ACTIVITY NUMBER:  RES010

ACTIVITY TITLE: Hirsutism

ACCREDITATION STATEMENT

The American Society for Reproductive Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Release Date:  April 1, 2013

Reviewed and Updated in 2019

Expiration Date: March 31, 2022

Under Review July 2022

Estimated Time to Complete Activity: 1.0 hour

NEEDS ASSESSMENT and IDENTIFICATION OF PRACTICE GAP

Hirsutism is the presence of excess coarse hair in females, distributed on the chin, upper lip, chest, abdomen, or back.  In addition to the obvious cosmetic changes in the woman with hirsutism, an underlying pathologic process is underway.  Because the most common endocrinopathy in reproductive-aged women is hyperandrogenic oligo-ovulation, more commonly known as polycystic ovary syndrome (PCOS) and because there is a significant overlap of this condition with hyperinsulinemic conditions such as the metabolic syndrome, it is critical that practitioners carefully evaluate women who present with hirsutism.  Even women who apparently have normal cyclic menstrual cycles may not have effective ovulation when this is carefully investigated.  The question of whether hirsutism is purely a superficial issue of appearance or whether there is something medically wrong with affected women raises an important concern. Many women who have hirsutism may not seek medical evaluation for fear of appearing vain or merely feeling self-conscious about voicing a “superficial” concern to their healthcare provider.  This area has been identified as a physician practice gap for reproductive care physicians based on recent competence assessments by the American Society for Reproductive Medicine.

This educational activity is designed to address the Unit 5 Reproductive Endocrinology educational objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG) on this topic.

EDUCATIONAL OBJECTIVES

At the conclusion of the educational activity, participants should be able to:

1.      Describe the principal causes of hirsutism.

2.      Elicit a pertinent history to evaluate hirsutism.

3.      List the essential components of a focused physical examination to evaluate hirsutism.

4.      Choose and interpret selected tests to determine the etiology of hirsutism.

5.      Identify appropriate medical/surgical interventions for hirsutism.

6.      Describe the indications for referral.

7.      Describe long-term follow-up for an affected patient and counsel her about possible effects on reproduction.

TARGET AUDIENCE

This activity is designed to meet the educational needs of resident physicians in obstetrics and gynecology and other related specialties.

ACGME COMPETENCIES

Medical Knowledge

Patient Care

Interpersonal and Communication Skills

SUCCESSFUL COMPLETION REQUIREMENTS

Successful completion of this educational activity requires the learner to:

·        View a course overview page, containing all CME and disclosure information, including acknowledgement of commercial support and disclosure of unlabeled use, prior to the start of each module.

·        Complete a 10-question pre-exam prior to the module. Learners should note any pre-exam questions answered incorrectly for clarification during module study.  

·        Be given the option of downloading a printed syllabus containing the presentation and narrative.

·        Participate in the interactive activity: Audio narration is synchronized with PowerPoint presentation that can be advanced, stopped or reversed as desired.

·        Complete a 10-question post-exam, with feedback of correct/incorrect answers, scoring a minimum of 70% in two attempts.

·        Complete the evaluation survey.

·        Print certificate of completion.

DISCLOSURES FOR PLANNERS AND FACULTY

Ruben J.  Alvero, MD – Nothing to Disclose

Alicia Y. Armstrong, MD – Nothing to Disclose

Valerie Baker, MD – Institutional Support from IBSA

G. Wright Bates, MD – Nothing to Disclose

Nancy A. Bowers, BSN, RN, MPH – Nothing to Disclose

Bruce R. Carr, MD – Research support from Wyeth, Neurocrine, Boehringer Ingelheim; Consultant for Novo Nordisk

Marcelle I. Cedars, MD  – Nothing to Disclose

Bradley S. Hurst, MD – Nothing to Disclose

Andrew R. La Barbera, PhD, HCLD  – Nothing to Disclose

Lawrence C. Layman, MD – Nothing to Disclose

Meredith Loveless, MD – Nothing to Disclose

Patricia M. McShane, MD – Consultant, World Egg Bank

Shona C. Murray, MD - Consultant, World Egg Bank

Steven T.  Nakajima, MD –Consultant, research support, speaker’s bureau for Warner Chilcott; Stockholder for IntegraMed

Genevieve Neal-Perry, MD, PhD – Nothing to Disclose

Linda R. Nelson, MD, PhD  – Nothing to Disclose

Lubna Pal, MBBS, MS – Research grant from Ferring

Staci E. Pollack, MD – Nothing to Disclose

Robert W. Rebar, MD – Nothing to Disclose

Nanette Santoro, MD  – Consultant for QuatRx

James H. Segars, MD – Nothing to Disclose

Mary D. Stephenson, MD, MSc –  Consultant for NoraTherapeutics

Kim L. Thornton, MD – Consultant for Parexel

Ellen Wilson, MD – Nothing to Disclose

Bo Yu, MD – Nothing to Disclose

It is the policy of the ASRM to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty/authors participating in this activity were required to disclose any relationships they may have with commercial entities whose products or services are used to treat patients so that participants may evaluate the objectivity of the presentations. The content and views presented in this activity are those of the faculty/authors and do not necessarily reflect those of the ASRM or CREOG. Any discussion of off-label, experimental, or investigational use of drugs or devices will also be disclosed. The disclosure statements were reviewed by the Subcommittee for Standards of Commercial Support of the CME Committee of ASRM and any perceived conflicts of interest were resolved in accordance with the policies of the ACCME.

STATEMENT OF SUPPORT

No commercial support has been provided for this activity.