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1. Hirsutism: Scenario: Management of hirsutism

Hirsutism: Scenario: Management of hirsutism Scenario: Management | Management | Hirsutism | CKS | NICE Search CKS… Menu Scenario: Management Hirsutism: Scenario: Management of hirsutism Last revised in February 2020 Scenario: Management of hirsutism From age 18 years onwards (Female). When should I refer a woman with hirsutism? Refer urgently (within 2 weeks) to endocrinology if there is a possibility of an underlying adrenal or ovarian neoplasm. Features of androgen-secreting tumours include (...) and Canadian guidance on hirsutism [ ; ], Royal College of Obstetricians and Gynaecologists guidance on the long-term consequences of polycystic ovary syndrome [ ], and expert opinion in a review article that notes virilisation is a red flag symptom which requires urgent referral to an endocrinologist [ ]. Referral if an underlying endocrine condition is suspected This recommendation is pragmatic and is based on what CKS considers to be good clinical practice, reflecting expert opinion that in women

2020 NICE Clinical Knowledge Summaries

2. Hirsutism: How should I assess for an underlying cause of hirsutism?

Hirsutism: How should I assess for an underlying cause of hirsutism? Assessment for an underlying cause | Diagnosis | Hirsutism | CKS | NICE Search CKS… Menu Assessment for an underlying cause Hirsutism: How should I assess for an underlying cause of hirsutism? Last revised in February 2020 How should I assess for an underlying cause of hirsutism? Ask about, and look for, features of underlying conditions, such as: Polycystic ovary syndrome (PCOS), including oligomenorrhoea or amenorrhoea (...) , infertility, acne, central obesity, and acanthosis nigricans. For information on the diagnosis of PCOS, see the section on in the CKS topic on . An androgen-secreting tumour, including sudden onset or rapid progression of hair growth, progression despite treatment, signs of virilization (hair loss from the scalp, voice deepening, increased muscle bulk, clitoromegaly), and a pelvic or abdominal mass. Endocrine conditions (uncommonly cause hirsutism), including: Cushing's syndrome — facial weight gain (moon

2020 NICE Clinical Knowledge Summaries

3. Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome. (Abstract)

Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome. Metformin has been proposed as possibly a safer and more effective long-term treatment than the oral contraceptive pill (OCP) in women with polycystic ovary syndrome (PCOS). It is important to directly compare the efficacy and safety of metformin versus OCP in the long-term treatment of women with PCOS. This is an update of a Cochrane Review comparing insulin (...) to identify additional studies.We included randomised controlled trials (RCTs) of the use of metformin versus the OCP (alone or in combination) for women with PCOS.We used standard methods recommended by Cochrane. The primary review outcomes were the clinical parameters of hirsutism and adverse events, both severe (requiring stopping of medication), and minor. In the presence of substantial heterogeneity (I2 statistic > 50), which could be explained by pre-specified subgroup analyses on the basis of BMI

2020 Cochrane

4. New advice from the MHRA regarding cyproterone acetate: how does this affect prescribing of Co-cyprindiol/Dianette® for acne/hirsutism? July 2020

New advice from the MHRA regarding cyproterone acetate: how does this affect prescribing of Co-cyprindiol/Dianette® for acne/hirsutism? July 2020 1 FSRH CEU Statement : New advice from the MHRA regarding cyproterone acetate: how does this affect prescribing of Co-cyprindiol/Dianette ® for acne/hirsutism? 13 July 2020 Background New data from a French cohort study [1] indicate that use of high dose cyproterone acetate (high dose products contain 50-100mg per tablet) is associated (...) acetate with ethinylestradiol Co-cyprindiol/Dianette ® tablets containing cyproterone acetate with ethinylestradiol are used for treatment of acne and hirsutism in women of reproductive age. In contrast to the high dose products described above, they contain only 2mg of cyproterone acetate; annual cumulative exposure to cyproterone acetate is only about 0.8g. The Yellow Card scheme has received no reports of meningioma associated with use of these low-dose products. The MHRA advises that although

