Risk Factors Contributing to Hirsutism

Hirsutism refers to the growth of coarse, dark hair in areas where women typically grow fine hair or no hair at all. The condition is associated with increased (or normal) levels of circulating androgens (sex hormones) mostly testosterone. Aim of my study was to observe the factors responsible for abnormal growth of hairs .This was a retrospective study carried out in various hospitals of Lahore. A total of 30 patients were studied having Hirsutism. They were presented in Gynae out patient department of Sir Gangaram hospital, Services hospital, and lady Wallington hospital Lahore between the period of 16 June 2010 to 30 June 2010. Following were the major risk factors. About 53.33% patients develop Hirsutism due to polycystic ovary disease (PCOS) . In 60% of patients menstrual irregularities were observed . 43.33% patients show Hirsutism sign were having a family history of Hirsutism. 6.66% patients developed Hirsutism after Menopause. About 10% patients suffered from Hirsutism were with premature menarche. 20% women were overweight and 66.66% having a history of steroid and cosmetic use. Most of the women were having more than 1 factors which may be the cause of Hirsutism. Hirsutism itself is not a disease it is a symptom of other abnormalities. It has a vary bad social impact on women. Key words; Hirsutism, Androgens, PCOS, Menopause, Premature menarche INTRODUCTION Hirsutism is a condition of increased hair growth in a woman associated with increased (or normal) levels of circulating androgens (sex hormones). Androgens are the steroids that help in development of masculine secondary sexual characteristics. Most important androgen is testosterone. The onset of these symptoms is usually gradual. Sudden onset of Hirsutism is often seen in adrenal tumors. Hirsutism is a clinical condition commonly encountered in the practice of primary care medicine . The etiology and the age of the patient when it occurs vary widely . Hirsutism may appear in childhood as well as in older persons .Some drugs (oral contraceptives, L-thyroxine, danazol, and Diaz oxide), tobacco smoke, some syndromes (polycystic ovary syndrome, obesity, insulin resistance , hyperprolactinemia, hyperthecosis, congenital adrenal hyperplasia, and idiopathic), and some neoplasm (adrenal or ovarian) may lead to Hirsutism. [1] Hirsutism can be regarded as a virilizing symptom and may be defined as a male type of body hair distribution in the female. The pathogenesis of hirsutism may be due to an increased androgen production or to an enhanced sensitivity of the hair follicles in sexual areas. The androgen production in the female depends upon direct secretion by the ovaries and the adrenals and upon peripheral conversion of androgen precursors. [2] The most common cause of hirsutism is polycystic ovarian syndrome. Patients with “idiopathic” hirsutism have normal ovulatory cycles and androgen levels. Other causes are late onset congenital adrenal hyperplasia, Cushing's syndrome, and the HAIR-AN syndrome. Pituitary, ovarian, and adrenal tumors are important, but rare causes of hirsutism. A thorough history and examination are important. Laboratory investigation is essential in women with moderate to severe, sudden onset or rapidly progressing hirsutism. [3] PCOS can be viewed as a heterogeneous androgen excess disorder with varying degrees of reproductive and metabolic abnormalities determined by the interaction of multiple genetic and environmental factors. Polycystic ovary syndrome (PCOS) Khawaja Tahir Mahmood et al / J Biomed Sci and Res., Vol 3 (1), 2011,347-352