DOUGLAS Biggs, MD, Senior Assistant Resident in Medicine, Jewish Hospital of St. Louis, Assistant in Medicine, Washington University School of Medicine: The patient for consideration is a 34-year-old woman who was referred to us from Campbell, Mo, for evaluation of hirsutism. She had a three-year history of excessive hair growth on the face, breast, axillae, legs, and lower part of the abdomen. Prior to the onset of the hirsutism, she had had very minimal axillary hair and no facial hair. During this period, the patient developed a decrease in libido, generalized alopecia, and a receding hairline. Menarche began at the age of 12 years, and menstrual cycles were regular until three years prior to admission when bilateral tubal ligation was performed. She previously had eight successfully completed pregnancies. One year of amenorrhea followed the tubal ligation, after which menstrual function normalized until two months prior to the admission when menses
Haddad JG, Avioli LV. Cushing Disease. Arch Intern Med. 1976;136(1):115–117. doi:10.1001/archinte.1976.03630010093019
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