Clinico-investigative profile of patients of hirsutism in a tertiary level institution

Sharma, Divya; Shanker, Vinay; Tegta, Gitaram; Gupta, Mrinal; Verma, Ghanshyam

doi:10.4103/0974-7753.96904

Cited by 19 publications

(34 citation statements)

References 21 publications

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“…[18192021] Menstrual irregularities reported in 43% of our patients was also in agreement and disagreement with other studies. [1718192021] Contradictory to previous reports 80% of our patients were married with 26.3% having a history of infertility. [1820]…”

Section: Discussionsupporting

confidence: 78%

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Modified Ferriman–Gallwey score in hirsutism and its association with metabolic syndrome

Aswini

Jayapalan

2017

Int J Trichol

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Background:Hirsutism is the presence of terminal hair in females in males pattern. It occurs in 5%–15% of women. Modified Ferriman–Gallwey (mFG) score of ≥ 8 is considered hirsutism, but there are populations with a low mFG score. In clinical practice, hirsutism is subjective. Although hirsutism is considered as a purely esthetic problem, it is associated with many underlying disorders, especially androgen excess disorders. Polycystic ovarian syndrome (PCOS) disease is the most common cause of androgen excess in females, and there are reports of its association with metabolic syndrome. Metabolic syndrome occurs alone in hirsutism.Aims:To assess mFG score in patients who consider themselves as hirsute. To study the association between metabolic syndrome and hirsutism.Methods:Hospital-based cross-sectional study design was adopted. A structured questionnaire was used to collect sociodemographic and clinical data. The severity of hirsutism was assessed using mFG score and metabolic syndrome was diagnosed by the American Heart Association criteria. mFG score was expressed as mean and Student's t-test and Chi-square statistic were used as the tests of significance. Logistic regression analysis was performed.Results:The mean mFG score was 5.5. Metabolic syndrome was present in 44%. About 65.2% of patients with score ≥8 had metabolic syndrome, whereas only 37.7% of patients with score <8 had metabolic syndrome (P = 0.019). Metabolic syndrome (P = 0.018) and PCOS (P = 0.003) were the significant variables in logistic regression analysis. Triglyceride levels ≥150 mg/dl and waist circumference ≥88 cm were the components of metabolic syndrome that were significantly associated with hirsutism (P = 0.006 in both).Conclusions:To find the ideal cutoff of mFG score to define hirsutism in our population, a population study among females in the reproductive age group has to be conducted. As there is a definite association of hirsutism and metabolic syndrome, and metabolic syndrome can result in cardiovascular complications, any women presenting with terminal hair in a male pattern should be evaluated for metabolic syndrome irrespective of the mFG score.

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Section: Discussionsupporting

confidence: 78%

“…[1820] The mean score was 12.4 and 13.5 in Delhi and Kashmir, respectively. [1619] The low score in our study may be due to our inclusion criteria definition of hirsutism as terminal hair in at least one androgen dependent site rather than the definition of mFG score ≥8 used by others.…”

Section: Discussionmentioning

confidence: 88%

Modified Ferriman–Gallwey score in hirsutism and its association with metabolic syndrome

Aswini

Jayapalan

2017

Int J Trichol

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“…The mean age ranges from 20.9 years to 24.18 years and mean duration ranges from 5 to 6.1 years in various studies. 5,6 The duration of hirsutism in our study was higher, may be because unlike other studies a higher proportion of patients had mild hirsutism for which they were adapting their own methods of hair removal.…”

