Medical treatment of hirsutism
Medical treatment of hirsutism
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DOI：
10.1111/j.1529-8019.2008.00215.x
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发表时间：
2008-09-01
影响因子：
3.6
通讯作者：
Hahn, Susanne
中科院分区：
文献类型：
--
作者：
Blume-Peytavi, Ulrike;Hahn, Susanne
多毛症通常是由多囊卵巢综合征引起的肾上腺、卵巢或中枢内分泌异常引起的，但也可能是特发性或药物引起的。多毛症医学治疗的目的是纠正任何因果性激素平衡，减缓或停止毛发过度生长，并改善多毛症的美观，从而对患者的生活质量产生积极影响。今天，对于大多数女性，具有抗雄激素活性的口服避孕药单药治疗被推荐为多毛症的一线治疗。如果单药治疗6-9个月后多毛症的临床改善不充分，建议联合口服避孕药和抗雄激素药物。在患有多毛症、高雄激素血症和胰岛素抵抗的妇女中，胰岛素增敏剂对多毛症以及高胰岛素血症、高雄激素血症和不孕症有效，但没有令人信服的证据表明它们单独对多毛症有效。局部依氟鸟氨酸是一种药物治疗，当与全身药物或激光/光脱毛联合使用时，可以成为多毛症的有用辅助治疗。
Hirsutism is usually the result of an underlying adrenal, ovarian, or central endocrine abnormality mainly due to polycystic ovary syndrome but may also be idiopathic or drug induced. The aim of medical treatment of hirsutism is to rectify any causal hormonal balance, slow down or stop excessive hair growth, and improve the aesthetic appearance of hirsutism, thereby positively affecting the patient's quality of life. Today, for the majority of women, a monotherapy with oral contraceptives that have antiandrogenic activity is recommended as a first-line treatment for hirsutism. Combining an oral contraceptive pill with an antiandrogen is recommended if clinical improvement of hirsutism is insufficient after 6-9 months' monotherapy. In women who present with hirsutism, hyperandrogenism, and insulin resistance, insulin sensitizers are effective for the hirsutism as well as the hyperinsulinemia, hyperandrogenism, and infertility but there is no convincing evidence that they are effective for hirsutism alone. Topical eflornithine is a medical therapy that can be a useful adjuvant for hirsutism when used in conjunction with systemic medications or with laser/photoepilation.