Reproductive Case: 34-year-old Woman with Hirsutism

00:01 Let's go on to another case.

00:03 Here we have a 34 year old woman who is seen for recent hirsutism of the face, chest and abdomen.

00:09 Hair growth has progressed over the last few years.

00:12 Menstrual cycles have become irregular over the same time course.

00:17 Medical history is otherwise unremarkable and she doesn't take any medications.

00:22 On physical exam, her blood pressure is 138/90 and the remainder of the vital signs are normal.

00:28 Her BMI is 26.

00:31 On exam, she has acne, dark terminal hairs appear on the face, chest and abdomen.

00:37 The patient's hair is thinning on the top of her head.

00:41 The remainder of the physical exam is noncontributory.

00:44 On lab evaluation, her estradiol level is 68 picograms per ml, her FSH is 12 mU/ml and her beta HCG is negative.

00:55 She has a normal prolactin level and a testosterone level of 120 ng/dL, with a normal TSH.

01:03 What is the best diagnosis for this case? So looking at the patient's history, she has hirsutism, altered menses, increased blood pressure, slightly elevated body mass index and an elevated testosterone.

01:18 These all suggest hyperandrogenism or abnormal masculine characteristics that develop in a female.

01:27 The best diagnosis is polycystic ovary syndrome, this is the most common cause in most women who present with hirsutism.

01:36 Women with chronic hirsutism and menstrual cycles every 25 to 35 days mostly have idiopathic hirsutism or polycystic ovarian syndrome.

01:45 This accounts for 95% of cases.