Menopausal hormone therapy for hirsutism

Menopausal hormone therapy (MHT) is used in postmenopausal individuals with hirsutism. See Systemic MHT in individuals with hirsutism for advice on formulations most likely to be effective.

If hirsutism does not respond to MHT after 6 months, consider repeating laboratory investigations. If biochemical hyperandrogenism has not responded, consider investigating for nonclassical congenital adrenal hyperplasia. Also consider imaging to exclude another cause such as an adrenal or ovarian tumour. If biochemical hyperandrogenism has been suppressed but clinical response is inadequate, consider adding an antiandrogen.