**Question:** A teenage girl complained about increased growth of facial hair. Her menstrual cycle is regular and she has normal body weight. Following may be used in treatment of hirsutism, EXCEPT:

A. Anti-androgens
B. Estrogen therapy
C. Thyroid hormone therapy
D. Weight reduction

**Core Concept:** Hirsutism is a condition characterized by excessive hair growth in women due to androgen excess. Common causes include polycystic ovary syndrome (PCOS), Cushing's syndrome, and adrenal disorders.

**Why the Correct Answer is Right:** In the case of hirsutism, the primary goal of treatment is to suppress androgens and their effects. Anti-androgens, such as spironolactone, are specifically used to block the binding of androgens to their receptors, reducing their effects on hair growth.

**Why Each Wrong Option is Incorrect:**

B. Estrogen therapy: Estrogens are gonadal hormones that play a crucial role in female reproductive function and secondary sex characteristics development. In the context of hirsutism, estrogen therapy would not address the root cause, which is androgen excess.

C. Thyroid hormone therapy: Thyroid hormones (T3 and T4) are involved in regulating energy expenditure, body temperature, and heart rate. They are not related to hair growth or androgen excess.

D. Weight reduction: Weight reduction may be beneficial in PCOS-induced hirsutism, as weight loss can improve insulin resistance and ovarian function. However, it is not the primary treatment for androgen excess.

**Clinical Pearl:** In treating hirsutism, it is essential to understand the underlying cause (e.g., PCOS, Cushing's syndrome, adrenal disorders) and select the most appropriate therapy. Anti-androgens are crucial for addressing androgen excess, while estrogen therapy, thyroid hormone therapy, and weight reduction may be supportive measures, but are not the primary intervention for hirsutism.