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Hirsutism with hair all over but thinning on head and enlarged clitoris

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My dermatologist advised me to see an endocrinologist about excessive hair on my body. I'm a 19 year old woman and I have had abnormal hair growth since I was around 12. I have hair all over my legs, arms, chest, back, butt and stomach (most of the hair is around my stomach). I also have facial hair around my temples, cheeks and sideburn areas. Along with this, I also have thinning hair on the top of my head, I have been noticing the thinning for about four years now. Although I have not been diagnosed with it, I am pretty sure that I have hirsutism. I did have a blood test to check my testosterone levels and the results were normal. Thyroid was normal too. Lately, I have been feeling that my menstrual flow has been decreasing as well. I am planning on seeing an OBGYN about my menstrual flow. I also think that I have an enlarged clitoris (I intend to consult my OBGYN about this, as well). The symptoms that I described seem to match up to symptoms caused by PCOS, late onset CAH and maybe a prolactin disorder. Are any of these disorders plausible? Are there any other possible explanations for these symptoms? Should I try to get an appointment with an endocrinologist right away?

Category: Endocrinologist

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Dr. J Muthukrishnan
Category: Diabetologist
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 21 Doctors Online

Expert:  Dr. J Muthukrishnan
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Hello,

Yes, From what you describe, it is evident that you have hirsutism, which is significant. And with loss of hair over scalp, and enlarged clitoris and menstrual irregularity, it is important to investigate you for the conditions you mention and certain others too. What ever you have mentioned are all possibilities, but cornerstone of diagnosis in Endocrinology is Physical examination and lab assays. So let's not jump into conclusions.

Please consult an endocrinologist for this condition, even before you consult a OBGY. Unless the OBGYN has expertise in Gyno-endocrinology, it will delay the definitive treatment. And do not worry your issue can be addressed successfully after a confirmed diagnosis.

Hope this helps
Please feel free to ask followup questions.
Thank you.

Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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