Hirsutism : a clinical and biochemical study among Iraqi women in Hilla city

Abstract EN

Background : Hirsutism is defined as excessive terminal hairs that appear in women in a male-like pattern (i.e., sexual hair).

It is relatively a common and important medical problem affecting about 5-10 % of women in reproductive age.

The growth of sexual hair is entirely under the influence of androgens, many hormones have androgenic potential in the human body, but testosterone is the key circulating androgen which is produced by the ovaries and adrenals.

Hirsutism can be familial, idiopathic, or caused by excess androgen secretion by the ovary, adrenal glands or exogenous pharmacologic sources of androgen and other miscellaneous endocrine abnormalities.

Aim of the study : To shed light on hirsutism as a rising problem among women in our society, evaluating those hirsute women both clinically and biochemically.

Results : fifty women with hirsutism were included in this study, their ages ranged from 14-45 years with a mean of 27.64 + 7.266.

Mean duration of disease was 7.52 + 6.217 years; while mean age of onset 20.36 + 4.758 years.

All patients had slow progression of hirsutism over years.

Positive family history was found in 80 % of patients, 38% were married, 6 (12 %) are infertile.

Irregular menstrual cycles were found in 44%, mostly in a form of oligomenorrhea.

The number of hirsute patients who were overweight or obese (BMI ≥ 25) was 30 patients (60 %), [16 patients had android obesity (WHR ≥ 0.85) and 14 patients had overall (non- android) obesity], while the number of non-obese hirsute patients (BMI < 25) was 20 patients (40 %).

31 patients (62 %) had elevated serum total testosterone, there was highly significant statistical difference regarding serum testosterone when compared with control group (p-value 0.0001).

20 % of patients had elevated serum prolactin, while 4 patients (8 %) of control group had elevated serum prolactin.

There was no significant correlation between serum total testosterone and serum prolactin levels with BMI or WHR (P-value > 0.05).

36 patients (72 %) had mild hirsutism (score 8-15) and 14 patients (28 %) had moderate to severe hirsutism (score > 15).

Significant correlation was found between the score of the patients with BMI and WHR (P-value < 0.05).

Also there was highly significant statistical relationship between the score of the patients and serum androgen level ; patients with scores>15 had significantly higher levels of serum androgen than those with lower scores.

Seborrhea, androgen etic alopecia, acne and acanthuses nigricans were recorded in patients with decreasing frequencies, while hypertrichosis if found in 72 % of patients especially in those with high score hirsutism.

Conclusion : hirsutism is not merely aesthetic problem, it can be linked to several metabolic and endocrine abnormalities especially if a patient presents with moderate-severe hirsutism even when it had a slow progression or family history can be obtained.