Hirsutism

Definition

Hirsutism is the growth of coarse, dark hair on women in a male pattern (upper lip, chin, chest, abdomen, back). It is usually a sign of androgen excess or increased sensitivity to androgens.

Causes

• Polycystic ovary syndrome (PCOS). Most common
• Cushing's syndrome
• Congenital adrenal hyperplasia
• Adrenal or ovarian tumors
• Certain medications (steroids, testosterone, phenytoin)
• Idiopathic

Nursing Interventions

Assess for associated signs (menstrual irregularity, acne, obesity, insulin resistance in PCOS; central obesity, purple striae, moon face in Cushing's). Laboratory workup: testosterone, DHEA-S, cortisol, glucose, A1c. Treatment: lifestyle (weight loss), combined oral contraceptives, spironolactone (anti-androgen), insulin-sensitizing agents (metformin for PCOS). Provide cosmetic options (shaving, waxing, laser, electrolysis). Emotional support regarding body image.

NCLEX Relevance

PCOS is the most common cause. Cushing's triad of features.