Endocrine Abstracts

Introduction: Hirsutism is often caused by hormonal disorders such as high levels of circulating androgens, hormonal changes related to menopause or disorders of the ovarian or adrenal gland. The aim of our study was to evaluate the clinical and etiological profile of hirsutism.

Methods: A retrospective study was conducted at the endocrinology department of Rabta Hospital in Tunis including 100 patients who presented with hirsutism between January 2009 and December 2020. Clinical and paraclinical data were collected from medical records. Hirsutism was classified according to the Ferriman Galleway score.

Results: The mean age of our patients was 29.5 years ± 10.7 [15 -73]. Family history of hirsutism, infertility and death in early childhood were found in 27%, 36% and 4% of cases respectively. The average age of menarche was 12.1 years ± 1.2. Eight women were menopausal. The onset of hirsutism was progressive in 95 cases either peripubertal or post-pubertal respectively 44% versus 56%. Hirsutism was classified as mild, moderate and severe in 32%, 57% and 11% of cases respectively. The clinical features found to be associated with hirsutism included acne (28%), virilism signs (9%) and menstrual irregularities in 60% of patients. The mean of testosterone level was 0.9 ng/ml ± 0.7 [0.15-4.08]. Additional investigations such as dosage of Dehydroepiandrosterone sulfate, 4-androstenedione, and 17-OH progesterone were done according to etiological orientation and revealed means of 900.1 µg/ml, 354 ng/ml, and 1.86 ng/ml respectively. The etiologic investigation showed ovarian tumor, adrenal tumor with androgen secretion, late-onset congenital adrenal hyperplasia, Cushing’s syndrome, polycystic ovary syndrome (PCOS) and idiopathic hirsutism in 3%, 5%, 7%, 2%, 51% and 32% of cases respectively.

Conclusion: Hirsutism is a very frequent and troublesome symptom. However, it can reveal serious underlying pathology, especially in its severe form.