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Polycystic Ovary Syndrome pp 281–294Cite as

Pathogenesis of Hyperandrogenism in Polycystic Ovary Syndrome

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Part of the book series: Contemporary Endocrinology ((COE))

Summary

Androgen excess (AE) is an important, even essential feature of the polycystic ovary syndrome (PCOS), and arises primarily from ovarian AE, although a hyperactivity of adrenocortical function and adrenal androgen (AA) excess are present in a significant number of patients. Increased ovarian theca cell function, and possibly number, and augmented expression of steroidogenic enzymes have been demonstrated in PCOS. Increased LH stimulation of thecal androgen biosynthesis also appears to be an important, early event in PCOS. Abnormalities in other intrinsic ovarian factors such as inhibin, activin, and follistatin appear to modulate ovarian LH response. Granulosa cell dysfunction may also contribute, with PCOS women demonstrating arrested granulose development and increased 5α-reductase expression. Adrenal AE, possibly arising from generalized adrenocortical hyper-responsivity, is a relatively common feature of PCOS. Finally, the metabolic consequences of obesity and insulin resistance appear to potentiate excess androgen production in adolescent and adult PCOS patients. In short, the hyperandrogenism of PCOS appears to be aptly multifactorial, consistent with the complex nature of the syndrome itself.

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Authors
  1. Wendy Y. Chang MD
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  2. Ricardo Azziz MD MPH
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Editor information

Editors and Affiliations

  1. Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University, Chicago, IL

    Andrea Dunaif MD

  2. Department of Reproductive Medicine, University of California, San Diego School of Medicine, La Jolla, CA

    R. Jeffrey Chang MD

  3. Institute of Reproductive and Developmental Biology, Imperial College London, London, UK

    Stephen Franks MD, FMEDSCI

  4. Department of Ob/Gyn, Penn State College of Medicine, Hershey, PA

    Richard S. Legro MD

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Chang, W.Y., Azziz, R. (2008). Pathogenesis of Hyperandrogenism in Polycystic Ovary Syndrome. In: Dunaif, A., Chang, R.J., Franks, S., Legro, R.S. (eds) Polycystic Ovary Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-108-6_17

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