Nama = Fardhian Dhiyawardhana Tunas = Ginecology

HIRSUTISM Hirsutism is a medical condition characterized by excessive hair growth in women due to more high than normal male hormone levels, androgen, inside the body. Hair-unwanted coarse hair is usually arise in areas which are usually owned by men, such as the face, chest, abdomen and breast areas around putting. Due to the high levels of androgens in the body, patients are usually also indicated, HIRSUTISM, such as acne, in sound and a decrease in breast size. This condition can affect many facets of a woman's emotional and psychology because they often feel shy and has low self-esteem due to excessive hair growth.

There are several methods to remove hair. The first is with the hair removal method to manually/mechanical. The second method are Pharmacology. There are several ways to use this method. 1. oral contraceptive pills. Oral contraceptives will suppress the activity of androgen and Add Variant sex hormone-binding globulins (SHBG), thereby lowering testosterone. Oral contraceptives containing norethisterone or levonorgestrel should be avoided, as it could potentially worsen hirsutisisme. Combination of oral contraceptive pills with cyproterone acetate is an anti-androgen (Dianette *) more effectively. 2. Cyproterone acetate. Cyproterone acetate reduces hirsutisisme in two ways. This substance is an androgen receptor antagonist on the skin and also have a progestogen activity will hinder gonadotrophin secretion, thereby increasing production of ovarian androgen. Tremendous potential side effects include loss of libido, weight loss, easy fatigue, breast become mushy, bad taste in the gastrointestinal, and headaches. 3. Spironolactone. Oral Spironolactone is aldosterone antagonist with anti-androgenic properties. With increased metabolic activity reduction clearancedan 5-alpha-reductase kutan, took place against reductions in bioavailability testosterone. This is the case with the androgen receptor intracellular mengkomplekskan, which forms the biological receptor is inactive. Because of the effect of potassium-sparing diuretics, potassium serum levels should be monitored at the beginning of treatment. 4. Flutamide. Antiandrogen Flutamide is nonsteroid that can prevent an increase in androgen levels and/or inhibit nuclear ties on the structure of secondary sex. Flutamide androgen receptor with nuclear will become an inactive form of the complex. There are some reports suggesting that flutamide for the treatment of HIRSUTISM have their effectiveness. Flutamide has no undesirable activity, P-like, androgenik or antigonadotropik. Flutamide is also has no significant effect on LH or pulsasi of LH and FSH in response to GnRH. it was reported that after the treatment of Flutamide for 9 months or 1 year with a dose of the same shows the same results. 5. Finasteride. This is an inhibitor of 5-alpha-reductase, which is due to the mode of action is significantly tetragenik (potential feminization of male fetuses), so that effective contraception must be used. Use of finasteride should only be restricted in some cases severe enough, under the supervision of the tertiary centre. Prevention of the occurrence of further hair growth stimulation REFERENCES

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