Hirsutism

Excessive growth of terminal hair in women in a male pattern – on face, chest, back, and abdomen. Ferriman-Gallwey score ≥8. Most common cause is polycystic ovary syndrome. Endocrine Society 2018 base therapy: estrogen-progestin contraceptives when contraception is needed and/or antiandrogens (spironolactone, cyproterone acetate, finasteride). Cosmetic epilation and laser/light hair removal complement pharmacotherapy.

ICD-10 L68.01 drug

Also known as: PCOS-related hirsutism, Idiopathic hirsutism

Drugs used for this condition

BCyproterone acetateSecond line · Antiandrogen with progestogenic activityUsed in moderate-to-severe hirsutism in women combined with ethinyl estradiol (Diane-35, withdrawn in France in 2013). Endocrine Society 2018 places estrogen-progestin contraceptives and spironolactone as first-line; cyproterone acetate is an alternative when those fail or are intolerable. Dose 25–50 mg for 10 days of the cycle (Hammerstein regimen).

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit