Prevalence of polycystic ovaries in women with androgenic alopecia.
OBJECTIVE
Although androgenic alopecia is recognised to be a symptom of polycystic ovary syndrome (PCOS), it is not known whether polycystic ovaries (PCO) and associated endocrine abnormalities are present in patients who present with alopecia as a primary complaint. We therefore set out to determine the strength of the association between androgenic alopecia and PCO. We examined the prevalence of ultrasound-based polycystic ovarian morphology and associated clinical and biochemical features in a large multiethnic group of women whose presenting complaint was of alopecia, and in a control group.


METHODS
We studied 89 women of mixed ethnic origin with androgenic alopecia and compared them to 73 control women. A detailed history was taken, anthropometry was performed and assessment of body-hair distribution was made. The presence of PCO was established by pelvic ultrasound scan. Serum gonadotrophins, testosterone, androstenedione, dihydrotestosterone and sex hormone binding globulin concentrations were measured.


RESULTS
Women with alopecia had a higher prevalence of PCO and hirsutism than the control population (PCO: 67% vs 27%, P<0.00001; hirsutism: 21% vs 4%, P=0.003). Women with alopecia (with or without PCO) had higher testosterone, androstenedione and free androgen index than controls, even though few had frankly abnormal androgens.


CONCLUSIONS
These findings confirm an association between androgenic alopecia and PCO, and other symptoms of hyperandrogenaemia. Thus most women who present with androgenic alopecia as their primary complaint also have PCO and have indices of abnormal androgen production. Since PCO is a well known risk factor for development of type 2 diabetes, this association has important implications for long-term management.
Department of Obstetrics and Gynaecology, St Mary's Hospital, London W2 1PG, Hammersmith Hospital, London W12 0NN, UK.
Ester
E
Cela
Carole
C
Robertson
Karen
K
Rush
Eleni
E
Kousta
Davinia M
DM
White
Helen
H
Wilson
Glenn
G
Lyons
Philip
P
Kingsley
Mark I
MI
McCarthy
Stephen
S
Franks
D000328:Adult; D000505:Alopecia / Q000097:blood / Q000453:epidemiology*; D000735:Androstenedione / Q000097:blood; D005260:Female; D006628:Hirsutism / Q000097:blood / Q000453:epidemiology; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D000735:Androstenedione