Loss of pubic hair in women over 40 years: prevalence and association with osteoporotis risk

Background: Loss of pubic hair has been associated with the socalled androgen insufficiency syndrome, a clinical entity, mostly occurring after surgical menopause, which comprises other signs and symptoms, including osteoporotic risk. Objectives: To assess the prevalence of self-reported loss of pubic hair in women between 40 and 75 years old who participated to the Menopause Day Campaign for osteoporosis prevention. Methods: A brief questionnaire was filled-in by 2,883 women screened by quantitative ultrasound (Achilles Express apparatus, GELunar Co., Madison, USA) performed at the right calcaneus. Results: In our study population, 1051 women (36.5%) reported loss of pubic hair [67/508 (13.2%) pre/perimenopause, 984/2375 (41.4%) postmenopause]. Being menopausal significantly influenced loss of pubic hair (OR: 4.3; 95% CI: 3.3-5.7). Indeed, women with loss of pubic hair were significantly older (p<0.001) and reported more years since menopause (p<0.001). Bilateral ovariectomy (9.9%) did not seem to influence the occurrence of loss of pubic hair (OR: 0.83; 95% CI: 0.6-1.1), likely due to the low rate (1%) of women who had surgery during the fertile age. However, 45.4% women with surgical menopause reported loss of pubic hair in comparison with 35.5% with natural menopause. Osteoporotic risk [osteopenia/osteoporosis (stiffness <79) was slightly higher (OR: 1.3; 95% CI: 1.05-1.4) in women with loss of pubic hair. Indeed, loss of pubic hair was reported by 50% of women with osteoporosis (stiffness <57), 41.4% with osteopenia (stiffness 57-78) and 32.8% with normal stiffness (>78). Conclusions: This study showed that loss of pubic hair is quite common in postmenopausal women, regardless ovariectomy. Moreover, one out of two women reporting loss of pubic hair has an osteoporotic risk and this simple clinical marker may guide screening campaign in the female population.