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The most common cause are
- polycystic ovarian syndrome (PCOS) – around 72% of women with clinical hyperandrogenism have PCOS (1)
- idiopathic - androgen levels are not increased, resulting
from hypersensitivity of the hair follicle to androgen (2). There may be a raised
level of peripherally derived androgens such as 3 alpha-androstanediol glucorinide.
The condition usually begins in the early teens and increases with age. A family
history may be present.
- adrenal -
- non-classic congenital adrenal hyperplasia (less than 5%)
- congenital adrenal hyperplasia
- Cushing's syndrome
- pituitary -
- hyperprolactinaemia (1)
- ovarian -
- virilising tumours
- gonadal dysgenesis
- thyroid dysfunction (1)
- iatrogenic -
- drugs - androgenic drugs, oral contraceptives, phenytoin
- menopause – is thought to be due to decreasing oestrogen levels leading to unopposed androgen effects, most present with facial hirsutism (4)
- Turner's syndrome
Last reviewed 01/2018