Women's Corner
Hirsutism - History and Physical Examination
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History and Physical Examination
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| In a case of hirsutism, the history includes rapidity
of hirsutism onset, associated symptoms and their progression, and menstrual
history. Past medical, social, family, and medication history help identify
less common causes of hirsutism. Key points during the physical examination are body mass index, blood pressure, and abdominal or pelvic masses. A thorough skin assessment includes distribution and texture of hair, the possible presence of acanthosis nigricans, and characteristics of masculinization. Determining the speed of hirsutism onset is essential to an accurate diagnosis. Persistent anovulation is almost always associated with gradual onset. Rapid-onset hirsutism suggests more aggressive underlying causes (eg, an androgen-producing tumor) and requires immediate referral to an endocrine specialist. In women whose hirsutism onset is unclear, it is important to rule out adrenal or ovarian tumors, late-onset adrenal hyperplasia, and Cushing's syndrome -- and to test for diabetes mellitus and insulin resistance. Other testing may include serum testosterone, morning levels of 17a-hydroxyprogesterone, 24-hour urinary free cortisol excretion, prolactin, and pelvic ultrasonography. |
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Copyrights Dr. Abel Maguid Ramzy 2000 All Rights
Reserved
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2000 جميع حقوق الطبع والنشر محفوظة للدكتور عبد
المجيد رمزي لعام
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