[Hirsutism].

The symptom of hirsutism, i.e. excessive sexual hair of the male pattern for the individual woman, must be strictly differentiated from hypertrichosis, which is not androgendependent and occurs in both sexes, and also from the disease of virilization. The suffering derives from a divergence from the feminine ideal rather than from reality, and most forms of solitary hirsutism are probably to be assigned to the outer area of a Gaussian curve of sexual hair growth in normal women, by analogy to baldness in men. Although slightly elevated androgen levels are by no means rare, receptorial and postreceptorial processes in the hair follicle cells are at least of equal importance; both are modulated by a variety of partial factors. The salient point in workup is to exclude virilization and other primary diseases: this is usually possible on clinical grounds and by limited hormone measurements. Longterm therapy of solitary hirsutism is chiefly cosmetic, if there is no simultaneous wish for contraception. If this is desired, and if the hirsutism is mild, an initial low-dose cyproterone acetate-estrogen combination may be (appropriate. A higher dosage of cyproterone acetate Hammerstein 's regimen) over many years should be confined to severe forms.