2020 Faculty of Sexual & Reproductive Healthcare

5. Hirsutism: What else might it be?

Hirsutism: What else might it be? Differential diagnosis | Diagnosis | Hirsutism | CKS | NICE Search CKS… Menu Differential diagnosis Hirsutism: What else might it be? Last revised in February 2020 What else might it be? Hirsutism should be differentiated from hypertrichosis — excessive hair growth distributed in a generalized, nonsexual pattern, commonly affecting the limbs, trunk and back. It is not caused by excess androgen, although it may be aggravated by hyperandrogenaemia. It can (...) of hirsutism in premenopausal women [ ; ], a consensus statement [ ], and review articles on hirsutism and its diagnosis and management [ ; ; ]. © .

2020 NICE Clinical Knowledge Summaries

6. Hirsutism: Topical eflornithine

Hirsutism: Topical eflornithine Topical eflornithine | Prescribing information | Hirsutism | CKS | NICE Search CKS… Menu Topical eflornithine Hirsutism: Topical eflornithine Last revised in February 2020 Topical eflornithine What should I advise a person using eflornithine? Topical eflornithine (Vaniqa ® 11.5% cream) is licensed for the treatment of facial hirsutism. Advise that: A thin layer of topical eflornithine should be applied to the affected area two times a day, at least eight hours

2020 NICE Clinical Knowledge Summaries

7. Hirsutism: How do I know my patient has it?

Hirsutism: How do I know my patient has it? Diagnosis | Diagnosis | Hirsutism | CKS | NICE Search CKS… Menu Diagnosis Hirsutism: How do I know my patient has it? Last revised in February 2020 How do I know my patient has it? Look for excessive terminal hair in androgen-dependent areas, including the face, chest, abdomen, lower back, upper arms, and thighs. Terminal hairs can be clinically distinguished from vellus hairs (soft, short, lightly pigmented) because they are longer, stiff (...) , and pigmented. The Ferriman-Gallwey scoring system is the gold standard for evaluating hirsutism, and includes nine androgen-sensitive body areas. Each area is scored from 0 (no hair) to 4 (extensive hair growth). A score of 8 or above is considered to define hirsutism in UK black or white women of reproductive age. Normal scores are lower in some Asian and South American populations, and higher in some Mediterranean, Middle Eastern, or Hispanic populations. However, the Ferriman-Gallwey scoring system has

2020 NICE Clinical Knowledge Summaries

8. Assessment of hirsutism

Assessment of hirsutism Assessment of hirsutism - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of hirsutism Last reviewed: February 2019 Last updated: November 2018 Summary Hirsutism is a condition seen in women that is associated with development of androgen-dependent terminal hair (coarse, pigmented) following a male-pattern distribution (face, chest, abdomen, back). Pathophysiology Hair in different (...) =bestpractice.com Hair response to androgens varies from person to person and includes increase in follicle size, fibre diameter, and the amount of time spent in anagen (the growth-cycle phase). Rosenfield RL. Clinical practice. Hirsutism. N Engl J Med. 2005 Dec 15;353(24):2578-88. http://www.ncbi.nlm.nih.gov/pubmed/16354894?tool=bestpractice.com Messenger AG. The control of hair growth: an overview. J Invest Dermatol. 1993 Jul;101(suppl 1):4S-9S. http://www.ncbi.nlm.nih.gov/pubmed/8326154?tool=bestpractice.com

