Assessment of hirsutism

Last reviewed: 11 Jul 2025
Last updated: 24 Jul 2025

Summary

Differentials

Common

  • Polycystic ovary syndrome
  • Idiopathic hirsutism
Full details

Uncommon

  • Hyperprolactinaemia
  • Non-classical congenital adrenal hyperplasia
  • Cushing's syndrome
  • Androgenic drugs
  • Androgen-secreting ovarian tumour
  • Ovarian hyperthecosis
  • Adrenocortical carcinoma
Full details

Contributors

Authors

Stephen L. Atkin, PhD, FRCP

Professor of Medicine

Head of School of Postgraduate Studies & Research

The Royal College of Surgeons in Ireland - Bahrain

Busaiteen

Bahrain

Disclosures

SLA has no competing interests.

Thozhukat Sathyapalan, MD, MRCP FRCPE

Professor of Endocrinology/Honorary Consultant Endocrinologist

Academic Endocrinology, Diabetes and Metabolism

Hull York Medical School

Michael White Diabetes Centre

Hull Royal Infirmary

Hull

UK

Disclosures

TS declares that he has received educational grants and clinical trials funding from Novo Nordisk, Eli Lillly, and Novartis.

Acknowledgements

Dr Stephen L. Atkin and Dr Thozhukat Sathyapalan would like to gratefully acknowledge Dr Shehzad Basaria and Dr Milena Braga-Basaria, the previous contributors to this topic.

Disclosures

SB and MBB declared that they had no competing interests.

Peer reviewers

Joe McKenna, MD

Professor of Investigative Endocrinology

University College

Dublin

Ireland

Disclosures

JM declares that he has no competing interests.

Udaya Kabadi, MD, FRCP(C), FACP, FACE

Director

Endocrinology

Department of Internal Medicine

VA Medical Center

University of Iowa

Iowa City

IA

Disclosures

UK declares that he has no competing interests.

References

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Key articles

Martin KA, Anderson RR, Chang RJ, et al. Evaluation and treatment of hirsutism in premenopausal women: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018 Apr 1;103(4):1233-57.Full text  Abstract

Elliott J, Liu K, Motan T. Guideline no. 444: hirsutism: evaluation and treatment. J Obstet Gynaecol Can. 2023 Dec;45(12):102272. Abstract

Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 International Evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2023 Oct;120(4):767-93.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Assessment of hirsutism images
  • Guidelines

    • Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome
    • Guideline no. 444: hirsutism: evaluation and treatment
    More Guidelines
  • Patient information

    Polycystic ovary syndrome

    Ovarian cancer

    More Patient information
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