Prevalence of androgenic alopecia in patients with polycystic ovary syndrome and characterization of associated clinical and biochemical features

ObjectiveTo describe the prevalence of androgenic alopecia (AGA) in patients with polycystic ovary syndrome (PCOS) and to characterize associated clinical and biochemical features.DesignCross-sectional study.SettingMultidisciplinary PCOS clinic at a tertiary academic center.Patient(s)A total of 254 women with PCOS according to the Rotterdam criteria were systematically examined from 2007 to 2012 by a reproductive endocrinologist, a dermatologist, and a psychologist.Intervention(s)Comprehensive dermatologic exams, ultrasonic imaging, serum testing, and Beck Depression Inventory Fast Screen (BDI-FS).Main Outcome MeasuresPresence of AGA, acne, hirsutism, biochemical hyperandrogenemia, metabolic dysfunction, and clinical depression.Result(s)Fifty-six of 254 patients with PCOS (22.0%) had AGA. Subjects with PCOS and AGA were more likely to have acne or hirsutism than those without AGA (96.3% vs. 70.6%). Subjects with AGA were more likely to report concern with hair loss (70.4% vs. 37.7%); however, their BDI-FS scores were no different from subjects without AGA. There were no differences between subjects with and without AGA in biochemical hyperandrogenism or metabolic parameters.Conclusion(s)AGA is prevalent in 22% of subjects meeting diagnostic criteria for PCOS. AGA is associated with other manifestations of clinical hyperandrogenism, but not with greater risk of biochemical hyperandrogenemia or metabolic dysfunction than with PCOS alone.