A Clinico-etiological Evaluation of Hirsutism Patients: A Case Series

Background: Hirsutism is a condition of excess hair growth in females in male-like distribution. It is seen in almost 5-10% of women. Women having hirsutism have a negative impact on quality of life.

Aim: All patients were subjected to ultrasound imaging (Sonography) and hormonal evaluation to establish possible causative factors.

Methods: A prospective and retrospective study of hirsutism patients, who were evaluated at Samarpan medical research organization, Modasa, Gujarat from 2016 to 2019.

Results: In this case series age and clinical presentation were studied in five female patients diagnosed with hirsutism. The patients age ranged from 16 to 22 years with a mean of 19.60 years. All these patients showed localized hair growth on the upper lip, chin, and cheek on the face. Ultrasound study revealed that one of the five patients had a right bulky ovary and four patients showed both ovaries with multiple follicles. In hormonal evaluation, in one of the three patients the LH: FSH ratio was found to be more than 3. Three out of the five patients showed elevated levels of 17-OHP and serum testosterone. Two out of the three patients showed an elevated level of serum insulin. The level of DHEAS, serum prolactin, serum cortisol, and serum TSH were found to be in a normal range.

Conclusion: Ultrasonographic (USG) study revealed a positive correlation between PCOS and Hirsutism patients. Hirsutism patients were found to have higher levels of 17-OHP, serum testosterone, serum insulin, and a higher ratio of LH: FSH, one or more at a time suggesting a strong correlation between elevated levels of these hormones and hirsutism. The present study could not establish any meaningful correlation between the level of DHEAS, serum prolactin, serum cortisol, and serum TSH.