Hirsutism causes

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

The cause of hirsutism can be either an increased level of androgens (male hormones) or an oversensitivity of hair follicles to androgens, and the most common cause is polycystic ovary syndrome. Male hormones such as testosterone stimulate hair growth, increase size and intensify the pigmentation of hair. Other symptoms associated with a high level of male hormones include acne and deepening of the voice and increased muscle mass. Growing evidence implicates high circulating levels of insulin in women to the development of hirsutism. This theory is consistent with the observation that obese (and thus presumably insulin resistant hyperinsulinemic) women are at high risk of becoming hirsute. Further, treatments that lower insulin levels will lead to a reduction in hirsutism.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

There are no known life threatening causes of hirsutism.

Common Causes

Causes by Organ System

Cardiovascular	Insulin resistance syndrome
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	Dermatomyositis
Drug Side Effect	Aripiprazole, bimatoprost, bupropion, carbamazepine, clonazepam, corticosteroids, cyclosporine, danazol, dantrolene, desogestrel and ethinyl estradiol, dexamethasone, diazoxide, donepezil, estrogens, eszopiclone, ethosuximide, ethotoin, ethynodiol diacetate and ethinyl estradiol, fluoxetine, fluoxymesterone, gestrinone, interferon alfa, isotretinoin, lamotrigine, leuprolide, methyltestosterone, mycophenolate, olanzapine, oxandrolone, oxymetholone, paroxetine, phenytoin, prednisolone, pregabalin, progestin, selegiline, tacrolimus, testosterone, tiagabine, trazodone, valproic acid, vasodilators, venlafaxine, zonisamide
Ear Nose Throat	No underlying causes
Endocrine	Acromegaly, adrenal adenoma, adrenal carcinoma, adrenal tumor, arrhenoblastoma, congenital adrenal hyperplasia, Cushing syndrome, Cushing’s disease, hyperprolactinemia, hypothyroidism, insulin resistance syndrome, luteoma, pituitary tumor, polycystic ovary syndrome, porphyria cutanea tarda, Stein-Leventhal syndrome, testosterone
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	11β-hydroxylase deficiency, 21-hydroxylase deficiency, Achard-Thiers syndrome, alpha-L-iduronidase deficiency, Ambras syndrome, Coffin-Siris syndrome, congenital adrenal hyperplasia, Cornelia de Lange Syndrome, Hurler syndrome, hypertrichosis lanuginosa, Miller-Dieker syndrome, nodulosis-arthropathy-osteolysis syndrome, Turner syndrome
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	Alpha-L-iduronidase deficiency, cortisone reductase deficiency, Hurler syndrome, i-cell disease, porphyria cutanea tarda
Obstetric/Gynecologic	Ovarian cancer, ovarian hyperthecosis, ovarian tumor, polycystic ovary syndrome, Stein-Leventhal syndrome
Oncologic	Adrenal adenoma, adrenal carcinoma, adrenal tumor, arrhenoblastoma, luteoma, ovarian cancer, ovarian tumor, pituitary tumor, testicular tumor
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	Dermatomyositis, insulin resistance syndrome
Sexual	Ovarian cancer, ovarian hyperthecosis, ovarian tumor, polycystic ovary syndrome
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Idiopathic hirsutism

Causes in Alphabetical Order

References

↑ ^1.0 ^1.1 Klotz RK, Müller-Holzner E, Fessler S, Reimer DU, Zervomanolakis I, Seeber B; et al. (2010). “Leydig-cell-tumor of the ovary that responded to GnRH-analogue administration – case report and review of the literature”. Exp Clin Endocrinol Diabetes. 118 (5): 291–7. doi:10.1055/s-0029-1225351. PMID 20198556.
↑ Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR (2004). “Androgen excess in women: experience with over 1000 consecutive patients”. J. Clin. Endocrinol. Metab. 89 (2): 453–62. doi:10.1210/jc.2003-031122. PMID 14764747.
↑ Goldman JM, Kapadia LJ (1991). “Virilization in a postmenopausal woman due to ovarian stromal hyperthecosis”. Postgrad Med J. 67 (785): 304–6. PMC 2399029. PMID 2062784.

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[pmid20198556-1] 1.0 ^1.1 Klotz RK, Müller-Holzner E, Fessler S, Reimer DU, Zervomanolakis I, Seeber B; et al. (2010). “Leydig-cell-tumor of the ovary that responded to GnRH-analogue administration – case report and review of the literature”. Exp Clin Endocrinol Diabetes. 118 (5): 291–7. doi:10.1055/s-0029-1225351. PMID 20198556.

[pmid14764747-2] Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR (2004). “Androgen excess in women: experience with over 1000 consecutive patients”. J. Clin. Endocrinol. Metab. 89 (2): 453–62. doi:10.1210/jc.2003-031122. PMID 14764747.

[pmid2062784-3] Goldman JM, Kapadia LJ (1991). “Virilization in a postmenopausal woman due to ovarian stromal hyperthecosis”. Postgrad Med J. 67 (785): 304–6. PMC 2399029. PMID 2062784.

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