Objective To reevaluate the clinical significance of elevations of adrenal androgens in polycystic ovary syndrome (PCOS).
Methods Thirty women with PCOS and ten ovulatory controls were evaluated. Serum dehydroepiandrosterone (DHEA) sulfate and 11β-hydroxyandrostenedione were measured before and after 3 and 6 months of GnRH agonist (GnRH-A) therapy. All controls and 15 women with PCOS received intravenous ACTH before and after GnRH-A therapy
Results Twenty-one (70%) of the women with PCOS had elevations of DHEA sulfate, and 16 (53%) had elevations in 11β-hydroxyandrostenedione. Only two women with PCOS had normal values of both adrenal androgens. After GnRH-A therapy, only 11 subjects (37%) had elevated values of DHEA sulfate. Four of 16 women had reductions in 11β-hydroxyandrostenedione. Only those with elevated baseline DHEA sulfate levels had reductions after GnRH-A therapy. The reduction of DHEA sulfate with GnRH-A correlated with the reduction in androstenedione. Of the subjects who had reductions in DHEA sulfate with GnRH-A therapy, there was a blunted response of DHEA to ACTH after treatment.
Conclusion Our findings suggest that the ovary may influence the prevalence and magnitude of adrenal androgen excess in PCOS.
Address reprint requests to: Rogerio A. Lobo, MD, Department of Obstetrics and Gynecology, Women's and Children's Hospital, Room 1M2, 1240 North Mission Road, Los Angeles, CA 90033.
© 1995 The American College of Obstetricians and Gynecologists