Regional variability of modified Ferriman-Gallwey scorring in premenopausal healthy women in Southern Turkey

Abstract

Objective

Although modified Ferriman-Gallwey (mF-G) scorring has been the gold standard for assessing hirsutism, also known that this scorring could show variability according to ethnicity. Hence, false positive hirsutism diagnosis and unnecessary anti-androgen therapy can prescribed. It was aimed to disclose the regional characteristics of this scorring in healthy women living in Southern Turkey.

Methods

360 women between 18 and 50 years of age were randomly screened. Their medical history, including ovulation periods, gestation(s), family history, known drug use was obtained. Physical examination with mF-G scoring and serum hormone measurements were performed. Women with hirsutism who scored ≥ 8 were further investigated for any underlying disease or cause of hirsutism. After these investigations, the women were divided into three groups according to the mF-G ≥ 8 score and evaluated. Group A (n = 59) had an mF-G ≥ 8 and, revealed an underlying disease causing hirsutism; group B (n = 42) had an mF-G ≥ 8, but no underlying disease responsible for hirsutism; and the third group (Group C, n = 259) had an mF-G ≤ 8 and thus, no signs of hirsutism.

Results

The mean mF-G scores of three groups were 12.78 ± 4.4, 11.48 ± 4.6, and 5.53 ± 3.4, respectively. Of the 59 (16.1%) women in Group A, 46 (44.2%) were diagnosed as polycystic ovary syndrome (PCOS), 8 (7.7%) had idiopathic hyperandrogenism, 7 (6.7%) had nonclassic congenital adrenal hyperplasia, and 1 (1%) had a prolactinoma. When compared to group B, group A women had significantly decreased fertility (p = .001) and menstrual irregularities (p = .001).

Conclusions

In this study, results revealed a significant rate of healthy women (11.6%) who had an mF-G ≥ 8, but no underlying disease causing hirsutism yet were considered hirsute according to their mF-G cutoff. Also, the majority of the studied women (71.9%) living in Southern Turkey were found to have a hair-pattern similar to the European Women. Therefore, we suggest that regional and ethnical body-hair patterns should be considered before prescribing anti-androgen therapy.

摘要

目的

虽然改良Ferriman-Gallwey（MF-G）评分法是评估多毛症的金标准, 但也知道这种评分法可以显示出不同种族的差异。因此, 可以导致假阳性多毛症诊断和不必要的抗雄激素治疗。其目的是揭示居住在土耳其南部的健康女性的这种评分的区域特征。

方法

随机筛查18～50岁女性360例。病史, 包括排卵期, 妊娠期, 家族史, 已知的药物使用。采用MF-G评分和血清激素测定进行体格检查。得分≥8的多毛症妇女进一步调查基础疾病或多毛症原因。调查结束后, 按MF-G≥8分分为3组进行评估。 A组(n=59)的MF-g≥8, 且有引起多毛症的潜在疾病；B组(n=42),MF-G≥8,但无引起多毛症的基础疾病；第三组（C组, n=259)MF-g≤8, 无多毛症征象。

结果

3组MF-G评分平均值分别为12.78±4.4、11.48±4.6和5.53±3.4。 A组59例（16.1%）患者中, 46例（44.2%）诊断为多囊卵巢综合征(PCOS), 8例（7.7%）诊断为特发性雄激素血症, 7例（6.7%）诊断为非典型先天性肾上腺增生, 1例（1%）诊断为泌乳素瘤。与B组相比, A组妇女的生育能力显著降低(P=0.001)和月经不调(P=0.001)。

结论

在这项研究中, 结果显示有显著的比例（11.6%）的健康妇女有MF-G≥8, 但没有导致多毛症的基础疾病, 根据他们的MF-G截断值被认为是多毛症。此外, 居住在土耳其南部的大多数被研究妇女（71.9%）的头发模式与欧洲妇女相似。因此, 我们建议在开抗雄激素治疗前, 应考虑地区和种族的体毛模式。

Keywords:

• Hirsutism
• ethnical hirsutism
• modified Ferriman Gallwey
• women’s health
• gynecological endocrinology

关键词:

• 多毛症
• 民族多毛症
• 改良费里曼·高威
• 妇女健康
• 妇科内分泌学

Disclosure statement

The authors declare that they have no conflict of interest.

Ethical statement

Cukurova University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee. Number of Meetings: 75, Decision Number: 38, Date: 02.03.2018.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.