Skip to main content

Advertisement

SpringerLink
Log in

Does a male polycystic ovarian syndrome equivalent exist?

  • Review
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

The occurrence of a genetic background in the etiology of polycystic ovarian syndrome (PCOS) represents the rational basis to postulate the existence of a male PCOS equivalent. Hormonal and metabolic abnormalities have been described in male relatives of women with PCOS. These males also have a higher prevalence of early onset (<35 years) androgenetic alopecia (AGA). Hence, this feature has been proposed as a clinical sign of the male PCOS equivalent. Clinical evidence has shown that men with early onset AGA have hormonal and metabolic abnormalities. Large cohort studies have clearly shown a higher prevalence of type II diabetes mellitus (DM II) and cardiovascular diseases (CVDs) in elderly men with early onset AGA. In addition, prostate cancer, benign prostate hyperplasia (BPH) and prostatitis have been described. These findings support the existence of the male PCOS equivalent, which may represent an endocrine syndrome with a metabolic background, and might predispose to the development of DM II, CVDs, prostate cancer, BPH and prostatitis later in life. Its acknowledgment would be helpful for the prevention of these long-term complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

AGA:

Androgenetic alopecia

AMH:

Antimullerian hormone

BPH:

Benign prostate hyperplasia

CHD:

Coronary heart disease

CVDs:

Cardiovascular diseases

DHEAS:

Dehydroepiandrosterone

DM II:

Type II diabetes mellitus

EPC:

Endothelial progenitors cells

FIRI:

Fasting insulin-resistance index

FMD:

Flow-mediated dilation

FSH:

Follicle stimulating hormone

GnRH:

Gonadotropin releasing hormone

GWAS:

Genome-wide association studies

LH:

Luteinizing hormone

17αOH-P:

17α-hydroxy-progesterone

MI:

Myocardial infarction

mTORC1:

Mammalian target of rapamycin complex 1

PCOS:

Polycystic ovarian syndrome

PRL:

Prolactin

SHBG:

Sex hormone binding globulin

T:

Testosterone

References

  1. Fratantonio E, Vicari E, Pafumi C, Calogero AE (2009) Genetics of polycystic ovarian syndrome. Reprod Biomed Online 10(6):713–720

    Article  Google Scholar 

  2. Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E, American Association of Clinical Endocrinologists (AACE); American College of Endocrinology (ACE); Androgen Excess and PCOS Society (2015) American Association Of Clinical Endocrinologists, American College Of Endocrinology, And Androgen Excess and PCOS Society Disease State Clinical Review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome—part 2. Endocr Pract 21(12):1415–1426

    Article  PubMed  Google Scholar 

  3. Barber TM, Franks S (2013) Genetics of polycystic ovary syndrome. Front Hormone Res 40:28–39

    CAS  Google Scholar 

  4. Hamilton JB (1951) Patterned loss of hair in man: types and incidence. Ann N Y Acad Sci 53(3):708–728

    Article  CAS  PubMed  Google Scholar 

  5. Norwood OT (1975) Male pattern baldness: classification and incidence. South Med J 68(11):1359–1365

    Article  CAS  PubMed  Google Scholar 

  6. Lunde O, Magnus P, Sandvik L, Høglo S (1989) Familial clustering in the Polycystic Ovarian syndrome. Gynecol Obstet Invest 28(1):23–30

    Article  CAS  PubMed  Google Scholar 

  7. Carey AH, Chan KL, Short F, White D, Williamson R, Franks S (1993) Evidence for a single gene effect causing polycystic ovaries and male pattern baldness. Clin Endocrinol 38(6):653–658

    Article  CAS  Google Scholar 

  8. Govind A, Obhrai MS, Clayton RN (1999) Polycystic ovaries are inherited as an autosomal dominant trait: analysis of 29 polycystic ovary syndrome and 10 control families. J Clin Endocrinol Metab 84(1):38–53

    Article  CAS  PubMed  Google Scholar 

  9. Legro RS (2000) Is there a male phenotype in polycystic ovary syndrome families? J Pediatr Endocrinol Metab 13(5):1307–1309

