Hirsutism Guideline Resources

Full Guideline: Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline JCEM April 2018

Kathryn A. Martin (chair), R. Rox Anderson, R. Jeffrey Chang, David A. Ehrmann, Rogerio A. Lobo, M. Hassan Murad, Michel M. Pugeat, Robert L. Rosenfield

Differences between the 2008 and 2018 guidelines:

  • Modified recommendations for both the evaluation and management of hirsutism.
  • Broadened suggestions for biochemical testing.
  • A new recommendation for lifestyle changes for obese women with polycystic ovary syndrome.
  • A stronger recommendation against the use of flutamide.
  • Reconfirmed that all oral contraceptives appear to be equally effective for hirsutism.
  • More detail on the uses, efficacy, and safety of photoepilation.


Hirsutism: Evaluation and Management | ENDO 2018

Essential Points

  • Suggests testing for elevated androgen levels in all women with an abnormal hirsutism score.
  • 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).
  • Recommends against antiandrogen monotherapy unless adequate contraception is used.
  • Suggests against using insulin-lowering drugs.

Summary of Recommendations

+1.0 Diagnosis of hirsutism

+2.0 Treatment of hirsutism in premenopausal women

+3.0 Pharmacological Treatments

+4.0 Direct Hair Removal Methods