Endocrine Society Releases Treatment Guidelines for Hirsutism
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Endocrine Society Releases Treatment Guidelines for Hirsutism

CHEVY CHASE, Md -- April 22, 2008 -- The Endocrine Society has released new clinical practice guidelines for the treatment of hirsutism in premenopausal women. The guidelines appear in the April issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society.

"Hirsutism is a potential indication of an underlying medical disorder that may require specific treatment, and such a disorder may have implications for menstrual function, fertility, and metabolic risks," said Kathryn Martin, MD, Professor, Harvard Medical School; faculty member, Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts; and member of the Society's task force that developed the guidelines. "These evidence-based guidelines give healthcare professionals an approach to treating hirsutism based upon a comprehensive review of clinical trials of drug therapy and hair removal techniques such as laser and electrolysis."

The cause of hirsutism in women can be either an increased level of androgens or an oversensitivity of hair follicles to natural levels of androgens. The guidelines suggest testing for elevated androgen levels in women with moderate or severe hirsutism or hirsutism of any degree when it is sudden in onset, rapidly progressive, or associated with other abnormalities such as menstrual dysfunction or obesity.

For pharmacologic therapy, the guidelines suggest oral contraceptives for the majority of women, adding an antiandrogen after 6 months if the response is suboptimal. The guidelines recommend against using antiandrogens alone unless adequate contraception is used, because antiandrogens pose a potential risk to the normal sexual development of a male fetus.

Almost all women with hirsutism use temporary methods of hair removal such as shaving, plucking, and waxing. For those considering more "permanent" methods of hair removal, the guidelines suggest photoepilation as first-line therapy. Photoepilation methods, when compared with electrolysis, are more expensive per treatment session but are more efficient, less painful, and may be associated with less scarring.

SOURCE: The Endocrine Society

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