Hirsutism in Polycystic Ovary Syndrome: Pathophysiology and Management

Author(s): Poli Mara Spritzer, Carolina Rocha Barone, Fabiana Bazanella de Oliveira

Journal Name: Current Pharmaceutical Design

Volume 22 , Issue 36 , 2016

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Background: Hirsutism is defined as the presence of terminal hair with male distribution in women, and polycystic ovary syndrome (PCOS) is the most common etiology of hirsutism.

Methods: The aim of this study is to review aspects of hair growth that are relevant for the understanding of hirsutism in PCOS, along with current treatment alternatives.

Results: The prevalence of hirsutism in PCOS ranges from 70 to 80%, vs. 4% to 11% in women in the general population. Hirsutism in PCOS is associated with both ovarianderived androgen excess and individual sensitivity of the pilosebaceous unit to androgens. Interventions to decrease hirsutism in PCOS include the suppression of androgen excess by combined oral contraceptives (OCPs). If OCPs are contraindicated, mainly in the presence of insulin-resistance related comorbidities, a second-line option for reducing androgen secretion may be metformin associated with lifestyle changes. Other interventions should be guided by hirsutism severity, determined by the modified Ferriman-Gallwey score, and by the amount of distress hirsutism causes to the patient, and should be maintained for at least 6-12 months. Mild hirsutism is usually treated with a combination of non-pharmacological methods and OCPs, whereas moderate and severe hirsutism may require a combination of antiandrogens and OCPs, or, if OCPs cannot be used, antiandrogens plus a safe contraceptive method. In all cases, strong clinical support is crucial to ensure treatment adherence and success.

Conclusion: The understanding of the pathophysiology of hirsutism in PCOS, as well as classifying its severity and the distress it causes to each patient is essential to choose the proper treatment. The presence of metabolic comorbidities and menstrual disturbances will also guide the individualized management of hirsutism in women with PCOS.

Keywords: Hirsutism, polycystic ovary syndrome, pathophysiology of hair cycle growth, androgen excess, hair removal.

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Article Details

Year: 2016
Published on: 20 July, 2016
Page: [5603 - 5613]
Pages: 11
DOI: 10.2174/1381612822666160720151243
Price: $65

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