Hyperandrogenism in oligomenorrhoea with minimal or nil ‘unwanted hair growth’

Abstract

Aim. To detect whether oligomenorrhoea with minimal or nil ‘unwanted hair growth’ is a hyperandrogenic problem.

Materials and methods. Fifty-nine women with oligomenorrhoea with modified Ferriman Gallway score (m FG) = <5 (Group A), 40 women with oligomenorrhoea with m FG score = > 6 (Group B) and 22 eumenorrhoeic non-hirsute ‘control’ women (Group C) were studied. Body mass index, Waist–hip ratio were noted during clinical examination. Serum testosterone, Sex hormone binding globulin, fasting insulin levels were measured in each woman. Free androgen index (FAI) was calculated.

Results. No significant differences were noted in the clinical parameters. Though serum testosterone levels were within the normal ranges in Group A and Group B, they were significantly higher than that of Group C. Groups A and B had significantly higher FAI values and fasting insulin levels than Group C. Between Groups A and B there were no significant differences in any of the androgenic parameters studied.

Conclusion. Oligomenorrhoea without definite hirsutism is an androgen excess disorder. Definition of biochemical hyperandrogenism needs more clarity. Hirsutism is not a sensitive indicator of hyperandrogenism. The role of insulin in this type of hyperandrogenism needs further studies.

Keywords:

• Oligomenorrhoea
• minimal unwanted hair growth
• hyperandrogenism