Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss?

Samih A Odhaib; Khalil Al Hamdi; Abbas A Mansour

doi:10.7759/cureus.11732

Is There Any Association Between Clinical and Biochemical Hyperandrogenism in Women With Female Pattern Hair Loss?

Cureus. 2020 Nov 27;12(11):e11732. doi: 10.7759/cureus.11732.

Authors

Samih A Odhaib¹, Khalil Al Hamdi², Abbas A Mansour³

Affiliations

¹ Adult Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center, College of Medicine, University of Basrah, Basrah, IRQ.
² Dermatology, College of Medicine, University of Basrah, Basrah, IRQ.
³ Diabetes and Endocrinology, College of Medicine, University of Basrah, Basrah, IRQ.

Abstract

Background The exact association between clinical and biochemical hyperandrogenism (HA) is heterogeneous and cannot be ascertained, especially in normoandrogenic women. Objectives Evaluate any association between clinical phenotypes and biochemical parameters of HA in premenopausal women with female pattern hair loss (FPHL). Materials and methods A cross-sectional observational study on 362 women, who were assessed for general characteristics, the different FPHL severities by Sinclair's score, hirsutism by modified Ferriman-Gallwey (mFG) score. Evaluation for biochemical HA included total, calculated free and bioavailable testosterone (TT), free testosterone (FT), and bioavailable testosterone (BT), respectively, and dehydroepiandrosterone sulfate. The variables of clinical HA were FPHL, hirsutism, and acne. Results The enrolled young premenopausal women's age range was (14-47 years). Around 78% were overweight or obese women. Eighty-percent of women had a mild FPHL, with a median of three years, where 2/3 of women had a duration <3 years with no significant relationship to FPHL severity. About 73% of women had either a mild to moderate hirsutism, and around 16% had acne. The biochemical HA was confirmed in around 52% of women (n=188), who show high levels of calculated FT. The calculated BT is high in 78.5% of women (n=284). The means of HA's biochemical indicators were in their reference ranges or slightly above, with no specific change pattern with the corresponding FPHL severity. None of these parameters had a significant relationship with the severity of FPHL. The FPHL duration was not affected by any presumed variable of clinical or biochemical HA. Conclusions FPHL severity was associated with other clinical HA signs like hirsutism and acne, but not to HA's biochemical parameter. Other parameters, like sex hormone-binding globulin (SHBG), and BMI, had no significant relation to the FPHL severity.

Keywords: alopecia; androgen excess; androgenetic alopecia; androgens; bald; hair loss; hirsutism; premenopausal women; sex hormone binding globulin; testosterone.