Hirsutism - Classification of Causes

There are a number of ways to classify the causes of hirsutism:

1. Constitutional or familial - there may be a slight increase in androgens from the adrenal gland. In familial hirsutism no hormone abnormalities are found.
2. Hirsutism may be seen from abnormalities in the pituitary gland. There is an increase in ACTH causing secondary increases in cortisone and prolactin. Prolactin secreting tumours as well as some psychogenic drugs and the contraceptive pill can encourage prolactin secretion.
3. Abnormalities in the adrenal gland will produce increased DHEAS.
4. Certain ovarian tumours may produce progesterone, testosterone, and androstenedione.
5. A decrease in the sex hormone-binding globulins as is sometimes produced by liver abnormalities may enable more free testosterone to be available. This is converted into the hair top DHT (dehydrotesterone).
6. Certain drugs such as anabolic steroids may increase hirsutism.