Adrenal involvement in polycystic ovary syndrome

Seminars in Reproductive Endocrinology
F Gonzalez

Abstract

The etiology of hyperandrogenic chronic anovulation is heterogeneous and relatively unknown in the majority of cases. Affected individuals in this latter segment are considered to have polycystic ovary syndrome (PCOS) of which 50 to 60% exhibit androgen excess of adrenal origin. An understanding of normal adrenal function provides insight into the factors that contribute to adrenal androgen excess in PCOS. Since pituitary ACTH secretion promotes developmental growth and overall steroidogenic efficiency within the adrenal cortex, it is probable that these actions of ACTH along with the adrenal's unique centripetal circulation play a major role in the induction of adrenarche. This latter phenomenon is characterized by alterations in adrenocortical morphology and steroidogenic enzyme activities culminating in increases in adrenal androgens to normal circulating adult levels. Thus, it is not surprising that adrenal dynamic testing has revealed increased 17,20 lyase activity or adrenal androgen hyper-responsiveness to ACTH as the two abnormalities leading to adrenal androgen excess in PCOS. Whereas 17,20 lyase hyperactivity diagnosed by defined criteria in response to pharmacological ACTH may be an intrinsic genetic defect, increase...Continue Reading

Citations

May 10, 2003·Journal of Affective Disorders·Natalie L RasgonStanley G Korenman
Jan 28, 1999·Molecular and Cellular Endocrinology·K N Qin, R L Rosenfield
Jul 31, 1998·BMJ : British Medical Journal·Z E HopkinsonI A Greer
Nov 20, 2012·Fertility and Sterility·Frank González
Jun 20, 2006·Steroids·Suhail A R DoiKamal A S Al-Shoumer
Jul 2, 2009·The Journal of Clinical Endocrinology and Metabolism·Dimitra A VassiliadiPaul M Stewart
Dec 18, 1998·Journal of Endocrinological Investigation·E Carmina, R A Lobo
Jul 19, 2013·The Journal of Clinical Endocrinology and Metabolism·Yvonne V LouwersJoop S E Laven
Dec 1, 2001·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·M ZarkovićM Drezgić

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