Clinical and Biochemical Evaluation of Hirsutism in Young, Lean Girls from Kirkuk City, Iraq: A Cross-Sectional Study

Razaw Omar Ibrahim; Najlaa Kadhim Ali; Iqbal Sameen Ali

doi:10.54133/ajms.v5i1S.292

Authors

Razaw Omar Ibrahim Department of Physiology, College of Medicine, University of Kirkuk, Kirkuk, Iraq https://orcid.org/0000-0001-6017-502X
Najlaa Kadhim Ali Department of Physiology, College of Medicine, University of Kirkuk, Kirkuk, Iraq
Iqbal Sameen Ali Department of Physiology, College of Medicine, University of Kirkuk, Kirkuk, Iraq

DOI:

https://doi.org/10.54133/ajms.v5i1S.292

Keywords:

Hirsutism, Hyperandrogenemia, Idiopathic hirsutism, mFGs

Abstract

Background: An increase in terminal hair in androgen-dependent regions is known as hirsutism. It is not solely caused by hyperandrogenemia; idiopathic forms are also frequently seen. Objective: To examine the modified Ferriman Gallwey (mFG) cut-off score in female Iraqis as well as the etiological, biochemical, and clinical characteristics of hirsutism. Methods: This prospective cross-sectional study included one thousand young girls with a normal BMI. The features associated with clinical hirsutism were identified using the mFG scoring system. We eliminated eighty-eight young girls who were diagnosed with PCOS. Samples of blood were drawn for biochemical analyses. Results: 53.1%, 19.6%, and 1.2% of females had mild, moderate, or severe hirsutism, respectively. For the young females who participated in the study, their mean mFG scores were 7.07, 11.26, 16.26, and 29, respectively. Only 5% of girls with mild hirsutism had high serum free testosterone levels, despite a considerable difference in free testosterone levels between them and the normal girls. The chin, upper lip, and lower abdomen were the sites that contributed the most to mFGs. Of the girls who were moderately hirsute, 55% had a positive family history of hirsutism. Conclusion: Iraqi women do not need to consider the mFG score system's cut-off number of 8. The endocrine society's guidelines for hirsutism estimation should be adhered to by the examiner.

Downloads

Download data is not yet available.

References

Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endocr Rev. 2000;21(4):347-362. doi: 10.1210/edrv.21.4.0401. DOI: https://doi.org/10.1210/edrv.21.4.0401

Himelein MJ, Thatcher SS. Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv. 2006;61(11):723-732. doi: 10.1097/01.ogx.0000243772.33357.84. DOI: https://doi.org/10.1097/01.ogx.0000243772.33357.84

Escobar-Morreale HF, Carmina E, Dewailly D, Gambineri A, Kelestimur F, Moghetti P, et al. Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 2011;18(2):146-70. doi: 10.1093/humupd/dmr042. DOI: https://doi.org/10.1093/humupd/dmr042

Mofid A, Seyyed Alinaghi SA, Zandieh S, Yazdani T. Hirsutism. Int J Clin Pract. 2008;62(3):433-443. doi: 10.1111/j.1742-1241.2007.01621.x. DOI: https://doi.org/10.1111/j.1742-1241.2007.01621.x

Tehrani FR, Rashidi H, Azizi F. The prevalence of idiopathic hirsutism and polycystic ovary syndrome in the Tehran lipid and glucose study. Reprod Biol Endocrinol. 2011;9(1):144. doi: 10.1186%2F1477-7827-9-144. DOI: https://doi.org/10.1186/1477-7827-9-144

Bode D, Seehusen D, Baird D. Hirsutism in women. Am Fam Physician. 2012;85:373-380. PMID: 22335316.

Harrison S, Somani N, Bergfeld WF. Update on the management of hirsutism. Cleve Clin J Med. 2010;77(6):388. doi: 10.3949/ccjm.77a.08079. DOI: https://doi.org/10.3949/ccjm.77a.08079

Ghalib A, Tahir S. Prevalence of hirsutism in adult females in gynecology out patient clinic at Tikrit teaching hospital. J Fac Med Baghdad.1999;1:40-48.

