GynaecologyFree in the app
Hirsutism and hyperprolactinaemia
Exclude a tumour first.
Source: International PCOS guideline 2023 · Endocrine SocietyHirsutism
| Score | Modified Ferriman-Gallwey: 9 areas scored 0–4; cut-off varies by ethnicity. |
|---|---|
| Red flags | Rapid onset, virilisation, testosterone above 5 nmol/L: exclude androgen-secreting tumour and late-onset CAH (17-OHP). |
| Treatment | Combined pill for 6 months, cosmetic measures, eflornithine; anti-androgens only with contraception. |
Hyperprolactinaemia
| Causes | Pregnancy, lactation, drugs (antipsychotics, metoclopramide, domperidone), hypothyroidism, CKD, stress, macroprolactin, prolactinoma. |
|---|---|
| Above 200 ng/ml | Suggests macroprolactinoma — MRI. |
| Mild rise | Repeat rested sample; check macroprolactin. |
| Cabergoline | 0.25–0.5 mg once or twice weekly; stop when pregnant. |
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.