Visually scoring hirsutism
Open accessAbstract
BACKGROUND: Hirsutism is the presence of excess body or facial terminal (coarse) hair growth in females in a male-like pattern, affects 5-15% of women, and is an important sign of underlying androgen excess. Different methods are available for the assessment of hair growth in women. METHODS: We conducted a literature search and analyzed the published studies that reported methods for the assessment of hair growth. We review the basic physiology of hair growth, the development of methods for visually quantifying hair growth, the comparison of these methods with objective measurements of hair growth, how hirsutism may be defined using a visual scoring method, the influence of race and ethnicity on hirsutism, and the impact of hirsutism in diagnosing androgen excess and polycystic ovary syndrome. RESULTS: Objective methods for the assessment of hair growth including photographic evaluations and microscopic measurements are available but these techniques have limitations for clinical use, including a significant degree of complexity and a high cost. Alternatively, methods for visually scoring or quantifying the amount of terminal body and facial hair growth have been in use since the early 1920s; these methods are semi-quantitative at best and subject to significant inter-observer variability. The most common visual method of scoring the extent of body and facial terminal hair growth in use today is based on a modification of the method originally described by Ferriman and Gallwey in 1961 (i.e. the mFG method). CONCLUSION: Overall, the mFG scoring method is a useful visual instrument for assessing excess terminal hair growth, and the presence of hirsutism, in women.
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Hirsutism was assessed by the modified Ferriman-Gallwey score, which evaluated nine body areas and scored from 0 to four.
“Hirsutism was assessed by the modified Ferriman-Gallwey score, which evaluated nine body areas (upper lip, chin, chest, arm, upper and lower abdomen, and upper and lower back, thighs) and scored from 0 (no terminal hairs) to four (extensive hair growth) (Yildiz et al., 2010).”
From Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention (2021) · cites this paper as Yildiz et al., 2010
Ethnic and genetic variations influence the development of hirsutism.
“Ethnic and genetic variations influence the development of hirsutism [141].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [141]
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Dietz de Loos, A. L. P., Jiskoot, G., Timman, R., Beerthuizen, A., Busschbach, J. J. V., & Laven, J. S. E. (2021) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2021.05.008 · Cited by 39 · see citing works
Aydin, K., Arusoglu, G., Koksal, G., Cinar, N., Yazgan Aksoy, D., & Yildiz, B. O. (2014) · Clinical Endocrinology · doi:10.1111/cen.12468 · Cited by 39 · see citing works
Self-citationA rational approach to the diagnosis of polycystic ovarian syndrome during adolescence
Merino, P. M., Codner, E., & Cassorla, F. (2011) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302011000800013 · Cited by 35 · see citing works
- Authors
- Yildiz, B. O., Bolour, S., Woods, K., Moore, A., & Azziz, R.
- Affiliations
- Cedars-Sinai Medical Center (US)
- University of Alabama at Birmingham (US)
- Corresponding author
- Azziz, Ricardo
- ORCID
- Azziz, Ricardo
- Venue
- Human Reproduction Update
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-06-30
- Volume
- 16
- Issue
- 1
- Pages
- 51-64
- ISSN
- 1355-4786 (ISSN-L)
- 1460-2369
- PMC
- PMC2792145
- OpenAlex
- W2128200138
- Cited by
- 395
- References
- 88
- Citations by year
- 2026: 24 · 2025: 30 · 2024: 32 · 2023: 26 · 2022: 41 · 2021: 21 · 2020: 39 · 2019: 25 · 2018: 26 · 2017: 23 · 2016: 23 · 2015: 16 · 2014: 21 · 2013: 17 · 2012: 11
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Human Reproduction Update (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24HD001346, R01HD029364, K24 HD 01346, R01-HD29364)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Urology › Hair Growth and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- hirsutism, visual grading, Ferriman-Gallwey score, hyperandrogenism, polycystic ovary syndrome, race and ethnicity, interobserver variability
- MeSH terms
- Androgens, Female, Hair, Hirsutism, Humans, Polycystic Ovary Syndrome
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