Guideline No. 444: Hirsutism: Evaluation and Treatment
Abstract
OBJECTIVE: This guideline reviews the etiology, diagnosis, evaluation, and treatment of hirsutism.
TARGET POPULATION: Women with hirsutism.
OPTIONS: Three approaches to management include: 1) mechanical hair removal; 2) suppression of androgen production; and 3) androgen receptor blockade.
OUTCOMES: The main limitations of the management options include the adverse effects, costs, and duration of treatment.
BENEFITS, HARMS, AND COSTS: Implementation of the recommendations in this guideline may improve the management of hirsutism in women with this condition. Adverse effects and a potential long duration of treatment are the main drawbacks to initiating treatment, as is the possibility of significant financial costs for certain treatments.
EVIDENCE: A comprehensive literature review was updated to April 2022, following the same methods as for the prior Society of Obstetricians and Gynaecologists of Canada (SOGC) Hirsutism guidelines. Results were restricted to systematic reviews, randomized controlled trials, controlled clinical trials, and observational studies. There were no date limits, but results were limited to English- or French-language materials.
VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, along with the option of designating a recommendation as a "good practice point." See online Appendix A (Tables A1 for…
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