Endocrine Abstracts

Introduction: Hirsutism is a condition featuring an excessive growth of terminal hair at the woman’s androgen-dependent areas, which develops in a distribution model similar to that of men. It is one of the most common disorders in women during reproductive age. It affects up to 1 in 7 women. The objective of this work was to study the clinical and etiological aspects of hirsutism.

Material and Methods: This is a retrospective descriptive study involving 59 patients followed for hirsutism in the endocrinology-diabetology and nutrition department.

Results: We collected 59 patients with a mean age of 24.8 ± 6.9 years. 28.8% had a family history of hirsutism. The history of male stillbirths was reported in 12.5% of cases. Forty percent of patients had onset symptoms at puberty. Hirsutism was severe in 44.1% of cases, moderate in 35.6% and light in 20.34% of cases, with an average of Férriman and Gallway score at 17.95 ± 6.32. It was associated with acne in 44.07% of cases, seborrhea in 16.95% of cases, and menstrual disorders in 66.1% of patients. Four patients presented signs of virilization: clitoridomegaly (1 case), frontal gulfs with muscular hypertrophy (2 cases), alopecia (1 case). Overweight was found in 32.2%, while obesity was found in 25.42% of cases. The results showed elevated testosterolemia in 35.09% of cases with a mean of 1.10 ± 1.93 ng/ml. The etiologies were dominated by polycystic ovarian syndrome (PCOS) (60.34%), followed by idiopathic hirsutism in 24.14% of cases, and cushing disease in 8.62% of patients, adrenal tumour (1 case), 21 hydroxylase block (1 case), 11 betahydroxylase block (1 case), and drug use (1 case).

Conclusion and discussion

Polycystic ovarian syndrome is the most common cause of hirsutism in our study, which is consistent with the data reported in the literature. Hirsutism is a frequent reason for consultation; it not only reflects circulating androgen levels, but is also influenced by peripheral androgen metabolism, the sensitivity of the hair follicle to androgens, and insulin resistance. Women suffering of hirsutism often have low self-esteem and altered quality of life, which can lead sometimes to depression, hence the interest of a global therapeutic and psychological management.