Hirsutism

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             Risk factors for developing hirsutism include a family history of hirsutism , endocrine disorders , use of androgens (androgenic steroids or testosterone) , and older age .
             For some races or origins hirsutism is normal especially in more ethnic cultures but in the US since it is seen as unattractive most cases are not revealed .
             A lot of other females become hirsute because of drugs they have taken or during puberty or menstrual cycle . Hirsutism related to PCOS usually begins around the time of the menarche and increases slowly and steadily in the teens and twenties . Rapid progression and prepubertal or late onset suggests a more serious cause . The complaint of hirsutism is common and often accompanied by severe anxiety and social stress . The following are important issues to consider . The extent and severity of hirsutism should be recorded objectively , ideally using a scrolling system , to document the problem and to monitor treatment . The method and frequency of physical removal (e.g. shaving , plucking ) should also be recorded . Most patients who complain of hirsutism will have an objective excess of hair on examination , but occasionally a normal pattern of hair will be found . Most patients with hirsutism will have some disturbance of menstruation . The greater the disruption the more likely it is that there is a serious cause . Many patients with hirsutism are also overweight or obese . This worsens the underlying androgen excess and insulin resistance and inhibits the response to treatment , and is an indication for appropriate advice on diet and exercise . In severe cases the insulin resistance may have a visible manifestation on the neck and in the axillae .