2018 BMJ Best Practice

9. Assessment of hirsutism

Assessment of hirsutism Assessment of hirsutism - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of hirsutism Last reviewed: February 2019 Last updated: November 2018 Summary Hirsutism is a condition seen in women that is associated with development of androgen-dependent terminal hair (coarse, pigmented) following a male-pattern distribution (face, chest, abdomen, back). Pathophysiology Hair in different (...) =bestpractice.com Hair response to androgens varies from person to person and includes increase in follicle size, fibre diameter, and the amount of time spent in anagen (the growth-cycle phase). Rosenfield RL. Clinical practice. Hirsutism. N Engl J Med. 2005 Dec 15;353(24):2578-88. http://www.ncbi.nlm.nih.gov/pubmed/16354894?tool=bestpractice.com Messenger AG. The control of hair growth: an overview. J Invest Dermatol. 1993 Jul;101(suppl 1):4S-9S. http://www.ncbi.nlm.nih.gov/pubmed/8326154?tool=bestpractice.com

2018 BMJ Best Practice

10. Evaluation and Treatment of Hirsutism in Premenopausal Women Full Text available with Trip Pro

is present ( ). Hirsutism must be distinguished from hypertrichosis—generalized excessive hair growth that may be hereditary or result from certain medications ( e.g. , phenytoin, cyclosporine). Hypertrichosis is distributed in a generalized, nonsexual pattern ( i.e. , predominantly on forearms or lower legs) and is not caused by excess androgen (although hyperandrogenemia may aggravate it). Pathogenesis of hirsutism The growth of sexual hair is entirely dependent on the presence of androgen (...) Evaluation and Treatment of Hirsutism in Premenopausal Women We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society* Clinical Practice Guideline | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term

2018 The Endocrine Society

11. Hirsutism: Evaluation and Treatment

Hirsutism: Evaluation and Treatment No. 350-Hirsutism: Evaluation and Treatment - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 39, Issue 11, Pages 1054–1068 No. 350-Hirsutism: Evaluation and Treatment x Kimberly Liu Correspondence Corresponding Author: Dr. Kimberly Liu; University of Toronto, Department of Obstetrics and Gynecology, Toronto ON , MD ∗ , x Kimberly Liu Correspondence Corresponding Author: Dr. Kimberly (...) Liu; University of Toronto, Department of Obstetrics and Gynecology, Toronto ON Toronto, ON x Tarek Motan , MB, ChB Edmonton, AB x Paul Claman , MD Ottawa, ON No. 350, November 2017 DOI: To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Figures Figure 1 Ferriman-Gallwey score for hirsutism. Figure 2 Steroidogenesis pathway. Figure 3 Acanthosis nigricans. Abstract Objectives To review the etiology, evaluation, and treatment of hirsutism

2017 Society of Obstetricians and Gynaecologists of Canada

12. Hirsutism

Hirsutism Hirsutism | Topics A to Z | CKS | NICE Search CKS… Menu Hirsutism Hirsutism Last revised in February 2020 Hirsutism is the growth of excess terminal hair on the face, chest, linea alba, lower back, buttocks, and anterior thighs in women. Diagnosis Management Prescribing information Background information Hirsutism: Summary Hirsutism is the growth of excess terminal hair in androgen-dependent areas in women (for example face, chest, abdomen, lower back, upper arms, and thighs (...) ). Hirsutism occurs because of the effect of increased androgens on the pilosebaceous unit (from which the hair shaft appears), increased pilosebaceous unit sensitivity to androgens, or the peripheral metabolism of androgens. Polycystic ovary syndrome (PCOS) is the most common cause of hirsutism (more than 70% of cases). No apparent underlying cause is found in about half of women with mild hirsutism. Androgen secreting tumours, adrenal hyperplasia, Cushing’s syndrome, acromegaly, hyperprolactinaemia

