Xiaomiao Zhao

Xiaomiao Zhao

Sun Yat-Sen University, China

Title: Defining hirsutism in Chinese women: A cross-sectional study


Xiaomiao Zhao, MD.,Ph.D., an associate professor of reproductive endocrine, Gynecology. She has completed her M.D. at the age of 24 years and Ph.D at 30 years from Sun Yat-Sen University in Guangzhou, China and postdoctoral studies from Cedars-sinai medical center, University of California in Los Angeles. She has published more than 40 papers, among which, over 10 papers in reputed English journals (e.g. Fertility and Sterility, Clinical Endocrinology, International of Caner, and International Journal of Cardiology, etc.) and serving as reviewer of International Journal of Cancer and BMC Systems Biology. She takes charge of eight research grants of China.


Hirsutism (i.e. facial and body terminal hair growth in a male-like pattern in women) is the principal clinical sign of hyperandrogenism, although its definition remains unclear. We conducted a cross-sectional, population-based study by using a multistage systematic cluster random sampling among 16 communities from two rural and two city regions in southern China, to determine the normative cut-off score that defines hirsutism, and the effect of age, menstrual irregularities (MI), and polycystic ovaries (PCO) on the same. Totally, a representative sample of 2,988 women aged 20–45 years underwent physical and ultrasound evaluations; and their terminal hair growth were assessed using the modified Ferriman-Gallwey (mFG) scoring system. An mFG score of ≧ 5 was observed in 10% and a score of ≧ 2 in 25% of the subjects. Cluster analysis identified an mFG score of 5 as the cut-off value that defines hirsutism in the total population; scores of 6, 5, and 4 for women aged 20–25, 26–30, and >30 years, respectively. Defined by these cut-off values, the prevalence of hirsutism was 10.5%; and decreased with increasing age: 14.4%, 10.7%, 7.9%, 3.6%, and 1.5%, respectively, in women aged 20–25, 26–30, 31–35, 36–40, and 41–45 years. Furthermore, the incidence of acne, MI, PCO, and acanthosis nigricans were significantly increased among the hirsute women. This suggested that an mFG score of ≧ 5 indicates hair growth above the norm among women in the general Southern Chinese population, a cut-off value that decreases with increasing age.