Interpreting Findings in Hirsutism

Finding

Possible Causes

Abrupt-onset hirsutism, flank or pelvic mass

Adrenal cancer or ovarian cancer

Acanthosis nigricans

Polycystic ovary syndrome or other hyperinsulinemic states

Cancer

Central obesity, moon facies, striae, hypertension, proximal muscle wasting and weakness

Cushing syndrome

Galactorrhea, amenorrhea (with or without visual field deficits)

Pituitary disorder causing hyperprolactinemia

Irregular menses or amenorrhea, acne, obesity, hirsutism beginning after puberty

Polycystic ovary syndrome

Signs of undernutrition, poor dentition (particularly in adolescent females)

An eating disorder

Weight loss, fevers

Paraneoplastic syndromes caused by occult cancer