Abstract
Human reproduction has been demonstrated to be complex and more fragile than expected since a very complicated network is at the basis of its control. Such network is mainly based on specific endocrine and neuroendocrine pathways that control or modulate the hypothalamic–pituitary–ovarian axis.
Hyperandrogenic states are quite frequent and are considered the most common causes of chronic anovulation. It is important to note that chronic anovulation occur as the result of abnormal function and/or disease of other endocrine glands that impair the reproductive axis so that to induce a hyperandrogenic state and chronic anovulation.
This physiopathological situation is characterized by increased androgen plasma levels due to less frequently to adrenal disturbances but more frequently in relation with PCOS and polycystic morphology of the ovaries. Polycystic aspect of the ovaries occurs when ovaries are not correctly stimulated and functionally controlled by the hypothalamic–pituitary axis.
Several endocrine disturbances can negatively affect the ovary and induce PCOS, such as obesity, diabetes, insulin resistance or hyperinsulinism, hypo or hyperthyroidism, hyper PRL, and also functional hypothalamic amenorrhea. All these clinical conditions are able to affect the neuroendocrine control of the reproductive axis both directly and indirectly, through the abnormal function/modulation of the neuroendocrine systems induced by the impairment of the endocrine disease.
The endocrine evaluation is fundamental to define how to start the therapeutical strategy so that to solve chronic anovulation and permit a normal ovarian function.
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Santagni, S., Rattighieri, E., Chierchia, E., Despini, G., Genazzani, A.D. (2014). Pathophysiology and Clinical Assessment of Hyperandrogenic States. In: Genazzani, A.R., Brincat, M. (eds) Frontiers in Gynecological Endocrinology. ISGE Series. Springer, Cham. https://doi.org/10.1007/978-3-319-03494-2_8
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DOI: https://doi.org/10.1007/978-3-319-03494-2_8
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