Your doctor will ask you about your medical history with special attention to your menstrual cycles. He or she also will examine you. If you have a normal cyclic pattern of menstrual periods, the hirsutism is most likely genetic (inherited). If your menstrual cycles are irregular and have always been irregular, the cause could be polycystic ovary syndrome. If the hirsutism and menstrual irregularity are new, you will need to be evaluated for a potentially more serious condition, such as a tumor of the ovary, adrenal glands or pituitary gland. This is especially important is you are skipping periods. If you have mild hirsutism and don't have any symptoms that suggest you are significantly overproducing androgen hormones, you may not need any additional testing.
If you need more testing, you are likely to have several blood tests:
The hormones testosterone and dehydroepiandrosterone may be measured to check for signs of polycystic ovary syndrome, ovary tumors, adrenal gland tumors, adrenal gland hormone deficiencies (causing overgrowth, or hyperplasia, of the adrenal glands) or tumors that can stimulate the adrenal glands.
The hormone prolactin may be measured to check for signs of a tumor in the pituitary gland.
Blood sugar and cholesterol levels may be tested, because diabetes and high levels of cholesterol commonly are associated with some causes of hirsutism.
Depending on the results of these tests, your doctor may order additional hormone tests to help clarify the reason you are producing too much androgen by evaluating the function of your adrenal gland and pituitary gland. In some cases, your doctor will want to see a picture of one or more organs. Commonly used tests are magnetic resonance imaging (MRI) of the brain, a computed tomography (CT) scan of the adrenal glands or an ultrasound of the ovaries.