Hirsutism is a common endocrine disorder affecting 5–10% of women of reproductive age. A thorough history, physical examination and selected laboratory tests will confirm the underlying cause. This chapter reviews various causes and clinical management of hirsutism. Counselling, lifestyle modifications, mechanical hair removal and selected medical therapies can be used to reduce the degree of hirsutism and to improve self-esteem. Combined oral contraceptive pill is the first-line therapy for hirsutism, provided there has been no contraindication. At least 6–9 months of treatment may be necessary before an effect can be observed.

Imaging is an indispensable diagnostic tool in gynaecological practice. Transvaginal ultrasound (TVS) is most often used in an office environment as an adjunct to clinical examination. Transabdominal ultrasound is employed in specific applications and often as a first step before TVS by non-gynaecologists, while MRI and CT are used selectively as secondary tests for specific indications. Perioperative imaging is increasingly popular in clinical practice. In the first section, the essentials of the ultrasound technique and image optimization skills will be described as well as professional attributes necessary for safe ultrasound practice. In the clinical section, the prescribed approach was based on presenting symptoms as is the case in clinical practice where patients are referred or present themselves with a complaint. It is critical for ultrasound practitioners to accurately recognize normal features easily and, likewise, in the differential diagnosis of abnormal findings, they should master the salient features that will ultimately establish a diagnosis.