Al Saadi Y, Mohamad B. The prevalence of hyperandrogenism in Iraqi women with hirsutism. Iraqi J Sci. 2019;60:2600-2608. doi: 10.24996/ijs.2019.60.12.8. DOI: https://doi.org/10.24996/ijs.2019.60.12.8

Zargar A, Wani A, Masoodi S, Laway B, Iftikhar M, Salahuddin M. Epidemiologic and etiologic aspects of hirsutism in Kashmiri women in the Indian Subcontinent. Fertil Steril. 2002;77:674-678. doi: 10.1016/s0015-0282(01)03241-1. DOI: https://doi.org/10.1016/S0015-0282(01)03241-1

Noorbala MT, Kefaie P. The prevalence of hirsutism in adolescent girls in Yazd, central Iran. Iranian Red Crescent Med J. 2010;12:111-117.

Amiri M, Fallahzadeh A, Sheidaei A, Mahboobifard F, Ramezani Tehrani F. Prevalence of idiopathic hirsutism: A systematic review and meta-analysis. J Cosmet Dermatol. 2022;21(4):1419-1427. doi: 10.1111/jocd.14313. DOI: https://doi.org/10.1111/jocd.14313

Sharquie KH, A-Khalifa KH. The prevalence of hirsutism in Iraqi females. Ann Saudi Med. 1992;12:5-10. doi: 10.5144/0256-4947.1992.453. DOI: https://doi.org/10.5144/0256-4947.1992.453

Mohammad Y, Dana S. Clinical and hormonal evaluation of women presenting with hirsutism at child bearing age in Slemani city. Iraqi Postgrad Med J. 2010;9(4): 393-398.

Al-Fadhily Z. Hirsutism: A clinical and biochemical study among Iraqi women in Hilla city. Med J Babylon. 2012;9(1):120-130.

Unluhizarci K, Hacioglu A, Taheri S, Karaca Z, Keletimur F. Idiopathic hirsutism: Is it really idiopathic or it is misnomer? Word J Clin Cases. 2023;16(2):292-298. doi: 10.12998/wjcc.v11.i2.292. DOI: https://doi.org/10.12998/wjcc.v11.i2.292

Rosenfield RL. Hirsutism. New Engl J Med. 2005;353(24):2578-2588. doi: 10.1056/nejmcp033496. DOI: https://doi.org/10.1056/NEJMcp033496

Spritzer PM, Marchesan LB, Santos BR, Fighera TM. Hirsutism, normal androgens and diagnosis of PCOS. Diagnostics. 2022;12(8):1922. doi: 10.3390/diagnostics12081922. DOI: https://doi.org/10.3390/diagnostics12081922

Caglayan AO, Dunder M, Tanriverdi F, Baysal NA, Oakul Y, Unluhizarcci K, et al. Idiopathic hirsutism: Local and peripheral expression of aromatase (CYP19A) and alpha reductase genes (SRD5A1 and SRD5A2). Fertil Steril. 2011;96(2):479-482. doi: 10.1016/j.fertnstert.2011.05.040. DOI: https://doi.org/10.1016/j.fertnstert.2011.05.040

Teede H, Misso M, Costello M, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018;33. doi: 10.1016/j.fertnstert.2018.05.004. DOI: https://doi.org/10.1093/humrep/dey363

Parlak M, Parlak A, Toslak I. Etiologic factors and clinical characteristics of Turkish adolescent girls diagnosed with hirsutism. J Clin Anal Med. 2016;7(2). doi: 10.4328/JCAM.4168. DOI: https://doi.org/10.4328/JCAM.4168

lagan M, Paz-Pacheco E, Totesora D, Clemente-Chua L, Jalique J. The modified Ferriman-Gallwey score and hirsutism among Filipino women. Endocrinol Metab. 2019;34:374. doi: 10.3803/enm.2019.34.4.374. DOI: https://doi.org/10.3803/EnM.2019.34.4.374

Sharma D, Shanker V, Tegta G, Gupta M, Verma GK. Clinico-investigative profile of patients of hirsutism in a tertiary level institution. Int J Trichol. 2012;4(2):69. doi: 10.4103/0974-7753.96904. DOI: https://doi.org/10.4103/0974-7753.96904

Kahraman F, Erdoğan S. Grading of hirsutism: A practical approach to the modified Ferriman-Gallwey scoring system. Adv Dermatol Allergol. 2021;39:744-748. doi: 10.5114/ada.2021.108455. DOI: https://doi.org/10.5114/ada.2021.108455