Management of Hirsutism in Clinical Practice

Background: Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is a distressing and relatively common problem, affecting 5 to 10% of premenopausal women in the general population. Moreover, hirsutism is often associated with decreased quality of life and significant psychological stress. This study aims to assess prevalent current practice of our clinicians related to the management of hirsutism in Kurdistan region of Iraq. Subjects and Methods: An electronic questionnaire on current practice concerning the management of hirsutism was sent through e-mail to 190 clinicians. 166 of doctors completed the survey and were of from different specialties (endocrinologists, general internists, obstetricians, family medicine, general practitioners), from different cities of Kurdistan region of IRAQ (Duhok, Sulaymaniyah, Erbil, and Halabja). Results: Whilst 81 (48.8%) of all the responders assessed the severity of hirsutism clinically by applying Ferriman-Gallwey hirsutism scoring system or equivalent score, the remaining 85 (51.2%), consisting majority of responders, did not carry out any assessment for severity of hirsutism. Regarding exclusion of malignancies, 92.8% of responders, said that they are asking routinely for alarming signs and symptoms of malignancies. Concerning exclusion of hyperandrogenism workup, 92.2% of responders were routinely asked about hyperandrogenism workup. The last question was about the preferred androgen suppressive therapy only 41.0% of responders treat hirsutism by a combination of OCP plus androgen blocks.