Hirsutism in premenopausal women in Northern Iran: Etiology and associated clinical findings

Hirsutism is defined as the presence of terminal hairs in androgen dependent areas like upper lip, cheeks, chin, breasts, lower area of abdomen and thigh in women. The aim of this study was to determine the etiologic factors and clinical features of hirsutism in premenopausal women.
In this cross-sectional study, 180 premenopausal women with hirsutism who were admitted at a referral dermatologic clinic in a 1-year period were investigated. After taking full medical history and performing physical examinations, a transabdominal ultrasonography of the ovaries, and laboratory evaluation including early morning total and free serum testosterone, prolactin, dehydroepiandrosterone sulfate, FSH, LH and 17-hydroxyprogestron in all patients were performed.
The most common causes of hirsutism were idiopathic (51.1%), polycystic ovarian syndrome (37.7%), hyperprolactinemia (4.4%), adrenal hyperplasia (3.8%), and drug-induced (2.8%). Hirsutism was mild in 93 (51.6%) patients, moderate in 78 (43.3%) patients and severe in 9 (5%) patients. Family history of hirsutism was present in 100 patients. Clinical conditions associated with hirsutism were: acne (58.3%), obesity (55.5%), menstrual irregularity (38.8%), androgenic alopecia (17.7%) and acanthosis negricans (8.4%).
Idiopathic hirsutism and polycystic ovary syndrome were the most common causes of the hirsutism in premenopausal women. Obesity also had a significant role in hirsutism occurrence.