Gynaecological endocrinology: hirsutism: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological endocrinology: hirsutism

Sample item

A woman with PCOS and distressing hirsutism does not desire pregnancy. Which combination is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Combined oral contraceptive pill with spironolactone

COCs suppress ovarian androgens and raise SHBG, and spironolactone, finasteride or cyproterone acetate block androgen action. Effects take 6 months. Mechanical hair removal is adjunctive. Antiandrogens need reliable contraception because of the risk of feminising a male fetus.

Option by option

  • A. Testosterone

    Testosterone would worsen hirsutism.

  • B. Danazol

    Danazol is androgenic and worsens hirsutism.

  • C. Combined oral contraceptive pill with spironolactone (correct)

    Correct. This combination addresses androgen production and action.

  • D. Clomiphene alone

    Clomiphene induces ovulation and does not treat hirsutism.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Combined oral contraceptive pill with spironolactone. COCs suppress ovarian androgens and raise SHBG, and spironolactone, finasteride or cyproterone acetate block androgen action.

Why is "Testosterone" not the answer?

Testosterone would worsen hirsutism.

Why is "Danazol" not the answer?

Danazol is androgenic and worsens hirsutism.

Why is "Clomiphene alone" not the answer?

Clomiphene induces ovulation and does not treat hirsutism.

What concept does this question test?

It tests Gynaecological endocrinology: hirsutism in OBG. Effects take 6 months. Mechanical hair removal is adjunctive. Antiandrogens need reliable contraception because of the risk of feminising a male fetus.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological endocrinology: hirsutism?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.