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The adrenal and polycystic ovary syndrome

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Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders characterized by androgen excess, oligo-ovulation and polycystic ovaries. Although ovaries are the main source of increased androgens in the syndrome, between 20 and 30% of patients with PCOS have adrenal androgen (AA) excess, detectable primarily by elevated dehydroepiandrosterone sulfate (DHEAS) levels. Patients with PCOS demonstrate a generalized hypersecretion of adrenocortical products, basally and in response to ACTH stimulation. The mechanisms of these abnormalities are unclear although AA excess in PCOS is likely a complex trait, modulated by both intrinsic and acquired factors. To date, no specific genetic defects have been identified. The production of AAs in response to ACTH appears to be closely related to altered factors regulating glucose-mediated glucose disposal, increased peripheral metabolism of cortisol, and to a less extent to the effects of extra-adrenal androgens, insulin resistance, hyperinsulinemia or obesity. Finally, DHEAS levels and the response of AAs to ACTH are relatively constant over time and are closely correlated between PCOS patients and their siblings suggesting that this abnormality is an inherited trait in PCOS.

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Authors and Affiliations

  1. Department of Internal Medicine, Endocrinology and Metabolism Unit, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey

    Bulent O. Yildiz

  2. Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center and The David Geffen School of Medicine at UCLA, 8635 West Third Street, Suite 160 W, Los Angeles, CA, 90048, USA

    Ricardo Azziz

Authors
  1. Bulent O. Yildiz
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  2. Ricardo Azziz
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Correspondence to Ricardo Azziz.

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Yildiz, B.O., Azziz, R. The adrenal and polycystic ovary syndrome. Rev Endocr Metab Disord 8, 331–342 (2007). https://doi.org/10.1007/s11154-007-9054-0

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  • DOI: https://doi.org/10.1007/s11154-007-9054-0

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