Hirsutism, Normal Androgens, and Diagnosis of PCOS

    August 2022 in “ Diagnostics ”
    Poli Mara Spritzer, Lucas Bandeira Marchesan, Betânia Rodrigues dos Santos, Tayane Muniz Fighera
    TLDR Hirsutism can occur in women with PCOS even if their androgen levels are normal, making diagnosis challenging.
    The review discussed the prevalence and evaluation of hirsutism in women with PCOS, noting that it affected 65–75% of women with the condition, compared to 4–11% in the general population. It highlighted that hirsutism in PCOS was linked to androgen excess and individual hair follicle sensitivity to androgens. The modified Ferriman–Gallwey scoring system was used for evaluation, but ethnic variations and other factors were important considerations. Androgen levels did not always correlate with hirsutism severity, complicating PCOS diagnosis, especially in women with normal androgen levels. A study of 341 women, including 276 with PCOS, found higher hirsutism prevalence in darker skin types. The review emphasized the role of factors like insulin resistance and called for improved biochemical assessment methods and practical evaluation techniques for diverse populations.
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