Defining hirsutism in Chinese women: a cross-sectional study

To determine the normative cut-off score that defines hirsutism among Chinese women, and the effect of age, menstrual irregularities, and polycystic ovaries on the same. Cross-sectional, population-based study. A multistage systematic cluster random sampling among 16 communities from two rural and two city regions. A representative sample of 2,988 women aged 20–45 years from the general population of Southern China. Subjects underwent physical and ultrasound evaluations. Terminal hair growth was assessed using the modified Ferriman-Gallwey (mFG) scoring system. An mFG score ≥5 was observed in 10% and a score of ≥2 in 25% of the subjects. Cluster analysis identified an mFG score of 5 as the cut-off value that defines abnormal terminal facial and body hair growth in a male pattern (i.e., hirsutism) in the total population; scores of 6, 5, and 4 for women aged 20–25, 26–30, and >30 years, respectively. Defined by these cut-off values, the prevalence of hirsutism in our total population was 10.5%; and decreased with increasing age: 14.4%, 10.7%, 7.9%, 3.6%, and 1.5%, respectively, in women aged 20–25, 26–30, 31–35, 36–40, and 41–45 years. Furthermore, the incidence of acne, menses irregularities, polycystic ovaries, and acanthosis nigricans were significantly increased among the hirsute women. An mFG score of 5 or greater indicates hair growth above the norm among women in the general Southern Chinese population, a cut-off value that decreases with increasing age.