Hanyang Med Rev HMR Hanyang Medical Reviews 1738-429X 2234-4446 Hanyang University School of Medicine 10.7599/hmr.2012.32.4.197 Review Article Hyperandrogenism in Women: Polycystic Ovary Syndrome Sung Yeon-Ah Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. Corresponding author: Yeon-Ah Sung. Department of Internal Medicine, Ewha Mokdong Hospital, A-dong 813-ho, Uihakgwan, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: +82-2-2650-5034, Fax: +82-2-2061-5235, yasung@ewha.ac.kr 11 2012 28 11 2012 32 4 197 202 18 08 2012 23 10 2012 30 10 2012 © 2012 Hanyang University College of Medicine 2012

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Hyperandrogenism refers to classical androgen-dependent signs such as hirsutism, acne and androgenetic alopecia. Disorders that result in androgen excess include specific identifiable disorders (i.e. disorders of inclusion), but the great majority of women presenting with hirsutism and other symptoms or signs of hyperandrogenism suffer from polycystic ovary syndrome (PCOS). Hirsutism is the main hyperandrogenic symptom, defined as an excess of body hair in androgen-sensitive regions of skin in women. In this review, I attempt to focus on the pathogenesis of hirsutism, as well as clinical and biochemical features that are important in choosing therapeutic options. PCOS is the most common disorder of premenopausal women, affecting 4 to 8% of this population, and therefore, diagnostic issues of PCOS in Korean women will be addressed, specifically the reproductive and metabolic derangements and criteria for hyperandrogenism based on hirsutism and serum androgen concentrations.

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Ferriman-Gallwey hirsutism scoring system. Each of the nine body areas most sensitive to androgen is assigned a score from 0 (no hair) to 4 (frankly virile), and these separate scores are summed to provide a hormonal hirsutism score. Ref. 5 with permission from Endocrine Society.

Suggested algorithm for the initial evaluation of hirsute women for hyperandrogenism. T, testosterone; PCOS, polycystic ovary syndrome; OCP, oral contraceptive pill; AM, before noon. Ref. 5 with permission from Endocrine Society.

Etiology of Hirsutism

Various Diagnostic Criteria of Polycystic Ovary Syndrome

NICHD, national institute of children's health and disease; ESHRE, european society of human reproduction and embryology; AES, androgen excess society; PCO, polycystic ovary.