depends on the cause. The condition is often associated with a loss of self-esteem. Hirsutism reflects the interaction between circulating androgen concentrations, local androgen concentrations, and the sensitivity of the hair follicle to androgens. Polycystic ovary syndrome and idiopathic hirsutism are the most common causes […]

Polycystic ovarian syndrome (PCOS) is a lifelong disorder characterized by hyperandrogenism and ovulatory dysfunction, with a wide spectrum of clinical symptoms and signs. Three different sets of diagnostic criteria have been established in order to define this disease in adult women, but there is controversy regarding the use of these criteria in adolescence. During puberty, the adult criteria for ovulatory dysfunction does not seem applicable, because an irregular menstrual pattern and a decreased ovulatory rate is a physiologic event during […]

The polycystic ovary syndrome is one of the most common endocrinopathies, affecting approximately 7% of women of reproductive age. Although it was described in 1935, only in 1990 was published the first Consensus regarding it its diagnosis. Today, the syndrome is also considered a cardiovascular risk factor, with a high prevalence of metabolic disorders. Reflecting this new vision of the syndrome, several documents, including Consensus, Statement and Guidelines have been published, addressing different aspects of the syndrome. This review is […]

Adrenal incidentaloma is not infrequent and can be found in hirsute women. We report a case of a 54-year-old woman with amenorrhea and hirsutism of abrupt onset and mild signs of virilization that had an adrenal incidentaloma coexisting with ovarian hyperthecosis. Basal total and free testosterone were 191 ng/dL and 179 pmol/L. Pelvic ultrasonography disclosed a right ovary with 10.3 cc and a left ovary with 9.8 cc without nodules or cysts, and computerized tomography of the abdomen disclosed a […]

Hirsutism is one of the manifestations of the hyperandrogenic syndromes. A practical approach consists of dividing the hyperandrogenic syndromes into virilizing and non-virilizing, in accordance to the presence or absence of virilization symptoms. A case of a patient with hirsutism and a high basal and post-ACTH stimulation concentration of 17-OHP is presented. The absence of virilization and of clinical history discarded as etiology the virilizing neoplasias and hiperthecose of the ovary. Among the causes of non-virilizing syndromes, the presence of […]

Screening for non-classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) is performed with baseline 17-hydroxyprogesterone (17OHPb) and confirmed with the ACTH test. Because the cutoff level of 17OHPb that prompts an ACTH testing is still a matter of discussion, we evaluated the levels of 17OHPb in diagnosing CAH caused by 21OHD. An ACTH (0.25 mg IV) test was performed in 87 hyperandrogenic women, 24.8±0.8 years old. 17OHP levels greater than 1,500 ng/dL, 60min after administration of ACTH were […]

Hirsutism may be defined as the excessive growth of terminal hair in the women, with a male pattern of distribution. The clinical presentation is variable, with the presence of other signs of hyperandrogenism like menstrual irregularities and/or infertility, metabolic disturbances associated to hyperinsulinemia/ insulin resistance or presenting only an isolated hirsutism with ovulatory cycles. Hirsutism is an androgen-dependent event and is related to other factors like SHBG and free steroids levels, cutaneous responsivity to androgens and interconversions between androgens and […]