SHBG and alopecia: PCOS often develops during puberty inducing dermatological signs (hirsutism, acne, and alopecia), irregular menses, and biochemical alterations associated with high levels of testosterone, DHEA, androstenedione, and luteinizing hormone (LH) and increased LH/follicle-stimulating hormone (FSH) ratio, together with a concurrent reduction of sex hormone binding globulin (SHBG) and insulin-like growth factor (IGF) binding protein [32].