What is the Ferriman-Gallwey Scoring System and how is it used in the evaluation of androgen excess?

Updated: Mar 14, 2018
  • Author: Mohamed Yahya Abdel-Rahman, MD, MSc; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Ferriman and Gallwey [33] published a hirsutism rating scale that is illustrated in the table below. This scale allows the physician to measure a response to therapy objectively. This system is the most widely used and evaluates body areas for absent-to-severe hirsutism with scores of 0-4, respectively. Scores of 8 and higher are consistent with a diagnosis of hirsutism. This scale does not measure the thickness of the hair, which is another way of objectively assessing excess hair.

Scoring systems are a useful aid in quantifying hirsutism and in evaluating treatment response. However, they are somewhat subjective, so the absolute score is not used to define hirsutism. Even with scores >8, the patient determines if she is hirsute. When evaluating treatment response, the patient can determine if he or she notices a difference. Photographs are helpful for documentation and for following the progress of therapy.

Table. Ferriman-Gallwey Scoring System (Open Table in a new window)

Body Area Evaluated

Score

(Graded from 0-4*)

Upper lip

 

Chin

 

Upper abdomen

 

Lower abdomen

 

Upper arm

 

Thighs

 

Upper back

 

Lower back/buttocks

 

*0 = No hirsutism, 4 = Severe hirsutism


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