2016 NICE Clinical Knowledge Summaries

13. Evaluation and Treatment of Hirsutism in Premenopausal Women Full Text available with Trip Pro

Evaluation and Treatment of Hirsutism in Premenopausal Women 29522641 2018 07 03 2019 01 18 1538-3598 319 15 2018 Apr 17 JAMA JAMA Evaluation and Treatment of Hirsutism in Premenopausal Women. 1613-1614 10.1001/jama.2018.2611 Mimoto Mizuho S MS University of Chicago, Chicago, Illinois. Oyler Julie L JL University of Chicago, Chicago, Illinois. Davis Andrew M AM University of Chicago, Chicago, Illinois. eng P30 DK020595 DK NIDDK NIH HHS United States T32 DK007011 DK NIDDK NIH HHS United States (...) Journal Article United States JAMA 7501160 0098-7484 0 Androgen Antagonists 0 Contraceptives, Oral, Hormonal 3XMK78S47O Testosterone 68-96-2 17-alpha-Hydroxyprogesterone AIM IM 17-alpha-Hydroxyprogesterone blood Adult Androgen Antagonists therapeutic use Contraceptives, Oral, Hormonal therapeutic use Female Hair Removal Hirsutism diagnosis drug therapy therapy Humans Polycystic Ovary Syndrome Practice Guidelines as Topic Premenopause Testosterone blood 2018 3 10 6 0 2018 7 4 6 0 2018 3 10 6 0 ppublish

2018 JAMA

14. Androgens and hirsutism score of overweight women with polycystic ovary syndrome improved after vitamin D treatment: A randomized placebo controlled clinical trial. (Abstract)

Androgens and hirsutism score of overweight women with polycystic ovary syndrome improved after vitamin D treatment: A randomized placebo controlled clinical trial. The objective of this study was to investigate the effect of vitamin D treatment on androgen levels and hirsutism scores in overweight women with PCOS.A prospective, randomized, double-blind, placebo-controlled clinical study was conducted at King Abdullah University Hospital in Irbid, Jordan. Overweight Jordanian females aged 18-49 (...) years with vitamin D deficiency and PCOS (n = 60) were assigned to two groups: the treatment group (n = 30) who received 50,000 IU per week of vitamin D3 and the control group (n = 30) who received a placebo.After receiving the treatment for 12 consecutive weeks, the levels of total testosterone, parathyroid hormone, free androgen index, and hirsutism score were significantly decreased (P < 0.001), and the levels of 25-hydroxyvitamin D (25(OH)D), sex hormone binding globulin, and phosphorus were

2020 Clinical nutrition (Edinburgh, Scotland)

15. The associations of maternal polycystic ovary syndrome and hirsutism with behavioral problems in offspring. Full Text available with Trip Pro

The associations of maternal polycystic ovary syndrome and hirsutism with behavioral problems in offspring. To study the associations between maternal polycystic ovary syndrome (PCOS) and hirsutism with offspring attention-deficit/hyperactivity disorder (ADHD), anxiety, conduct disorder, and behavioral problems.Prospective birth cohort study.Not applicable.A total of 1,915 mother-child dyads.None.Maternal report of offspring ADHD, anxiety, or conduct disorder diagnosis at 7 to 8 years (...) ; emotional symptoms, behavioral problems (including peer relationship, conduct, hyperactivity/inattention), and prosocial problems measured with the Strengths and Difficulties Questionnaire (SDQ) at 7 years.Prevalence of PCOS and hirsutism were 12.0% and 3.9%; 84% of women with hirsutism had PCOS. After adjustment for sociodemographic covariates, prepregnancy body mass index, and parental history of affective disorders, children born to mothers with PCOS had higher risk of anxiety (adjusted risk ratio

2020 Fertility and Sterility

16. The evaluation of the relationship between some related hormone levels and diet in obese or overweight patients with hirsutism: A randomized clinical trial. Full Text available with Trip Pro

The evaluation of the relationship between some related hormone levels and diet in obese or overweight patients with hirsutism: A randomized clinical trial. Hirsutism is a common disorder that has remarkable physical and mental effects on individuals. No appropriate diet has yet specified for individuals with hirsutism. The present study was carried out to examine the effect of high-fibre, low-caloric balanced diet on some related hormone levels in obese or overweight women with hirsutism who (...) had referred to clinics affiliated with Shiraz University of Medical Sciences.The present study was a clinical trial that was carried out on 47 obese or overweight women with hirsutism in 2014. The women were randomly assigned to an intervention group and a control group that, respectively, consumed a high-fiber, low-caloric balanced diet and a normal diet for 3 months. A demographic characteristics questionnaire and a researcher-designed diet questionnaire were filled out by the two groups before

