➤ Endocrine Society (ES) suggests testing for elevated androgen levels in all
women with an abnormal hirsutism score. (2|⊕⊕
)
➤ In those cases where serum total testosterone levels are normal, if sexual
hair growth is moderate/severe or sexual hair growth is mild but there is
clinical evidence of a hyperandrogenic endocrine disorder (such as menstrual
disturbance or progression in spite of therapy), ES suggests measuring an
early morning serum total and free testosterone by a reliable specialty assay.
(2|⊕⊕
)
➤ ES suggests screening hyperandrogenemic women for nonclassical congenital
adrenal hyperplasia (NCCAH) due to 21-hydroxylase deficiency by measuring
early morning 17-hydroxyprogesterone levels in the follicular phase or on a
random day for those with amenorrhea or infrequent menses. (2|⊕⊕
)
• In hirsute patients with a high risk of congenital adrenal hyperplasia (positive family
history, member of a high-risk ethnic group), ES suggests this screening even if serum
total and free testosterone are normal. (2|⊕⊕
)
➤ ES suggests against testing for elevated androgen levels in eumenorrheic women
with unwanted local hair growth (i.e., in the absence of an abnormal hirsutism
score) because of the low likelihood of identifying a medical disorder that would
change management or outcome. (2|⊕⊕
)
Diagnosis
