Updated: 4/29/2015

Hirsutism / Virilization

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Hirsutism
  • Defined as excessive growth of androgen-responsive terminal hair in women
    • excess hair growth in areas where hair growth is normally minimal

Virilization
  • Defined as masculinization of a woman
  • Presentation
    • clitoromegaly (pathognomonic)
    • acne
    • deepening voice
    • ↑ muscle
Associated conditions
  • Ovarian (↑ testosterone)
    • polycystic ovarian syndrome
    • ovarian tumors (Sertoli-Leydig cell tumors)
  • Adrenal (↑ DHEA-sulfate)
    • congenital adrenal hyperplasia
    • Cushing's syndrome
    • adrenal tumors
  • Drug-related
    • cyclosporine
    • phenytoin
    • minoxidil
  • Idiopathic
    • presumed to be caused by increased androgen-receptor sensitivity
  • Obesity
    • due to ↓ in steroid-hormone binding globulin (SHBG)
      • results in ↑ concentration of free testosterone
  • Hypothyroidism
    • same cause as obesity
  • Aromatase deficiency 
    • inability to convert testosterone to estrogen
    • leads to maternal virilization when present in fetus
 

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