Severity of Hirsutism and Its Correlation With Hyperandrogenism: A Cross-Sectional Study in Erbil City

Hirsutism is defined as excessive terminal hair growth in females in androgen-dependent areas. Hyperandrogenism is a hormonal disease that clinically often presents as hirsutismus. Hirsutism is associated with high levels of androgens according to a few studies. This study is conducted to analyze this correlation in female individuals in Erbil City, Kurdistan Region, Iraq.

This case-control study included 100 hirsute females and their 100 non-hirsute counterparts. A thorough history was obtained for symptoms and conditions associated with hyperandrogenism. The severity of hirsutism was assessed with the modified Ferriman-Gallwey (mFG) score. Laboratory tests were performed to include thyroid function and androgen hormone levels.

Most hirsute cases (98%) had mild and moderate hirsutism, and only 2% had severe hirsutism. Thyroid function tests were comparable in cases and controls, and only 4% of the hirsute study population had hypothyroidism. There were no significant differences in serum testosterone (total and free) between groups. But mean serum 17-hydroxyprogesterone values were higher in hirsute cases.

Elevated testosterone levels were present in only 2% of hirsute females and there were no statistically significant differences between the cases and control group. However, 17-hydroxyprogesterone was higher in hirsute females suggesting its possible involvement in the pathophysiology of hirsutism. Further studies that explore this relationship are recommended.