| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on November 2, 2007
Accepted on January 25, 2008
Assistant Professor, Harvard Medical School, Massachusetts General Hospital, (K.A.M.), Boston, Massachusetts; Professor and Director, University California School of Medicine-San Diego (R.J.C.), La Jolla, California; Professor of Medicine, Associate Director, University of Chicago GCRC (D.A.E.), Chicago, Illinois; Associate Professor, University of Barcelona (L.I.), Barcelona; Spain; Columbia University Medical Center (R.A.L.), New York, New York; University of Chicago Comer Children (R.L.R.), Chicago, Illinois; Clinical Professor, University of British Columbia, Vancouver Coastal Health Research Institute (J.S.), Vancouver, British Columbia; Mayo Clinic (V.M.M.), Rochester, Minnesota; and Fellow, Mayo Clinic (B.A.S.) Rochester, Minnesota
* To whom correspondence should be addressed. E-mail: govt-prof{at}endo-society.org.
Objective: To develop clinician practice guidelines for the evaluation and treatment of hirsutism in premenopausal women.
Participants: The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee (CGS) of The Endocrine Society, six additional experts, two methodologists, and a medical writer. The Task Force received no corporate funding or remuneration.
Evidence: Systematic reviews of available evidence were used to formulate the key treatment and prevention recommendations. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) group criteria to describe both the quality of evidence and the strength of recommendations. We used ‘recommend’ for strong recommendations, and ‘suggest’ for weak recommendations.
Consensus Process: Consensus was guided by systematic reviews of evidence and discussions during one group meeting, several conference calls, and e-mail communications. The drafts prepared by the task force with the help of a medical writer were reviewed successively by The Endocrine Society's CGS, Clinical Affairs Committee (CAC), and Council. The version approved by the CGS and CAC was placed on The Endocrine Society's Web site for comments by members. At each stage of review, the Task Force received written comments and incorporated needed changes.
Conclusions: We suggest testing for elevated androgen levels in women with moderate or severe hirsutism, or hirsutism of any degree when it is sudden in onset, rapidly progressive, or associated with other abnormalities such as menstrual dysfunction, obesity, or clitoromegaly. For women with patient-important hirsutism despite cosmetic measures, we suggest either pharmacological therapy or direct hair removal methods. For pharmacological therapy, we suggest oral contraceptives for the majority of women, adding an antiandrogen after 6 months if the response is suboptimal. We recommend against antiandrogen monotherapy unless adequate contraception is used. We suggest against using insulin-lowering drugs. For women who choose hair removal therapy, we suggest laser/photoepilation.
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