Section: Discussioncontrasting

confidence: 59%

A Study on Clinical Profile of Patients With Hirsutism

Sobhanakumari¹,

Thomas²

2017

jemds

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BACKGROUND Hirsutism is the presence of terminal hair in male like pattern in females in prepubertal and adult life. It affects 5-10% of women in childbearing age. However, hirsutism has poorly been studied in Indian patients. Aim-To study the clinical profile of patients with hirsutism and to detect its various causes. MATERIALS AND METHODS In this observational cross sectional study, 60 consecutive cases of hirsutism attending the Dermatology and Endocrinology outpatient wings of Govt. Medical College, Kottayam were included. All underwent detailed clinical examination including modified Ferriman-Gallwey scoring and transabdominal ultrasound. Serum total testosterone, dehydroepiandrosterone sulfate (DHEAS), 17-hydroxyprogesterone (17-OHP), prolactin, free tri-iodothyronine, free tetra-iodothyronine, and thyroid stimulating hormone, fasting blood glucose and lipid profile were estimated. RESULTS The commonest cause of hirsutism was polycystic ovary syndrome (PCOS) in 42 (70%) cases, followed by idiopathic hirsutism (IH) in 16 (26.7%). There was 1 (1.7%) case each of non-classic congenital adrenal hyperplasia (NCCAH) and acromegaly with pituitary macroadenoma. 53 (88.3%) had mild hirsutism, 5 (8.4%) had moderate and 2 (3.3%) had severe hirsutism. The most common associated sign of hyperandrogenism in our study was seborrhoea (50%), followed by acne (43.3%), acanthosis nigricans (25%) and androgenetic alopecia (18.3%). 5 (8.3%) had associated metabolic syndrome and all of them had PCOS. Limitations-A small sample size and free testosterone levels were not estimated. CONCLUSION PCOS is the most common cause of hirsutism in this study. The term IH should be reserved only for those patients who have negative findings after a thorough investigation. Side burns, which is not included in mF-G scoring were more seen than the involvement of upper arms. The severity of hirsutism shows no correlation with androgen levels. So all hirsute women should undergo a complete workup.

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“…Similar results were reported by Sharma et al in which score of 38% females were ranging from 8-15. 15 There was no significant change in score in both the groups at 3 months, however the it showed significant reduction in both the groups at 6 months. The degree of reduction was more prominent in metformin and ethinyl estradiol-cyproterone acetate group as compared to metformin alone.…”

Section: Discussionmentioning

confidence: 76%

A randomized placebo controlled trial of metformin alone and metformin plus fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with polycystic ovarian syndrome

Jalota

Singh

Saini

2018

Int J Basic Clin Pharmacol

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Background: Polycystic ovarian syndrome is a common endocrine disorder seen in reproductive age group. Hirsutism, oligomennorhea and infertility being the most common chief complaint. Oral contraceptives have shown their efficacy in hirsute females. Metformin, an insulin sensitizer, have also shown some beneficial effects in improving metabolic abnormalities. Aim of this study is to compare the efficacy of metformin alone and metformin with fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with PCOS.Methods: 60 females of PCOS with chief complaint of hirsutism were enrolled. Patients were randomized to either metformin and Diane -35 (35 microgram ethinyl estradiol plus 2mg cyproterone acetate) or metformin and placebo for 9 months. Ferriman Gallwey score and body mass index was calculated at baseline, 3months, 6months and 9 months. FSH/LH/Prolactin/Testosterone/Fasting glucose and Fasting insulin levels were measured at the baseline and at the end of treatment.Results: Majority of females enrolled in the study were in third decade of life. Metformin and Diane- 35 showed higher reduction in Ferriman Gallwey score but Body mass index was reduced in both the groups. There was no significant difference seen between the groups with respect to biochemical profile.Conclusions: This data show that a combination of metformin and contraceptive pill may be more effective in treating hirsutism than metformin alone. Beneficial effects of therapy were seen in relation to BMI as well. Hence, combination therapy is better therapeutic option for treating hirsutism in PCOS.

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Clinico-investigative profile of patients of hirsutism in a tertiary level institution

Cited by 19 publications

References 21 publications

Modified Ferriman–Gallwey score in hirsutism and its association with metabolic syndrome

Modified Ferriman–Gallwey score in hirsutism and its association with metabolic syndrome

A Study on Clinical Profile of Patients With Hirsutism

A randomized placebo controlled trial of metformin alone and metformin plus fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with polycystic ovarian syndrome

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