DIAGNOSIS OF HIRSUTISM
1. Taking a medical history including the date at which hair started to grow, the date on which acne started to appear or the date when hair started to fall out, as well as subsequent follow-up of the clinical course; date of the first period and regularity of the following periods; medication the patient is taking or has taken; the presence of hair in close family members.
2. By performing a thorough physical examination to quantify the intensity, length and thickness of vellus hair and normal hair. Hair should be assessed per areas following international criteria. This exploration should also determine the presence of virilization or defeminization.
3. Performing measurements of hormones that may be involved between the second and ninth day of the menstrual cycle based on the data retrieved on the medical history and exploration. In general terms the following are usually measured: testosterone, dehydroepiandrosterone- sulphate, androstenedione, 17-hydroxy progesterone, sexual hormone transport protein, glucuronide, luteinizing and follicle-stimulating hormone.
When late suprarenal hyperplasia is suspected, an ACTH stimulation test should be performed.
FERRIMAN-GALLWEY SCALE
This scale measures the intensity of hirsutism according to the amount of hair in androgen-dependent areas:
Upper lip
Chin. Thorax.
Upper region of the back
Lumbosacral region
Upper abdomen
Lower abdomen
Arm
Forearm
Thigh
Leg
