What is the most common cause of androgen excess and hirsutism in women?

Polycystic ovarian syndrome (PCOS) is recognized as the most common cause of androgen excess and hirsutism in women. This condition affects a significant number of women of reproductive age and is characterized by a combination of symptoms, including irregular menstrual cycles, ovarian cysts, and elevated levels of androgens—male hormones that can lead to hirsutism (excessive hair growth in areas typically associated with male-pattern hair distribution).

In PCOS, the ovaries are often enlarged and there may be multiple cysts due to hormonal imbalances that disrupt ovulation. The elevated androgens can influence various bodily functions, leading to not only hirsutism but also acne and alopecia (hair loss). The interplay of insulin resistance and hormonal dysregulation in PCOS further exacerbates these symptoms, making it a distinct and prevalent cause of androgen excess.

Understanding PCOS as the most common cause is vital for proper diagnosis and management of hirsutism in women. Treatment often involves lifestyle modifications and pharmacological interventions aimed at reducing androgen levels and managing symptoms, which highlights the clinical significance of recognizing this syndrome.