    PubMed  Google Scholar 

  10. Dusková M, Cermáková I, Hill M, Vanková M, Sámalíková P, Stárka L (2004) What may be the markers of the male equivalent of polycystic ovary syndrome? Physiol Res 53(3):287–295

    PubMed  Google Scholar 

  11. Starka L, Hill M, Polacek V (2000) Hormonal profile of men with premature androgenetic alopecia. Sbornik Lékarsky 101(1):17–22

    CAS  PubMed  Google Scholar 

  12. Benítez R, Sir-Petermann T, Palomino A, Angel B, Maliqueo M, Pérez F, Calvillán M (2001) Prevalence of metabolic disorders among family members of patients with polycystic ovary syndrome. Rev Med Chil 129(7):707–712

    Article  PubMed  Google Scholar 

  13. Yilmaz M, Bukan N, Ersoy R, Karakoç A, Yetkin I, Ayvaz G, Cakir N, Arslan M (2005) Glucose intolerance, insulin resistance and cardiovascular risk factors in first degree relatives of women with polycystic ovary syndrome. Hum Reprod 20(9):2414–2420

    Article  CAS  PubMed  Google Scholar 

  14. Norman RJ, Masters S, Hague W (1996) Hyperinsulinemia is common in family members of women with polycystic ovary syndrome. Fertil Steril 66(6):942–947

    Article  CAS  PubMed  Google Scholar 

  15. Kaushal R, Parchure N, Bano G, Kaski JC, Nussey SS (2004) Insulin resistance and endothelial dysfunction in the brothers of Indian subcontinent Asian women with polycystic ovaries. Clin Endocrinol 60(3):322–328

    Article  CAS  Google Scholar 

  16. Legro RS, Kunselman AR, Demers L, Wang SC, Bentley-Lewis R, Dunaif A (2002) Elevated dehydroepiandrosterone sulfate levels as the reproductive phenotype in the brothers of women with polycystic ovary syndrome. J Clin Endocrinol Metab 87(5):2134–2138

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lenarcik A, Bidzińska-Speichert B, Tworowska-Bardzińska U, Krępuła K (2011) Hormonal abnormalities in first-degree relatives of women with polycystic ovary syndrome (PCOS). Endokrynologia Polska 62(2):129–133

    CAS  PubMed  Google Scholar 

  18. Torchen LC, Kumar A, Kalra B, Savjani G, Sisk R, Legro RS, Dunaif A (2016) Increased antimullarian hormone levels and other reproductive endocrine changes in adult male relatives of women with polycystic ovary syndrome. Fertil Steril 106:50–55

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Recabarren SE, Sir-Petermann T, Rios R, Maliqueo M, Echiburú B, Smith R, Rojas-García P, Recabarren M, Rey RA (2008) Pituitary and testicular function in sons of women with polycystic ovary syndrome from infancy to adulthood. J Clin Endocrinol Metab 93(9):3318–3324

    Article  CAS  PubMed  Google Scholar 

  20. Liu DM, Torchen LC, Sung Y, Paparodis R, Legro RS, Grebe SK, Singh RJ, Taylor RL, Dunaif A (2014) Evidence for gonadotrophin secretory and steroidogenic abnormalities in brothers of women with polycystic ovary syndrome. Hum Reprod 29(12):2764–2772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Hayes MG, Urbanek M, Ehrmann DA, Armstrong LL, Lee JY, Sisk R, Karaderi T, Barber TM, McCarthy MI, Franks S, Lindgren CM, Welt CK, Diamanti-Kandarakis E, Panidis D, Goodarzi MO, Azziz R, Zhang Y, James RG, Olivier M, Kissebah AH, Network Reproductive Medicine, Stener-Victorin E, Legro RS, Dunaif A (2015) Genome-wide association of polycystic ovary syndrome implicates alterations in gonadotropin secretion in European ancestry populations. Nat Commun 6:7502

