Hirsutism & Virilization

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• Suppression of androgen synthesis: 1. Combined oral contraceptives: • Dose: Low-dose formulations 20µg preparations. • Action: • Estrogen & progestin: ↓ gonadortopin ↓ ovarian androgen. • Estrogen: (++) ↑ SHBG. • Progestin: Displace active androgens at the hair follicle + (--) 5a-reductase activity. • Results: results within 1to 3 months
2. Medroxyprogesterone acetate: • Dose: 150 mg intramuscularly every 3 months. • Action: Progestin: as above (when COCs are contraindicated) 3. Gonadotropin-releasing hormone (GnRH) agnoists: • Action: (--) hypothalamic-pituitary-ovarian axis ↓ ovarian steroidogenseis. • Indications: severely androgenized patients refractory to other therapies. 4. Corticosteroids: • Indications: severe cases of adrenal hyperplasia (CAH).
Page 2 and 3: By Prof.Dr. Nabil Lymon Head of Int
Page 4 and 5: Virilization: • Is hirsutism asso
Page 6 and 7: Types of Hair 1. Lanugo hair: It is
Page 8 and 9: 2. Degree to which hair follicles a
Page 10 and 11: Sources of androgens in females:
Page 12 and 13: I- Testosterone • Total testoster
Page 14 and 15: II- Sex Hormone-Binding Globulin (S
Page 16 and 17: III- 5 α-Reductase • 5 α-Reduct
Page 18 and 19: Diagnosis of Hirsutism
Page 20 and 21: 2) Presence or absence of virilizat
Page 22 and 23: Differential Diagnosis of Hirsutism
Page 24 and 25: a) The fundamental pathophysiologic
Page 26 and 27: 2- Idiopathic hirsutism: • This c
Page 28 and 29: 4- Cushing syndrome: • Adrenocort
Page 30 and 31: 6- Disorders of pituitary origin
Page 32 and 33: Laboratory Evaluation of Hirsutism
Page 34 and 35: 2) Serum DHEAS (a marker of adrenal
Page 36 and 37: 5) Oestrogen levels. Estradiol is u
Page 38 and 39: Treatment
Page 42 and 43: • Androgen-receptor blockers: •

Hirsutism & Virilization

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