The simple idea (no memorising)
Three look‑alike words, kept straight:
- Hirsutism — coarse, dark hair in a male pattern (upper lip, chin, chest, tummy). Driven by androgens.
- Virilisation — hirsutism plus stronger effects: deep voice, muscle bulk, enlarged clitoris. This is a louder alarm.
- Hypertrichosis — just generally more hair everywhere, not androgen‑driven. A different thing entirely.
Where do the androgens come from?
Two factories:
- the ovary — mainly testosterone;
- the adrenal gland (on top of the kidney) — mainly DHEA‑S.
So the blood test points to the source: high testosterone → think ovary; high DHEA‑S → think adrenal.
The one warning sign
Slow, mild hirsutism in a young woman is usually PCOS, which you'll meet next. But rapid hair growth with virilisation is different — it suggests a hormone‑producing tumour and needs urgent evaluation. Speed is the alarm bell. 🚩
Doctors have a hair "score"
To measure hirsutism objectively, clinicians use the Ferriman–Gallwey score, rating hair at nine body sites. You don't need the numbers — just know that "how hairy" can be measured and tracked over time.
Why it matters
Extra hair isn't just cosmetic — it's a visible readout of the hormone loop. Reading it (ovary vs adrenal, slow vs rapid) tells you which door to open next.
Quick check ✅
- What's the difference between hirsutism and hypertrichosis?
- High testosterone points to which organ? High DHEA‑S?
Remember this 🌟
Where we're going next → The commonest reason for a young woman's extra hair and irregular cycles has a name — and it's much more than "cysts." Concept 17.