Vol 65, No 5 (2014)
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Published online: 2014-10-09

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Semiquantitative assessment of hirsutism in 850 PCOS patients and 2,988 controls in China

Meifong Wong, Xiaomiao Zhao, Yu Hong, Dongzi Yang
DOI: 10.5603/EP.2014.0050
Endokrynol Pol 2014;65(5):365-370.


Introduction: There is considerable individual and racial variation in the degree and pattern of body hair among PCOS patients. The purposes of this study were to define: 1) a suitable standard of hirsutism for Chinese women with PCOS and the general Chinese population; 2) the characteristics of hair distribution and degree in Chinese women with PCOS and the general population; and 3) the correlation of PCOS and FG score in Chinese women.

Material and methods: This retrospective study in Chinese women with PCOS in the reproductive centre of Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, comprised 850 patients with PCOS and 2,988 members of the general population. It was conducted crosssectionally by interview, physical examination, ultrasound scan, and modified Ferriman-Gallwey score. Eight hundred and fifty Chinese women with PCOS (aged 20–41) underwent an interview, blood drawing, physical and ultrasound examination. Body hair at nine sites (lip, chin, arm, thigh, chest, upper belly, lower belly, upper back and lower back) were evaluated using the scoring system described by Ferriman and Gallwey; 2,988 healthy women (aged 20–45) underwent an interview, physical examination, ultrasound scan and FG score evaluation by trained gynaecologists. Terminal body hair growth was assessed using the mFG scoring system in Chinese women with PCOS and the control group; nine body areas were scored from 0–4 for terminal hair growth distribution.

Results: Our findings showed that of the 850 patients, 367 had a FG score equal to or greater than 5 points [43.2% (367/850)], 282 patients had a FG score equal to or greater than 6 points [33.18% (282/850)], and 21% had a score of at least 8 points. Nobody’s FG score was equal to or greater than 24 points. Hirsutism was significantly higher in PCOS patients (score≥ 5 = 43.2%) than in the general population (score ≥ 5 = 10%). The lip is the most common place (score 0–3) where terminal hair grows in 850 PCOS patients and the general population. Next came the upper back and chest, and the number of 4 points was only recorded for the region of the lip (16), thigh (3), lower belly (3), arm (1), chest (1), and lower back (1). None of the PCOS patients displayed a score of more than 4 points for the chin, upper belly and upper back.

Conclusions: Our data indicates that: 1) an mFG score of 5 or above is out of the norm for the general unselected population and forms almost half of the possibility of diagnosing PCOS in Chinese women; 2) lips and upper back are the most common places that hair grows (score 1–2), but in terms of the serious situation (score 3–4), lips and thighs are the most common places that hair grows; 3) there is a good predictive value to diagnose PCOS by FG score for Chinese people; and 4) hirsutism is more common in PCOS than in the general population in China. (Endokrynol Pol 2014; 65 (5): 365–370)