Hirsutism

The commonest causes of hirsutism are idiopathic (no cause known), familial / racial, and the polycystic ovarian syndrome (PCOS).

The PCOS usually presents with gradual onset of hirsutism and weight gain on a background of long-standing oligomenorrhoea, typically dating back to puberty.

Virilizing tumours (ovarian or adrenal) are much less common, but should be suspected if there is a sudden onset of symptoms, when examination should look specifically for signs of virilization (male pattern muscle development, clitoromegally).