The authors question the sensitivity of increased hair growth as a marker of hyperandrogenism. The production of andorgens varies vastly among women. Despite very high androgens, some women have little increase in hair growth due to lack of receptors for the hormone in skin. Blondes, native Americans, and Orientals tend to have fewer receptors. Others may have hyperandrogenism manisfested as acne rather than hair growth.
Men differ from women in the pattern of hair growth.
A small increase of hair along the upper lip and around the nipples is not abnormal, and leg and arm hair amount is of little concern. Scoring of hirsutism is often subjective. This study benefits by using the Ferriman-Gallwey scoring system and by requiring a score of zero for inclusion. These findings may broaden the definition of PCOS even more and could have important nonreproductive medical consequences such as in diabetes and heart disease. K. Oktay et al.