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Tüttelmann F, Laan M, Grigorova M, Punab M, Sõber S, Gromoll J (2012) Combined effects of the variants FSHB-211G>T and FSHR 2039A>G on male reproductive parameters. J Clin Endocrinol Metab 97(10):3639–3647

    Article  PubMed  Google Scholar 

  23. Starka L, Duskova M, Cermakova I, Vrbiková J, Hill M (2005) Premature androgenic alopecia and insulin resistance. Male equivalent of polycystic ovary syndrome? Endocr Regul 39(4):127–131

    CAS  PubMed  Google Scholar 

  24. Starka L, Cermakova I, Duskova M, Hill M, Dolezal M, Polácek V (2004) Hormonal profile of men with premature balding. Exp Clin Endocrinol Diabetes 112(1):24–28

    Article  CAS  PubMed  Google Scholar 

  25. Pitts RL (1987) Serum elevation of dehydroepiandrosterone sulfate associated with male pattern baldness in young men. J Am Acad Dermatol 16(3):571–573

    Article  CAS  PubMed  Google Scholar 

  26. Sanke S, Chander R, Jain A, Garg T, Yadav P (2016) A comparison of the hormonal profile of early androgenetic alopecia in men with the phenotypic equivalent of polycystic ovarian syndrome in women. JAMA Dermatol 152(9):986–991

    Article  PubMed  Google Scholar 

  27. Sinclair RD, Dawber RP (2001) Androgenetic alopecia in men and women. Clin Dermatol 19:167–178

    Article  CAS  PubMed  Google Scholar 

  28. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO (2004) The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 89:2745–2749

    Article  CAS  PubMed  Google Scholar 

  29. Arias-Santiago S, Gutiérrez-Salmerón MT, Buendía-Eisman A, Girón-Prieto MS, Naranjo-Sintes R (2011) Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia. J Am Acad Dermatol 65(1):48–53

    Article  CAS  PubMed  Google Scholar 

  30. Narad S, Pande S, Gupta M, Chari S (2013) Hormonal profile in Indian men with premature androgenetic alopecia. Int J Trichol 5(2):69–72

    Article  Google Scholar 

  31. Golden SH, Dobs AS, Vaidya D, Szklo M, Gapstur S, Kopp P, Liu K, Ouyang P (2007) Endogenous sex hormones and glucose tolerance status in postmenopausal women. J Clin Endocrinol Metab 92(4):1289–1295

    Article  CAS  PubMed  Google Scholar 

  32. Hirsso P, Laakso M, Matilainen V, Hiltunen L, Rajala U, Jokelainen J, Keinänen-Kiukaanniemi S (2006) Association of insulin resistance linked diseases and hair loss in elderly men. Finnish population-based study. Cent Eur J Public Health 14(2):78–81

    PubMed  Google Scholar 

  33. Matilainen V, Koskela P, Keinänen-Kiukaanniemi S (2000) Early androgenetic alopecia as a marker of insulin resistance. Lancet 356(9236):1165–1166

    Article  CAS  PubMed  Google Scholar 

  34. Su LH, Chen TH (2010) Association of androgenetic alopecia with metabolic syndrome in men: a community-based survey. Br J Dermatol 163(2):371–377

    Article  PubMed  Google Scholar 

  35. González-González JG, Mancillas-Adame LG, Fernández-Reyes M, Gómez-Flores M, Lavalle-González FJ, Ocampo-Candiani J, Villarreal-Pérez JZ (2009) Androgenetic alopecia and insulin resistance in young men. Clin Endocrinol 71(4):494–499

    Article  Google Scholar 

  36. Pengsalae N, Tanglertsampan C, Phichawong T, Lee S (2013) Association of early-onset androgenetic alopecia and metabolic syndrome in Thai men: a case-control study. J Med Assoc Thailand 96(8):947–951

    Google Scholar 

  37. Mumcuoglu C, Ekmekci TR, Ucak S (2011) The investigation of insulin resistance and metabolic syndrome in male patients with early-onset androgenetic alopecia. Eur J Dermatol 21(1):79–82

