HIRSUTISM AND VIRILISM Flashcards Preview

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Flashcards in HIRSUTISM AND VIRILISM Deck (13)
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1
Q

What is hirsutism?

A

Excessive hairiness in a woman in those parts in which hair growth is normally either absent or minimal. Eg beard or chest hair.

2
Q

What are the features of hirsutism with virilism in women?

A

Excessive hair growth

Clitoral hypertrophy

Breast atrophy

Deepening of voice

Male pattern balding

3
Q

What percentage of healthy women are said to have a degree of hirsutism with or without virilism?

A

10%

4
Q

Are virilism and hirsutism independent (ie one does not necessarily come with the other)?

A

Hirsutism can occur without virilism, however, virilism does not tend to occur without hirsutism (apart from in neonates)

5
Q

What are the causes of hirsutism?

A

Idiopathic

Adrenal:
Congenital adrenal hyperplasia
Cushing’s syndrome

Ovarian:
PCOS

Iatrogenic:
Androgens
Anabolic steroids
Danazol
Norethisterone
Phenytoin
6
Q

What are the causes of virilism with hirsutism?

A

Never idiopathic

Adrenal:
Congenital adrenal hyperplasia
Cushing’s syndrome

Ovarian:
Tumours
Arrhenoblastomas
Hiler cells
Pregnancy luteomas

Iatrogenic:
Androgens
Anabolic steroids
Danazol

7
Q

What is the most common cause of hirsutism?

A

PCOS

8
Q

What are the features seen on examination of a patient with PCOS?

A

Obesity

Acanthosis nigricans

Hirsutism

Acne

9
Q

What are the features seen on examination a patient with congenital adrenal hyperplasia?

A

Obesity

Hirsutism/virilism

Ambiguous external genitalia in severe cases

10
Q

What are the features seen on examination of a patient with Cushing’s syndrome?

A

Hirsutism/virilism

Central obesity

Peripheral muscle atrophy

Hypertension

Striae

11
Q

What are the features seen on examination of a patient with an androgen producing tumour?

A

Hirsutism/virilism

Very little in terms of systemic upset

Often no masses felt

12
Q

How can we treat idiopathic hirsutism?

A

Bleaching

Electrolysis

Psychological support

13
Q

How do you treat hirsutism associated with PCOS?

A

Encourage weight loss

Medical treatment is a combination of Ethinyloestradiol and an anti-androgen such as cyproterone acetate

Metformin has also been shown to help with all features of PCOS, as recent evidence insulin resistance is a causative factor rather than just a complication.