Muhammad Usman Anjum, Surriya Yasmin, Hashim Riaz, Syed Humayun Shah.
Hirsutism; etiological profile in Abbottabad, Pakistan.
Professional Med J Jan ;23(06):741-5.

Hirsutism is a clinical condition which commonly affects women. This is associated with loss of self-esteem, psychological distress and cosmetic embarrassment. Objective: To study the clinical, biochemical and etiological profile of patients with hirsutism in Abbottabad, Pakistan. Duration and place: This descriptive study was performed in Frontier Medical & Dental College, Abbottabad from January, 2015 to December, 2015. Methods: Fifty patients were included in the study. Complete clinical assessment and abdominal and pelvic ultrasonography was carried out. Ferriman and Gallwey score was used to assess the extent and pattern of hirsutism. Endocrinological investigations performed in these patients included prolactin, testosterone, luteinizing and follicular stimulating hormone (LH, FSH), thyroid function tests and cortisol. Results: Fifty patients were included in the study. Their mean age was 28.30±5.83 years. About 88% of the women were married and 70% were obese. The polycystic ovarian syndrome (58%) was diagnosed as the main cause of hirsutism followed by idiopathic hirsutism (38%) and drug-induced hirsutism (4%). Majority of patients, 50%, had hirsutism for 1-5 years while 22% and 20% had hirsutism for 6-10 years and > 10 years respectively. The rate of infertility among hirsute women was 70% (35 cases), out of which, 24 (48%) cases had primary infertility while 11 (22%) had secondary infertility. Most of the hirsuite patients, 26 (52%), presented with the complaints of infertility and menstrual disturbances followed by infertility alone in 9 (18%) cases, hirsutism in 6 (12%) cases and menstrual irregularities in 5 (10%). The 60% of patients belonged to moderate category according to FG score, (FG score 17-24). The 26% belonged to mild category (FG score 8-16) and 14% belonged to severe category (FG score 25-30). About 72% of our patients used treatment of any kind for their disease. The common hair removing practices used by these patients included bleaching (22%), waxing (20%), epilation (20%), electrolysis (6%) and shaving (4%). Serum free testosterone levels were elevated in 44% of our patients, LH/FSH ratio was more than 2 in 42.1% patients and prolactin levels were raised in 10% of the patients. Conclusion: Hirsutism is not uncommon in Pakistan. The most common cause of hirsutism was polycystic ovarian syndrome and idiopathic hirsutism. There is a need to conduct large scale studies to determine the true prevalence and etiological profile of patients with hirsutism.

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