Advertisement

Hirsutism and Quality of Life

  • S. Davies
Reference work entry

Abstract:

Hirsutism in women results in significant psychological and social problems. It impacts negatively upon the quality of life of women and is the cause of stress, anxiety and depression, particularly in cultures where hairlessness is viewed as the norm for women. Facially hirsute women perceive themselves to be in poorer health than non-hirsute women, and there are fewer in employment despite having similar educational experiences and levels of attainment.

Hirsute women spend much time and effort in removing excess facial: and can feel overwhelmed and frustrated by their efforts. All currently available treatments have limited effectiveness and can have serious side-effects. It is therefore a testament to the levels of distress caused by the problem that women persist with treatment despite the difficulties encountered.

There is very limited evidence as to the cost-effectiveness of the various treatments for hirsutism but the evidence that does exist indicates that the use eflornithine cream results in a small gain in Quality Adjusted Life Years ( QALYs) for patients and provides acceptable value for money.

When women and their partners were asked to consider what they would be willing to pay for an effective treatment for hirsutism, the average amounts were £40 and £47 per month respectively which is more than is currently spent on alternatives by women with the condition.

It is essential that research continues to be undertaken into this distressing problem and that clinicians who treat women with hirsutism deal with them sensitively, acknowledging the major psychological and emotional difficulties these women are facing.

Keywords

Polycystic Ovary Syndrome Hair Growth Hair Removal Facial Hair Hirsute Woman 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

