Free androgen index and its relation with female pattern hair loss

Androgenetic alopecia (AGA) is more common in women than in men. This study aims to evaluate various androgenic hormones in women and to assess if free androgen index (FAI) can be used as a marker of hyperandrogenism in women. Forty women with AGA (defined as grade 1, 2, or 3) were taken as subjects, and 40 other healthy women were included as controls in the study. The serum concentrations of testosterone (T) and sex hormone-binding globulin (SHBG) were measured, and FAI was calculated accordingly and compared with the control group. Results revealed that there were significant differences in the mean value of the two indicators (testosterone and FAI) in cases as compared to the controls. While the level of SHBG tended to be higher in controls than AGA cases. FAI appeared to be a better biomarker to predict hyperandrogenism than testosterone and SHBG alone. It can be concluded that FAI could be considered a good marker for an individual's androgen and can be recommended to be a vital biomarker of AGA in females. It is recommended to apply these parameters in the routine investigations for female patients with AGA.