title: Prevalence of functional disorders of androgen excess in unselected premenopausal women: a study in blood donors.
abstract: BACKGROUND
  The polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. On the contrary, the prevalences of other disorders of androgen excess such as idiopathic hyperandrogenism and idiopathic hirsutism remain unknown. We aimed to obtain an unbiased estimate of the prevalence in premenopausal women of (i) signs of androgen excess and (ii) PCOS, idiopathic hyperandrogenism and idiopathic hirsutism.
  
  
  METHODS
  A multicenter prevalence survey included 592 consecutive premenopausal women (393 from Madrid, Spain and 199 from Bologna, Italy) reporting spontaneously for blood donation. Immediately before donation, we conducted clinical and biochemical phenotyping for androgen excess disorders. We determined the prevalence of (i) hirsutism, acne and alopecia as clinical signs of androgen excess and (ii) functional disorders of androgen excess, including PCOS, defined by the National Institute of Child Health and Human Development/National Institute of Health criteria, idiopathic hyperandrogenism and idiopathic hirsutism.
  
  
  RESULTS
  Regarding clinical signs of hyperandrogenism, hirsutism and acne were equally frequent [12.2% prevalence; 95% confidence interval (CI): 9.5-14.8%], whereas alopecia was uncommon (1.7% prevalence, 95% CI: 0.7-2.7%). Regarding functional disorders of androgen excess, PCOS and idiopathic hirsutism were equally frequent (5.4% prevalence, 95% CI: 3.6-7.2) followed by idiopathic hyperandrogenism (3.9% prevalence, 95% CI: 2.3-5.4).
  
  
  CONCLUSIONS
  Clinical signs of hyperandrogenism and functional disorders of androgen excess show a high prevalence in premenopausal women. The prevalences of idiopathic hyperandrogenism and idiopathic hirsutism are similar to that of PCOS, highlighting the need for further research on the pathophysiology, consequences for health and clinical implications of these functional forms of androgen excess.
authors.affiliation: Diabetes, Obesity and Human Reproduction Research Group,  Hospital Universitario Ramón y Cajal and Universidad de Alcalá and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid E-28034,  Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Sanchón
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gambineri
authors.forename: Macarena
authors.initials: M
authors.lastname: Alpañés
authors.forename: M Ángeles
authors.initials: MÁ
authors.lastname: Martínez-García
authors.forename: Renato
authors.initials: R
authors.lastname: Pasquali
authors.forename: Héctor F
authors.initials: HF
authors.lastname: Escobar-Morreale
mesh_terms: D000152:Acne Vulgaris / Q000097:blood / Q000453:epidemiology; D000328:Adult; D000505:Alopecia / Q000097:blood / Q000453:epidemiology; D000728:Androgens / Q000097:blood*; D001782:Blood Donors; D004700:Endocrine System Diseases / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006628:Hirsutism / Q000097:blood / Q000453:epidemiology; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D013030:Spain / Q000453:epidemiology
chemical_list: D000728:Androgens