Human Reproduction Update Advance Access published online on June 30, 2009
Human Reproduction Update, doi:10.1093/humupd/dmp024
Visually scoring hirsutism
1 Endocrinology and Metabolism Unit, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06100, Turkey 2 Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA 3 The Center for Androgen Related Disorders, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 160 W, Los Angeles, CA 90048, USA 4 Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35233, USA 5 Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA 6 Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA
To whom correspondence should be addressed at: 7 Correspondence address. Tel: +1-310-423-7433; Fax: +1-310-423-3470; E-mail: azzizr{at}cshs.org
BACKGROUND: Hirsutism is the presence of excess body or facial terminal (coarse) hair growth in females in a male-like pattern, affects 5–15% of women, and is an important sign of underlying androgen excess. Different methods are available for the assessment of hair growth in women.
METHODS: We conducted a literature search and analyzed the published studies that reported methods for the assessment of hair growth. We review the basic physiology of hair growth, the development of methods for visually quantifying hair growth, the comparison of these methods with objective measurements of hair growth, how hirsutism may be defined using a visual scoring method, the influence of race and ethnicity on hirsutism, and the impact of hirsutism in diagnosing androgen excess and polycystic ovary syndrome.
RESULTS: Objective methods for the assessment of hair growth including photographic evaluations and microscopic measurements are available but these techniques have limitations for clinical use, including a significant degree of complexity and a high cost. Alternatively, methods for visually scoring or quantifying the amount of terminal body and facial hair growth have been in use since the early 1920s; these methods are semi-quantitative at best and subject to significant inter-observer variability. The most common visual method of scoring the extent of body and facial terminal hair growth in use today is based on a modification of the method originally described by Ferriman and Gallwey in 1961 (i.e. the mFG method).
CONCLUSION: Overall, the mFG scoring method is a useful visual instrument for assessing excess terminal hair growth, and the presence of hirsutism, in women.
Key words: hirsutism / hair growth / androgen excess / polycystic ovary syndrome
Received on July 20, 2007; revised May 11, 2009; accepted on May 20, 2009