what is androgen excess? | fast facts | glossary of terms | faq
Tools to evaluate ovulation and hirsutism in women with potential androgen excess
Clinicians or researchers who are interested in evaluating women with androgen excess often need to assess ovulatory function, in the event the patient/study subject appears to have regular menstrual cycles (i.e. regular episodes of vaginal bleeding, or eumenorrhea). A basal body temperature chart ( BBT ) is a useful tool for this, along with the measurement of a serum progesterone level 20 to 24 days after the start of the vaginal bleeding (a.k.a. day 22-24 of the menstrual cycle, or in the luteal phase). Most practioners define a progesterone level of greater than 3 to 5 ng/mL as evidence of ovulation. The BBT allows for a better assessment of the timing of ovulation and of the blood sample relative.
Hirsutism, or the presence of male-pattern terminal hair growth on the face or body, is an important feature and consequence of many patients with androgen excess. Quantifying the extent of male-pattern terminal hair growth is then critical for the thorough evaluation of women with potential androgen excess. The use of the modified Ferriman-Gallwey visual scoring method has been used extensively for this purpose. This method requires the visual scoring of the extent of terminal hairs (hairs that are coarse, medullated, pigmented and that would grow to greater than 5 mm in length) in nine body areas: a) upper lip, b) chin, c) chest, d) upper abdomen (above the umbilicus), e) lower abdomen (a.k.a. male escutcheon, below the umbilicus), f) upper back, g) lower back, h) thighs (front and back), and i) upper arms (biceps area). Each area is assigned a score of zero (no detectable terminal hairs), 1 (minimum terminal hairs), 2 (more than minimum but not quite that of a man), 3 (that of a mildly hirsute man), and 4 (that of a hirsute man). Note that the lower arms or lower legs are not included in this assessment.