2019 Journal of family medicine and primary care Controlled trial quality: uncertain

17. Combination of Intense Pulse Light and Topical Eflornithine Therapy versus Intense Pulse Light Therapy alone in the Treatment of Idiopathic Facial Hirsutism: A Randomized Controlled Trial. (Abstract)

Combination of Intense Pulse Light and Topical Eflornithine Therapy versus Intense Pulse Light Therapy alone in the Treatment of Idiopathic Facial Hirsutism: A Randomized Controlled Trial. To compare the efficacy of combination of Intense Pulse Light and topical eflornithine therapy versus Intense Pulse Light therapy alone in the treatment of idiopathic facial hirsutism.A total of 78 patients were included in the study, and were divided into two groups, having 39 patients each. Patients (...) therapy is more efficacious than intense pulse light therapy alone in the treatment of idiopathic facial hirsutism.

2019 JPMA. The Journal of the Pakistan Medical Association Controlled trial quality: uncertain

18. Long-pulsed Nd: YAG Laser and Intense Pulse Light-755 nm for Idiopathic Facial Hirsutism: A Comparative Study. Full Text available with Trip Pro

Long-pulsed Nd: YAG Laser and Intense Pulse Light-755 nm for Idiopathic Facial Hirsutism: A Comparative Study. Hirsutism means excessive terminal hair growth in a female in male pattern distribution. Perception of hirsutism is subjective. Permanent laser hair reduction is a slow process taking many sessions and tracking of improvement parameters is tedious. Hence, a lot of confusion still exists regarding the type of laser most beneficial for treatment.The aim of this study was to compare (...) the effectiveness and safety profile of long-pulsed Nd: YAG laser (1064 nm) and intense pulse light (IPL)-755 nm in management of idiopathic facial hirsutism.Open-labelled, randomly allocated experimental study.The study included 33 cases of idiopathic facial hirsutism. Patients were randomly divided into Group A, treated with long-pulsed Nd: YAG laser and Group B, treated with IPL-755 for a total of six sessions at 1 month interval.Chi-square test was used in Medcalc® version 9.0 and the test of significance

2019 Journal of cutaneous and aesthetic surgery Controlled trial quality: uncertain

19. Correction: The effect of CAG repeats length on differences in hirsutism among healthy Israeli women of different ethnicities. Full Text available with Trip Pro

Correction: The effect of CAG repeats length on differences in hirsutism among healthy Israeli women of different ethnicities. [This corrects the article DOI: 10.1371/journal.pone.0195046.].

2018 PLoS ONE

20. The effect of CAG repeats length on differences in hirsutism among healthy Israeli women of different ethnicities. Full Text available with Trip Pro

The effect of CAG repeats length on differences in hirsutism among healthy Israeli women of different ethnicities. Variations in the degree of hirsutism among women of different ethnic backgrounds may stem from multiple etiologies. Shorter length of the polymorphic CAG repeats of the androgen receptor (AR) gene may be associated with increased activity of the receptor leading to hirsutism. We hypothesized that there are ethnic differences in the degree of hirsutism that is unrelated to androgen (...) levels among Israeli women, and that the CAG repeats length may contribute to these differences. Anti-androgenic therapies, such as spironolactone, could be suggested if a shorter CAG repeats length is found to affect the difference in the degree of hirsutism between the ethnic groups.Healthy Israeli Jewish women aged 18-45 years of Ashkenazi and non-Ashkenazi origin were invited to participate. Hirsutism was assessed using the simplified Ferriman-Gallwey (sFG) score, and serum total testosterone

2018 PLoS ONE

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