Etiology of hirsutism. Is there a correlation between menstrual regularity, body mass index and severity of hirsutism with the cause?

Authors

  • Dr. Farid-ur-Rehman
  • Irum Sohail
  • Zartaj Hayat
  • Nadeem Ahmed Niazi

Keywords:

Hirsutism, polycystic ovarian syndrome, idiopathic hirsutism

Abstract

Background Hirsutes having regular menstrual history or with body mass index (BMI) within normal range or mild hirsutism are often taken as idiopathic hirsutism.Objective To investigate the etiology of hirsutism in patients presenting in the Fauji Foundation Hospital (FFH), Rawalpindi and to determine if menstrual regularity, BMI and severity of hirsutism correlates with the cause. Patients and methods It was a descriptive study over a period of fourteen months in the departments of Dermatology and Gynecology & Obstetrics of FFH, Rawalpindi. Females who presented to either department with hirsutism were enrolled in this study. A detailed history, clinical examination with special reference to Ferriman-Gallwey (FG) scoring system, endocrinological workup and abdominopelvic ultrasonography (USG) was done in all patients. SPSS version 12 was used for statistical analysis.Results Out of a total of 71 patients, the commonest cause of hirsutism in our study was polycystic ovarian syndrome (PCOS) in 57.7%. Idiopathic hirsutism was present in 22.6% and late onset congenital adrenal hyperplasia in 9.9% patients. Hyperprolactinemia and thyroid disorders were diagnosed in 4.2% respectively. One (1.4 %) patient had multiple etiologies. The correlation between menstrual regularity, BMI and severity of hirsutism with the cause of hirsutism was not statistically significant (p ≥0.05).Conclusion PCOS is the commonest cause in our study population. The correlation of menstrual regularity

References

Carole GS, Stephen F. Hirsutism and Virilization. In: Robert WS, Patrick S, Stuart LS, eds. Gynecology, 3rd edn. London: Elsevier Science; 2003. P. 387-400.

Mofid A, Alinaghi SAS, Yazdani T. Hirsutism. Int J Clin Pract 2008; 62: 433-43.

Ansarin H, Aziz Jalali MH, Rasi A et al. Clinical presentation and etiological factors of hirsutism in premenopausal Iranian women. Arch Iran Med 2007; 10: 7-13.

Moran C, Tapia MC, Hernandez E et al. Etiological review of hirsutism in 250 patients. Arch Med Res 1994; 25: 311-4.

Somani N, Harrison S, Bergfeld WF. The clinical evaluation of hirsutism. Dermatol Ther 2008; 21: 376-91.

Hatch R, Rosenfield RL, Kim MH et al. Hirsutism: implications, etiology and management. Am J Obstet Gynecol 1981; 140: 815-30.

Balen AH. Polycystic ovary syndrome and secondary amenorrhea. In: Edmonds DK, ed. Dewhurst’s Textbook of Obstetrics and Gynecology, 17th edn. London: Blackwell Science; 2007. P. 387-400.

Balen AH, Laven JSE, Tan SL. Ultrasound assessment of the polycystic ovary: international consensus definitions. Human Reprod Update 2003; 9: 505-14.*

Ehrmam DA. Polycystic ovary syndrome. N Engl J Med 2005; 352: 1223-36.

Setji TL, Brown AJ. Polycystic ovary syndrome: diagnosis and treatment. Am J Med 2007; 120: 128-32.

Lloyd J, Crounch NS, Minto CL et al. Female genital appearance ‘normally’ unfolds. BJOG 2005; 112: 643-6.

Olan KS. The modern management of hirsutism. Rev Gynecol Prac 2004; 4: 211-20.

Tekin O, Istik B, Avci Z et al. Hirsutism: common clinical problem or index of serious disease? Med Gen Med 2004; 6: 56.

Onalan G, Goktolga U, Ceyhan T et al. Predictive value of glucose-insulin ratio in PCOS and profile of women who will benefit from metformin therapy obese, lean, hyper or non-insulinemic? Eur J Obstet Gynecol Reprod Bio 2005; 123: 204-11.

Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endocr Rev 2000; 21: 34-62.

Unluhizarci K, Gokce C, Atmaca H et al. A detailed investigation of hirsutism in a Turkish population: idiopathic hyperandrogenemia as a perplexing issue. Exp Clin Endocrinol Diabetes 2004; 112: 504-9.

Hassa H, Mete TH, Yildirim A et al. The hirsutism scoring system should be population specific. Fertil Steril 2005; 84: 778-80.

Malik LM, Khursheed K, Haroon TS et al. An etiological study of moderate to severe hirsutism. Pak J Med Sci 2007; 23: 167-71.

Zargar AH, Wani AI, Masoodi SR et al. Epidemiological and etiological aspects of hirsutism in Kashmiri women in the Indian subcontinent. Fertil Steril 2002; 77: 674-8.

Carmina E, Lobo RA. Polycystic ovaries in hirsute women with normal menses. Am J Med 2001; 111: 602-6.

Kazmi AH, Bajwa UM, Mehmood K. The prevalence of hirsutism in Pakistani females. J Pak Inst Med Sci 1993; 4: 195-7.

Rosenfield RL. Clinical practice. Hirsutism. N Engl J Med 2005; 353: 2578-88.

Azziz R. The evaluation and management of hirsutism. Obstet Gynecol 2003; 101: 995-1007.

Lobo RA, Carmina E. The importance of diagnosing the polycystic ovary syndrome. Ann Intern Med 2000; 132: 989-93.

Paus R, Olsen EA, Messenger AG. Hair growth disorders. In: Wolff K, Goldsmith LA, Katz SI et al, eds. Fitzparick’s Dermatology in General Medicine. New York: McGraw Hill; 2008. P. 753-77.

Downloads

Published

2016-12-21

How to Cite

1.
Farid-ur-Rehman D, Sohail I, Hayat Z, Niazi NA. Etiology of hirsutism. Is there a correlation between menstrual regularity, body mass index and severity of hirsutism with the cause?. J Pak Assoc Dermatol [Internet]. 2016Dec.21 [cited 2024Dec.8];20(1):4-9. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/360

Issue

Section

Original Articles