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modified Ferriman-Gallway (mFG) score used to score hair growth in nine body areas

scored from 0 (no hair) to 4 (frankly virile)

it has not been determined whether it is appropriate to use the mFG score in these groups for the diagnosis of hirsutism

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van Zuuren, E.J. et al. (2015) ‘Interventions for hirsutism (excluding laser and photoepilation therapy alone)’, The Cochrane Database of Systematic Reviews, 2015(4), p. CD010334. Available at:

https://doi.org/10.1002/14651858.CD010334.pub2

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Inconsistent prevalence of PCOS likely due to variability in diagnostic criteria

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prevalence of PCOS across ethnicities show large variability likely due to varied use of diagnostic criteria

the definition of hirsutism in ethnic groups with less dense villus hair has not been established

Williamson, K. et al. (2001) ‘The impact of ethnicity on the presentation of polycystic ovarian syndrome’, The Australian & New Zealand Journal of Obstetrics & Gynaecology, 41(2), pp. 202–206. Available at:

https://doi.org/10.1111/j.1479-828x.2001.tb01210.x

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Effect of androgens on hair follicles

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PCOS is the most common cause of hirsutism

Androgens have multiple impacts on hair follicle: increase hair follicle size, hair fiber diameter, and the proportion of time terminal hairs spend in the anagen phase

Androgen excess in women leads to increased hair growth in most androgen-sensitive sites (eg, upper lip, chin, mid sternum, upper abdomen, back, and buttocks) + loss of hair in the scalp region, due to reducing the time scalp hairs spend in anagen phase.

Androgens necessary for terminal hair and sebaceous gland development and cause differentiation of pilosebaceous units (PSUs) into either a terminal hair follicle or a sebaceous gland