Late onset congenital adrenal hyperplasia (LO CAH) can be seen in association with
polycystic ovary syndrome (PCOS) or idiopathic
hirsutism (IH). The study aimed to find out the prevalence of LO CAH in Central Anatolia among hirsute women. Sixty-three patients with
hirsutism were evaluated to determine the frequency of LO CAH by comparing them with their age and body mass index matched 28 healthy controls. Of those 63 hirsute women, 43 were diagnosed as PCOS, and 20 were diagnosed as IH. Following basal hormonal evaluation, all subjects underwent
ACTH stimulation test and
ACTH stimulated
17-hydroxyprogesterone (17-OH P),
11-desoxycortisol (11-DOC),
cortisol (F), and
dehydroepiandrosterone sulfate (
DHEA-S) levels were determined in all subjects.
ACTH stimulated 17-OH P, 11-DOC, and
DHEA-S levels did not differ between groups. However, stimulated F levels were found to be higher in hirsute women (p<0.001). Six out of 63 (9.52%) patients with
hirsutism met the criterion for
21 hydroxylase deficiency. We found no subject presumed to have 11-beta
hydroxylase deficiency, but one subject in control group (3.57%) and two patients among PCOS subjects (4.65%) had exaggerated
DHEA-S response which was suggestive of mild
3-beta hydroxysteroid dehydrogenase deficiency. In conclusion, the most frequent form of LO CAH seems to be due to 21
OH deficiency among women with PCOS and IH in Central Anatolia. Mild 3-beta HSD deficiency may also be an underlying cause for
hirsutism and it may be seen without any clinical presentation. Adrenal hyperactivity is likely to be the main reason of hyperandrogenemia in women with
hirsutism.