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Updated: Apr 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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