Examination of the chin or lower abdomen only for the prediction of hirsutism

Objective: To test the hypothesis that scoring terminal hair growth on only the chin or abdomen can serve as a reliable predictor for hirsutism. Design: A prospective observational study. Patient(s): Six hundred and ninety-five consecutive hyperandrogenic women seen between June 1987 and December 1997. Main Outcome Measure(s): All hirsutism exams were performed by one examiner. Hirsutism was scored using a modification of the Ferriman-Gallwey (F-G) method. An F-G score of ≥8 defined hirsutism. Result(s): Of the 695 women examined 352 (50.1%) had hirsutism scores of 8. Thirty percent (79 of 344) of women who had an F-G score of < 8 had previously underwent electrology. If either the chin or lower abdomen hair growth score was ≥2, the sensitivity was 100% for the prediction of hirsutism, although the specificity was 27%. The positive predictive value (PPV) for hirsutism using a hair score of ≥2 at either of these sites was 58%. Conclusion(s): A hair growth score of ≥2 on the chin or lower abdomen only was found to be a highly sensitive predictor for hirsutism. However, because of its very low PPV, this screening method is virtually useless in populations where the hirsutism frequency is expected to be low, about 5%. However, this screening method for the detection of hirsutism would be useful for the study of high-risk populations with an expected hirsutism prevalence of >20% (e.g., family studies). (C) 2000 by American Society for Reproductive Medicine.