    CAS  PubMed  Google Scholar 

  38. Arias-Santiago S, Gutiérrez-Salmerón MT, Castellote-Caballero L, Buendía-Eisman A, Naranjo-Sintes R (2010) Male androgenetic alopecia and cardiovascular risk factors: a case-control study. Actas Dermosifiliograficas 101(3):248–256

    Article  CAS  Google Scholar 

  39. Lesko SM, Rosenberg L, Shapiro S (1993) A case-control study of baldness in relation to myocardial infarction in men. JAMA 269(8):998–1003

    Article  CAS  PubMed  Google Scholar 

  40. Lotufo PA, Chae CU, Ajani UA, Hennekens CH, Manson JE (2000) Male pattern baldness and coronary heart disease: the Physicians’ Health Study. Arch Intern Med 160(2):165–171

    Article  CAS  PubMed  Google Scholar 

  41. Herrera CR, D’Agostino RB, Gerstman BB, Bosco LA, Belanger AJ (1995) Baldness and coronary heart disease rates in men from the Framingham study. Am J Epidemiol 142(8):828–833

    Article  CAS  PubMed  Google Scholar 

  42. Ford ES, Freedman DS, Byers T (1996) Baldness and ischemic heart disease in a national sample of men. Am J Epidemiol 143(7):651–657

    Article  CAS  PubMed  Google Scholar 

  43. Shahar E, Heiss G, Rosamond WD, Szklo M (2008) Baldness and myocardial infarction in men: the atherosclerosis risk in communities study. Am J Epidemiol 167(6):676–683

    Article  PubMed  Google Scholar 

  44. Trieu N, Eslick GD (2014) Alopecia and its association with coronary heart disease and cardiovascular risk factors: a meta-analysis. Int J Cardiol 176(3):687–695

    Article  PubMed  Google Scholar 

  45. Su LH, Chen LS, Lin SC, Chen HH (2013) Association of androgenetic alopecia with mortality from diabetes mellitus and heart disease. JAMA Dermatol 149(5):601–606

    Article  PubMed  Google Scholar 

  46. Amoretti A, Laydner H, Bergfeld W (2013) Androgenetic alopecia and risk of prostate cancer: a systematic review and meta-analysis. J Am Acad Dermatol 68:937–943

    Article  PubMed  Google Scholar 

  47. Dastgheib L, Shirazi M, Moezzi I, Dehghan S, Sadati MS (2015) Is there a relationship between androgenic alopecia and benign prostatic hyperplasia? Acta Medica Iranica 53(1):30–32

    PubMed  Google Scholar 

  48. Oh BR, Kim SJ, Moon JD, Kim HN, Kwon DD, Won YH, Ryu SB, Park YI (1998) Association of benign prostatic hyperplasia with male pattern baldness. Urology 51(5):744–748

    Article  CAS  PubMed  Google Scholar 

  49. Chen W, Yang CC, Chen GY, Wu MC, Sheu HM, Tzai TS (2004) Patients with a large prostate show a higher prevalence of androgenetic alopecia. Arch Dermatol Res 296(6):245–249

    Article  PubMed  Google Scholar 

  50. Kaplan SA (2005) Patients with a large prostate show a higher prevalence of androgenetic alopecia. J Urol 174(5):1905

    Article  PubMed  Google Scholar 

  51. Kaplan SA (2012) Re: androgenetic alopecia as an early marker of benign prostatic hyperplasia. J Urol 188(5):1846–1847

    Article  PubMed  Google Scholar 

  52. Arias-Santiago S, Arrabal-Polo MA, Buendía-Eisman A, Arrabal-Martín M, Gutiérrez-Salmerón MT, Girón-Prieto MS, Jimenez-Pacheco A, Calonje JE, Naranjo-Sintes R, Zuluaga-Gomez A, Serrano Ortega S (2012) Androgenetic alopecia as an early marker of benign prostatic hyperplasia. J Am Acad Dermatol 66(3):401–408

    Article  PubMed  Google Scholar 

  53. Kucerova R, Bienova M, Kral M, Bouchal J, Trtkova KS, Burdova A, Student V, Kolar Z (2015) Androgenetic alopecia and polymorphism of the androgen receptor gene (SNP rs6152) in patients with benign prostate hyperplasia or prostate cancer. J Eur Acad Dermatol Venereol 29(1):91–96

