HIRSUTISM

ETIOLOGICAL PROFILE IN ABBOTTABAD, PAKISTAN

Abstract

elf-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.