Modified Ferriman-Gallwey Score (mFG)

Ferriman & Gallwey, 1961 · modified 9-area version: Hatch et al., 1981 · cut-offs: AE-PCOS Society 2012, International PCOS Guideline 2023

Purpose
Standardised visual quantification of terminal hair growth in androgen-dependent areas to define and grade hirsutism, the main clinical marker of hyperandrogenism in PCOS.
Population
Women of reproductive age (and adolescents, with caution). Only terminal hairs (> 5 mm, pigmented, medullated) count; cosmetic removal lowers the apparent score — ask about it.
Formula
mFG = Σ grade (0–4) over 9 areas: upper lip, chin, chest, upper back, lower back, upper abdomen, lower abdomen, upper arms, thighs  ·  Range 0–36
Severity thresholds
Hirsutism if mFG ≥ population cut-off: ≥ 8 White/Black women (Hatch 1981; AE-PCOS 2012) · ≥ 4–6 depending on ethnicity (PCOS guideline 2023) · ≥ 3 East/South-East Asian women (AE-PCOS 2012). Severity (AE-PCOS 2012): mild ≤ 15 · moderate 16–25 · severe > 25.
📍 Nine body areas (0–4 each)

Grade the amount of terminal hair in each area, ideally against the mFG photographic atlas. The modified score drops the forearm and lower leg of the original 11-area scale.

0No terminal hair
1Minimal terminal hair
2More than minimal, but less than an adult male
3Equivalent to a not very hairy adult male
4Typical of a well-virilised adult male
Running total 0 / 36
🌍 Population cut-off

The threshold that defines hirsutism is the 95th percentile of the local reference population. Choose the closest option — the applied cut-off can be edited below.

Original cut-off: only 4.3 % of UK women scored ≥ 8 in Ferriman & Gallwey's series (Hatch 1981); confirmed at the 95th percentile in US White and Black women (DeUgarte 2006).
ℹ️ Hirsutism alone predicts biochemical hyperandrogenism and PCOS (2023 guideline, EBR 1.3.1). Continue with the PCOS diagnostic guide (Rotterdam criteria, 2023 update) and grade any hair loss with the FPHL classification.
📚 References
  1. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–7. doi:10.1210/jcem-21-11-1440
  2. Hatch R, Rosenfield RL, Kim MH, Tredway D. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol. 1981;140(7):815–30. doi:10.1016/0002-9378(81)90746-8
  3. Escobar-Morreale HF, Carmina E, Dewailly D, et al. Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 2012;18(2):146–70. doi:10.1093/humupd/dmr042
  4. DeUgarte CM, Woods KS, Bartolucci AA, Azziz R. Degree of facial and body terminal hair growth in unselected Black and White women: toward a populational definition of hirsutism. J Clin Endocrinol Metab. 2006;91(4):1345–50. doi:10.1210/jc.2004-2301
  5. Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447–69. doi:10.1210/clinem/dgad463
  6. Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14(5):270–84. doi:10.1038/nrendo.2018.24
Clinical decision support only. This tool is intended to assist clinical assessment and does not replace professional judgment. Always interpret results in the context of the individual patient.