Women with clinically significant hirsutism always have detectable endocrinological abnormalities

Abstract Aim In this study a consecutive series of 120 hirsute Saudi women were thoroughly investigated for possible causes of their hirsutism. Methods In addition to a detailed clinical evaluation the following hormones were measured: testosterone, free testosterone, dehydroepiandrosterone sulphate, prolactin, progesterone, luteinising hormone, follicle stimulating hormone, thyroid stimulating hormone, T 3 , T 4 , cortisol, 17-hydroxyprogesterone, androstenedione and dihydrotestosterone. Results All evaluable patients had at least one hormonal abnormality and 85.9% had at least one of the five major androgens elevated. Polycystic ovaries were found in 59% of the patients, hyperprolactinaemia in 34.6%, and 14.1% had congenital adrenal hyperplasia. Conclusion We recommend a two-step laboratory work-up that will unravel a cause for hirsutism in most if not all hirsute women.