BAD

British Association of Dermatologists

CI

confidence interval

DTB

Drug and Therapeutics Bulletin

EQ5d

EuroQol 5d

FDA

Food and Drugs Administration

GP

general practitioner

HRQoL

health related quality of life

PCDS

primary care dermatology society

PCOS

polycystic ovary syndrome

QALY

quality adjusted life year

SD

standard deviation

VAS

visual analogue scale

WTP

willingness to pay

References

  1. Azziz R. (2003). Obstet Gynecol. 101: 995–1007.PubMedCrossRefGoogle Scholar
  2. Azziz R, Carmina E, Sawaya ME. (2000). Endocr Rev. 21: 347–362.PubMedCrossRefGoogle Scholar
  3. Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lanzenby J, Stephens KC, Taylor K, Boots LR. (2004). J Clin Endocrinol Metab. 89: 453–462.PubMedCrossRefGoogle Scholar
  4. Balen A. (1999). Lancet. 354: 966–967.PubMedCrossRefGoogle Scholar
  5. Brazier J, Deverill M, Green C. (1999). J Health Serv Res Policy. 4: 174–184.PubMedGoogle Scholar
  6. British Association of Dermatologists. (2006). Available at: http://www.bad.org.uk/public/leaflets/hirsutism.asp (Accessed: February 20, 2008).
  7. Brooks R. (1996). Health Policy. 37: 53–72.PubMedCrossRefGoogle Scholar
  8. Ching HL, Burke V, Stuckey BG. (2007). Clin Endocrinol. 66(3): 373–379.Google Scholar
  9. Clayton WJ, Lipton M, Elford J, Rustin M, Sherr L. (2005). Br J Dermatol. 152: 986–992.Google Scholar
  10. Coffey S, Mason H. (2003). Gynecol Endocrinol. 17: 379–386.PubMedCrossRefGoogle Scholar
  11. Davies S, Phillips CJ. (2007). J Med Econ. 10: 107–118.CrossRefGoogle Scholar
  12. Deplewski D, Rosenfield RL. (2000). Endocr Rev. 21: 363–392.PubMedCrossRefGoogle Scholar
  13. Drug and Therapeutics Bulletin (DTB). (2001). 39: 1–5.Google Scholar
  14. Ferrante J. (1998). Cult Med Psychiatry. 12: 219–238.CrossRefGoogle Scholar
  15. Finlay AY, Khan GK. (1994). Clin Exp Dermatol. 19: 210–216.PubMedCrossRefGoogle Scholar
  16. Givens JR, Kurtz BR. (1992). Hirsutism, virilization, and androgen excess. In: Hurst JW, Ambrose SS, et al. (eds.) Medicine for the Practicing Physician, 3rd ed. Butterworth-Heinemann, Boston, pp. 568–571.Google Scholar
  17. Goodheart HP, Uyttendaele HI. (2008). Available at: http://www.emedicine.com/derm/topic472.htm (Accessed: February 20 2008).
  18. Griffing GT. (2007). Available at: http://www.emedicine.com/med/topic1017.htm (Accessed: February 20 2008).
  19. Hahn S, Janssen OE, Tan S, Pleger K, Mann K, Schedlowski M, Kimmig R, Benson S, Balamitsa E, Elsenbruch S. (2005). Eur J Endocrinol. 153(6): 853–860.PubMedCrossRefGoogle Scholar
  20. Hamzavi I, Tan E, Shapiro J, Lui H. (2003). Lasers Surg Med. 15: 32.Google Scholar
  21. Harborne L, Fleming R, Lyall H, Norman J, Sattar N. (2003). Lancet. 361: 1894–1901.PubMedCrossRefGoogle Scholar
  22. Hopkinson ZEC, Sattar N, Fleming R, Greer IA. (1998). Br Med J. 317: 329–332.Google Scholar
  23. Hunter MH, Carek PJ. (2003). Am Fam Physician. 67 Available at: http://www.aafp.org/afp/20030615/2565.html (Accessed: February 20, 2008).
  24. Keegan A, Liao LM, Boyle M. (2003). J Health Psychol. 8:327–345.PubMedGoogle Scholar
  25. Kitzinger C, Wilmott J. (2002). Soc Sci Med. 54: 349–361.PubMedCrossRefGoogle Scholar
  26. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. (1998). J Clin Endocrinol Metab. 83: 3078–3082.PubMedCrossRefGoogle Scholar
  27. Lipton MG, Sherr L, Elford J, et al. (2006). J Psychosom Res. 61:161–168.PubMedCrossRefGoogle Scholar
  28. Loo WJ, Lanigan SW. (2002). Clin Exp Dermatol. 27: 439–441.PubMedCrossRefGoogle Scholar
  29. Moghetti P, Toscana V. (2006). Best Pract Res Clin Endocrinol Metab. 20: 221–234.PubMedCrossRefGoogle Scholar
  30. National Horizon Scanning Centre: New and Emerging Technology Briefing. (2001). Available at: http://www.pcpoh.bham.ac.uk/publichealth/horizon/PDF_files/2001reports/Eflornithine.PDF (Accessed February 20 2008).
  31. Primary Care Dermatology Society (PCDS). (2005). Guidelines: Medical Management of Hirsutism.Available at: (http://www.evidence-based-medicine.co.uk/guidelines.html)
  32. Reingold SB, Rosenfield RL. (1987). Arch Dermatol. 123: 209–212.PubMedCrossRefGoogle Scholar
  33. Rosenfield RL. (2005). N Engl J Med. 353: 2578–2588.PubMedCrossRefGoogle Scholar
  34. Smith SR, Piacquadio D, Beger B. (2003). Abstract from the 61st Annual Meeting of the American Academy of Dermatology. San Francisco, CA.Google Scholar
  35. Soliman N, Wardle P. (2006). Available at: http://student.bmj.com/issues/06/10/education/360.php (Accessed: February 20, 2008).
  36. Sonino N, Fava GA, Mani E, et al. (1993). Postgrad Med J. 69: 186–189.PubMedCrossRefGoogle Scholar
  37. Stevens A, Colin-Jones D, Gabbay J. (1995). Health Trends. 27: 37–42.PubMedGoogle Scholar
  38. Toerien M, Wilkinson S. (2003). Womens Stud Int Forum. 26: 333–344.CrossRefGoogle Scholar
  39. Towse A, Pritchard C. (2002). Does NICE have a threshold? An external view. In: Costeffectiveness Thresholds: Economic and Ethical Issues. Office of Health Economics, London, UK.Google Scholar
  40. Walling AD. (2004). Am Fam Physician. 69. Available at: (http://www.aafp.org/afp/20040115/tips/17.html) (Accessed: February 20, 2008).

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • S. Davies

There are no affiliations available

Personalised recommendations