Which condition can cause excessive hair growth on face, neck, chest, and thighs, high levels of male androgens?

• A. PCOS
• B. Cushing's syndrome
• C. Hypothyroidism
• D. Diabetes mellitus

Answer: (A)

Excess androgens in women lead to hirsutism, especially in androgen-sensitive areas such as the face, neck, chest, and thighs. In polycystic ovarian syndrome, two main factors drive this: the ovaries overproduce androgens because of increased LH stimulation of the theca cells, and insulin resistance raises insulin levels, which lowers liver production of sex hormone–binding globulin. That combination increases free testosterone in the circulation, promoting hair growth in those regions. PCOS is the most common cause of this pattern of hirsutism in reproductive-age women, often alongside irregular menses and metabolic features.

Other conditions can cause hair changes but not the same androgen-driven pattern. Cushing's syndrome involves cortisol excess and may present with thin or unusual hair changes but not primarily from elevated androgens. Hypothyroidism typically causes hair thinning or loss rather than new coarse facial or body hair. Diabetes mellitus doesn’t by itself explain androgen-driven hirsutism.