KnE Medicine

Published date: Jan 01 2017

Journal Title: KnE Medicine

Issue title: The 6th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2016)

Pages: 186–192

DOI: 10.18502/kme.v1i1.640

Karimah P.putri8_deva@yahoo.com

Hestiantoro A.

Objective: To determine the distribution of the Ferriman–Gallwey score in Asia and to study any association between hirsutism and endocrine markers, and also to find the cut off of  F-G score.                                       

Background: Hirsutism is the most widely used clinical diagnostic criterion for hyperandrogenism, it is present in approximately 70% of PCOS women. Using the Ferriman- Gallwey (F-G) scoring systems for evaluation of hirsutism, the degrees of hyperandrogenism from different regions are distinct and have different cut off.

Material and methods: A descriptive cross-sectional study was carried out at Dr. Cipto Mangunkusumo General Hospital Jakarta in 2015. Reproductive age women who commits with PCOS criteria were included in the study. Clinical data was taken by interview, physical examination and US examination. Patient’s blood was taken for FTI, and testosterone.

Results: The data indicated that 32.4% PCOS woman shows clinical signs of hyperandrogenism, with the minimum score of hirsutism 2 and based on laboratory findings 34.3% subjects show high FTI and testosterone level. However not all patient with high androgen level have a high score of hirsutism.                              

Conclusion: Clinical and laboratory finding of hyperandrogenism have a correlation to determine the score of Ferriman–Gallwey (F-G). The cut off is lower than European and west countries.

[1] R. Li, J. Qiao, D. Yang, S. Li, S. Lu, X. Wu, and Z. Wei, Epidemiology of hirsutism among women of reproductive age in the community: A simplified scoring system, European Journal of Obstetrics Gynecology and Reproductive Biology, 163, no. 2, 165– 169, (2012).


[2] J. J. Espinós, J. Calaf, J. Estadella, and M. A. Checa, Hirsutism scoring in polycystic ovary syndrome: Concordance between clinicians’ and patients’ self-scoring, Fertility and Sterility, 94, no. 7, 2815–2816, (2010).


[3] D. Dewailly, S. Hieronimus, P. Mirakian, and J.-N. Hugues, Polycystic ovary syndrome (PCOS), Annales d’Endocrinologie, 71, no. 1, 8–13, (2010).


[4] M. M. Al-Khawajah and M. A. Fouda Neel, Women with clinically significant hirsutism always have detectable endocrinological abnormalities, Journal of the European Academy of Dermatology and Venereology, 9, no. 3, 226–231, (1997).


[5] H. Cook, K. Brennan, and R. Azziz, Reanalyzing the modified Ferriman-Gallwey score: Is there a simpler method for assessing the extent of hirsutism? Fertility and Sterility, 96, no. 5, 1266–e1, (2011).


[6] S. P. Hertweck, J. L. Yoost, M. E. McClure, Y. Siow, G. N. Brock, K. A. Wintergerst, and M. E. Fallat, Ferriman-Gallwey Scores, Serum Androgen and Mullerian Inhibiting Substance Levels in Hirstute Adolescent Girls, Journal of Pediatric and Adolescent Gynecology, 25, no. 5, 300–304, (2012).


[7] T. Kale-Gurbuz, S. E. Akhan, E. Bastu, A. Telci, A. C. Iyibozkurt, and S. Topuz, Adiponectin, Leptin and Ghrelin Levels in Obese Adolescent Girls with Polycystic Ovary Syndrome, Journal of Pediatric and Adolescent Gynecology, 26, no. 1, 27–30, (2013).


[8] CB. Winters S, Testosterone synthesis, transport and metabolism, Humana press, transport and metabolism, 2003.


[9] E. Yasmin, A. H. Balen, and J. H. Barth, The association of body mass index and biochemical hyperandrogenaemia in women with and without polycystic ovary syndrome, European Journal of Obstetrics Gynecology and Reproductive Biology, 166, no. 2, 173–177, (2013).


[10] E. T. Wang, C.-N. Kao, K. Shinkai, L. Pasch, M. I. Cedars, and H. G. Huddleston, Phenotypic comparison of Caucasian and Asian women with polycystic ovary syndrome: A cross-sectional study, Fertility and Sterility, 100, no. 1, 214–218, (2013).


[11] A. M. Matsumoto and W. J. Bremner, Editorial: Serum Testosterone Assays - Accuracy Matters, Journal of Clinical Endocrinology and Metabolism, 89, no. 2, 520– 524, (2004).


[12] T.-H. Liou, J.-H. Yang, C.-H. Hsieh, C.-Y. Lee, C.-S. Hsu, and M.-I. Hsu, Clinical and biochemical presentations of polycystic ovary syndrome among obese and nonobese women, Fertility and Sterility, 92, no. 6, 1960–1965, (2009).


[13] X. Zhao, J. Zhong, Y. Mo, X. Chen, Y. Chen, and D. Yang, Association of biochemical hyperandrogenism with type 2 diabetes and obesity in Chinese women with polycystic ovary syndrome, International Journal of Gynecology and Obstetrics, 108, no. 2, 148–151, (2010).


[14] M. Landay, A. Huang, and R. Azziz, Degree of hyperinsulinemia, independent of androgen levels, is an important determinant of the severity of hirsutism in PCOS, Fertility and Sterility, 92, no. 2, 643–647, (2009).