    Article  CAS  PubMed  Google Scholar 

  54. Russo GI, Castelli T, Urzì D, Privitera S, La Vignera S, Condorelli RA, Calogero AE, Favilla V, Cimino S, Morgia G (2015) Emerging links between non-neurogenic lower urinary tract symptoms secondary to benign prostaticobstruction, metabolic syndrome and its components: a systematic review. Int J Urol 22(11):982–990

    Article  PubMed  Google Scholar 

  55. Kurzrock R, Cohen PR (2007) Polycystic ovary syndrome in men: Stein-Leventhal syndrome revisited. Med Hypotheses 68(3):480–483

    Article  PubMed  Google Scholar 

  56. Dimitriadis GK, Kyrou I, Randeva HS (2016) polycystic ovary syndrome as a proinflammatory state: the role of adipokines. Curr Pharm Des 22(36):5535–5546

    Article  CAS  PubMed  Google Scholar 

  57. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, Boivin J, Petraglia F, Wijeyeratne CN, Norman RJ, Dunaif A, Franks S, Wild RA, Dumesic D, Barnhart K (2012) Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 97(1):28–38

    Article  PubMed  Google Scholar 

  58. Fernandez JD, Tannock LR (2016) Metabolic effects of hormone therapy in transgender patients. Endocr Pract 22(4):383–388

    Article  PubMed  Google Scholar 

  59. Cadagan D, Khan R, Amer S (2016) Thecal cell sensitivity to luteinizing hormone and insulin in polycystic ovarian syndrome. Reprod Biol 16(1):53–60

    Article  PubMed  Google Scholar 

  60. Ahn SW, Gang GT, Kim YD, Ahn RS, Harris RA, Lee CH, Choi HS (2013) Insulin directly regulates steroidogenesis via induction of the orphan nuclear receptor DAX-1 in testicular Leydig cells. J Biol Chem 288(22):15937–15946

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. La Vignera S, Condorelli R, Vicari E, D’Agata R, Calogero AE (2012) Diabetes mellitus and sperm parameters. J Androl 33(2):145–153

    Article  PubMed  Google Scholar 

  62. Fadini GP, Agostini C, Sartore S, Sartore S, Avogaro A (2007) Endothelial progenitor cells in the natural history of atherosclerosis. Atherosclerosis 194:46–54

    Article  PubMed  Google Scholar 

  63. Bahtiyar G, Weiss K, Sacerdote AS (2007) Novel endocrine disrupter effects of classic and atypical antipsychotic agents and divalproex: induction of adrenal hyperandrogenism, reversible with metformin or rosiglitazone. Endocr Pract 13(6):601–608

    Article  PubMed  Google Scholar 

  64. Duskova M, Hill M, Starka L (2010) Changes of metabolic profile in men treated for androgenetic alopecia with 1 mg finasteride. Endocr Regul 44(1):3–8

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Catania, Policlinico “G. Rodolico”, via S. Sofia 78, 95123, Catania, Italy

    R. Cannarella, R. A. Condorelli, L. M. Mongioì, S. La Vignera & A. E. Calogero

Authors
  1. R. Cannarella
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. A. Condorelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. M. Mongioì
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. La Vignera
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. E. Calogero
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. E. Calogero.

Ethics declarations

Funding

This research did not receive any specific grant from any funding agencies in the public, commercial, or not-for-profit sector.

Conflict of interest

Authors declare no actual or potential conflict of interest in relation to this article.

Ethical approval

This article does not contain any studies with human subjects performed by any of the authors.

Informed consent

Informed consent is not applicable.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cannarella, R., Condorelli, R.A., Mongioì, L.M. et al. Does a male polycystic ovarian syndrome equivalent exist?. J Endocrinol Invest 41, 49–57 (2018). https://doi.org/10.1007/s40618-017-0728-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-017-0728-5

Keywords

Search

Navigation