​Pathology - Hirsutism 
Hirsutism refers to excessive hair development in regions of the body where terminal hair does not ordinarily occur or is limited. It is most typically seen in women in whom aberrant hair growth takes on a pattern of masculine hair growth. This issue is a medical symptom rather than an illness and should be investigated appropriately. Hirsutism can be induced by either an increase level of androgens or an oversensitivity of hair follicles to androgens. Symptoms of aberrant hair growth may be accompanied by additional indicators of enhanced androgenic circulation, such as deepening of the voice, increased muscular mass, or cystic acne. Increased circulating levels of insulin in women may contribute to hirsutism, as high insulin levels stimulate ovarian theca cells to produce androgens. In addition, excessive doses of insulin may act at IGF-1 receptors in these same cells, resulting in increased androgen synthesis. Evaluation of this disorder comprises serum FSH level, free cortisol, 21-alpha hydroxylase deficiency, human growth hormone, fasting blood sugar, and hemoglobin A1c to check for PCOS, adrenocorticosteroid excess, congenital adrenal hyperplasia, acromegaly, and insulin resistance, respectively. Imaging of ovaries and adrenal glands may be indicated in some instances. Careful examination of drugs is also necessary, as hirsutism can be seen as a side effect of various medications including phenytoin, aldomet, metoclopramide, danazol, oral contraceptives, or phenothiazines.