Management and treatment of hirsutism in the elderly woman

Hirsutism in the menopause is understudied and probably underrated. Virilization should be sought and appropriate therapy instituted when it accompanies hirsutism. A number of treatments are available to manage hirsutism. Most are empirical and not approved by the U.S. Food and Drug Administration (FDA) for this use. In general, multiagent treatment has been used to treat hirsutism through a variety of mechanisms. This can become complex if there are other underlying medical disorders. Recently, a skin cream utilizing eflornithine hydrochloride has been found to be effective in treating hirsutism in postmenopausal women, and antiandrogens should also be considered as a medical treatment. The role of hormone replacement as an adjuvant therapy in suppressing circulating androgens and improving hirsutism has not been fully studied in menopausal women. The onset of action with medical treatments can last several months before improvement is noted. Physical removal methods including electrolysis and laser are often used as adjuvant therapies after adequate medical suppression has been achieved.