Evidence for an Underlying Adrenocortical Abnormality in Hirsute Women

Urinary testosterone levels were measured in twenty‐eight hirsute women and ten control subjects before and after the administration of corticotrophin. Twenty‐four patients had elevated basal urinary testosterone levels, and of these, nineteen showed an abnormal response to corticotrophin stimulation. Ten hirsute women from the latter group of nineteen, and eight control subjects, were further studied by measurement of the urinary pregnanetriol excretion before and following the concurrent administration of corticotrophin and metyrapone. An abnormal increment in pregnanetriol excretion was observed in eight out of the ten hirsute patients. It is suggested that this is evidence that an adrenal abnormality may be responsible for certain cases of idiopathic hirsutism, which may be operative at the 21‐hydroxylase level.