Testosterone or Dehydroepiandrosterone Sulfate as a Biomarker for Hirsutism in Women with Polycystic Ovary Syndrome

Abstract

Background:Hirsutism is a distressing medical problem for women. Most of hirsutism in women is associated with excess androgen, and most cases have PCOS as an underlying cause.Which androgen to be used to evaluate clinical or biochemical hyperandrogenism in women with PCOS is still debated.There are a small number of studies that evaluated androgens in women with PCOS having hirsutism with conflicting results. The Objective of this study was to determine which androgen predict hirsutism in women with polycystic ovary syndrome (PCOS). Patients and Methods:A case-control study was done in Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), Basrah, Iraq. A total of 130 women with PCOS (based on Rotterdam criteria) and 70 healthy controls of comparable age (16-40 years) were investigated for androgens (total testosterone, free testosterone, DHEA-S) using Electrochemiluminescence technology assay; excess hair was examined according to the modified Ferriman-Gallwey (mFG) score and a cut-off value of 8 defined hirsutism. Results: In the three groups of women, the first (n=100) included PCOS with hirsutism, the second (n=30) PCOS without hirsutism, and the third (n=70) women without PCOS or hirsutism as healthy control, hirsutism was seen in about 77 % of PCOS women mostly of moderate severity; High TT, FT, DHEA-S, and overall androgens were seen in 69%, 76%, 37%, and 99% respectively of our PCOS women with hirsutism. No correlation was found between TT, FT, and DHEA-S and the mFG score. Conclusions: This study provides evidence that presence of hirsutism in women with PCOS was associated with a higher level of biochemical hyperandrogenism than seen in PCOS without hirsutism; however, there was no correlation between the studied androgens and mFG score.