Hirsutism is a common medical condition that in most women is due to t
he polycystic ovary syndrome or is idiopathic. For a few women, hirsut
ism signals a serious underlying disorder such its an ovarian or adren
al tumor, congenital adrenal hyperplasia, or Gushing's syndrome. A det
ailed medical history and examination can identify women in whom a ser
ious disease is suspected and for whom laboratory evaluation is warran
ted. Measurements of serum testosterone, dehydroepiandrosterone, and 1
7 alpha-hydroxyprogesterone levels, and 24-hour urinary cortisol conce
ntrations are important screening tests. Therapy is directed at suppre
ssing ovarian or adrenal androgen production, inhibiting the conversio
n of testosterone to dihydrotestosterone, or antagonizing the effects
of androgens at the receptor level.