Objective: To evaluate the prevalence of idiopathic hirsutism in a lar
ge population of hirsute women. Design: 588 hirsute women (mean age 24
+/- 1, range 15-36 years) were evaluated as outpatients at the Depart
ment of Endocrinology of the University of Palermo, Italy. The diagnos
is of idiopathic hirsutism was established in hirsute patients present
ing regular ovulatory menstrual cycles and normal serum androgen level
s (total testosterone, unbound testosterone and dehydroepiandrosterone
sulfate). Methods: Hirsutism was calculated by the Ferriman-Gallwey-L
orenzo index. Serum androgens were evaluated in the follicular phase (
days 5 or 6) and normal androgen ranges were calculated as the mean +/
- 2 S.D. of serum levels of 30 ovulatory non-hirsute women. The presen
ce of ovulation was determined by serum progesterone levels during the
presumed luteal phase (days 21 or 22). All steroids were determined b
y specific RIAs. Results: 36 hirsute women (6%) had regular ovulatory
cycles and normal androgen levels and were diagnosed as being affected
by idiopathic hirsutism. Conclusions: Idiopathic hirsutism is a relat
ively uncommon cause of hirsutism, affecting approximately 6% of our p
opulation.