**Question:** All of the following drugs may cause Hirsuitism, EXCEPT:

A. Gonadotropin-releasing hormone (GnRH) agonists
B. Glucocorticoids
C. Estrogens (e.g., conjugated estrogens)
D. Selective serotonin reuptake inhibitors (SSRIs)

**Core Concept:**
Hirsuitism is a condition characterized by excessive hair growth in women, typically caused by hypersecretion of androgens (male hormones) due to ovarian activity. Gonadotropin-releasing hormone (GnRH) agonists, glucocorticoids, and estrogens are all known to cause hirsuitism by different mechanisms. On the other hand, selective serotonin reuptake inhibitors (SSRIs) are primarily used to treat depression and anxiety disorders by modulating serotonin reuptake, not androgen production.

**Why the Correct Answer is Right:**

SSRIs, specifically, work by inhibiting the reuptake of serotonin, which improves mood, reduces anxiety, and enhances social interaction. They do not directly interfere with the production of androgens (male hormones) or gonadotropin secretion, which are primarily responsible for hirsuitism. While GnRH agonists and glucocorticoids can lead to hypersecretion of gonadotropins (LH and FSH) and subsequent increased ovarian androgen production, SSRIs do not have this effect.

**Why Each Wrong Option is Incorrect:**

Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide and buserelin, are used to treat endocrine disorders like prostate cancer and precocious puberty. They stimulate the pituitary gland to release more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn increase gonadotropin secretion and ovarian androgen production.

Glucocorticoids, such as prednisolone, are corticosteroids used to treat inflammatory and autoimmune disorders. They act as anti-inflammatory agents but can also stimulate adrenal cortisol production, which indirectly leads to increased gonadotropin release and subsequent androgen production in the ovaries or testes.

Estrogens, such as conjugated estrogens (e.g., Premarin), are estrogenic hormones used to replace low estrogen levels during menopause, pregnancy, or in cases of hypothalamic-pituitary-ovarian axis dysfunction. They primarily act on the hypothalamic-pituitary-ovarian axis, leading to increased gonadotropin secretion and ovarian androgen production.

**Clinical Pearl:**

SSRIs are not the primary cause of hirsutism or androgen excess, as they do not directly affect the hypothalamic-pituitary-gonadal axis. In contrast, medications like GnRH agonists, glucocorticoids, and estrogens do have direct or indirect effects on the hypothalamic