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Hyperandrogenism in women with polycystic ovary syndrome persists after menopause.
J Clin Endocrinol Metab. 2011 Mar; 96(3):623-31.JC

Abstract

CONTEXT

Ovarian and adrenal hyperandrogenism characterize premenopausal women with polycystic ovary syndrome (PCOS). Androgens decline with age in healthy and PCOS women.

OBJECTIVE

The objective of the study was to investigate hyperandrogenism in PCOS after menopause.

DESIGN

This was a case-control, cross-sectional study.

SETTING

The study was conducted at a university hospital endocrinology unit.

PATIENTS

Twenty postmenopausal women with PCOS and 20 age- and body mass index-matched controls participated in the study.

INTERVENTIONS

Serum cortisol, 17-hydroxyprogesterone (17-OHP), Δ(4)-androstenedione (Δ(4)A), dehydroepiandrosterone sulfate (DHEAS), total testosterone (T), and free androgen index (FAI) levels were measured at baseline, after ACTH stimulation, and after 3-d dexamethasone suppression. The ACTH and cortisol levels were measured during the CRH test.

MAIN OUTCOME MEASURES

Androgen profile at baseline, after ACTH stimulation, and 3-d dexamethasone suppression tests were the main outcome measures.

RESULTS

Postmenopausal PCOS women had higher 17-OHP, Δ(4)A, DHEAS, total T, FAI (P < 0.05) and lower SHBG (P < 0.05) baseline levels than control women. ACTH and cortisol responses during the CRH test were similar in the two groups. After ACTH stimulation, Δ(4)A, DHEAS, and total T levels were equally increased in both groups. After dexamethasone suppression, LH levels did not change in either group; 17-OHP-, Δ(4)A-, and FAI-suppressed levels remained higher in PCOS than in control women (P < 0.05), whereas total T and DHEAS levels were suppressed to similar values in both groups.

CONCLUSIONS

In postmenopausal PCOS women, ACTH and cortisol responses to CRH are normal. Androgen levels at baseline are higher in PCOS than control women and remain increased after ACTH stimulation. The dexamethasone suppression results in postmenopausal PCOS women suggest that DHEAS and total T are partially of adrenal origin. Although the ovarian contribution was not fully assessed, increased Δ(4)A production suggests that the ovary also contributes to hyperandrogenism in postmenopausal PCOS women. In conclusion, postmenopausal PCOS women are exposed to higher adrenal and ovarian androgen levels than non-PCOS women.

Authors+Show Affiliations

Second Department of Obstetrics and Gynecology, Athens University Medical School, Aretaieion Hospital, Athens 11528, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21177795

Citation

Markopoulos, Marios C., et al. "Hyperandrogenism in Women With Polycystic Ovary Syndrome Persists After Menopause." The Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 3, 2011, pp. 623-31.
Markopoulos MC, Rizos D, Valsamakis G, et al. Hyperandrogenism in women with polycystic ovary syndrome persists after menopause. J Clin Endocrinol Metab. 2011;96(3):623-31.
Markopoulos, M. C., Rizos, D., Valsamakis, G., Deligeoroglou, E., Grigoriou, O., Chrousos, G. P., Creatsas, G., & Mastorakos, G. (2011). Hyperandrogenism in women with polycystic ovary syndrome persists after menopause. The Journal of Clinical Endocrinology and Metabolism, 96(3), 623-31. https://doi.org/10.1210/jc.2010-0130
Markopoulos MC, et al. Hyperandrogenism in Women With Polycystic Ovary Syndrome Persists After Menopause. J Clin Endocrinol Metab. 2011;96(3):623-31. PubMed PMID: 21177795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperandrogenism in women with polycystic ovary syndrome persists after menopause. AU - Markopoulos,Marios C, AU - Rizos,Demetrios, AU - Valsamakis,George, AU - Deligeoroglou,Efthimios, AU - Grigoriou,Odysseas, AU - Chrousos,George P, AU - Creatsas,George, AU - Mastorakos,George, Y1 - 2010/12/22/ PY - 2010/12/24/entrez PY - 2010/12/24/pubmed PY - 2011/5/24/medline SP - 623 EP - 31 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 96 IS - 3 N2 - CONTEXT: Ovarian and adrenal hyperandrogenism characterize premenopausal women with polycystic ovary syndrome (PCOS). Androgens decline with age in healthy and PCOS women. OBJECTIVE: The objective of the study was to investigate hyperandrogenism in PCOS after menopause. DESIGN: This was a case-control, cross-sectional study. SETTING: The study was conducted at a university hospital endocrinology unit. PATIENTS: Twenty postmenopausal women with PCOS and 20 age- and body mass index-matched controls participated in the study. INTERVENTIONS: Serum cortisol, 17-hydroxyprogesterone (17-OHP), Δ(4)-androstenedione (Δ(4)A), dehydroepiandrosterone sulfate (DHEAS), total testosterone (T), and free androgen index (FAI) levels were measured at baseline, after ACTH stimulation, and after 3-d dexamethasone suppression. The ACTH and cortisol levels were measured during the CRH test. MAIN OUTCOME MEASURES: Androgen profile at baseline, after ACTH stimulation, and 3-d dexamethasone suppression tests were the main outcome measures. RESULTS: Postmenopausal PCOS women had higher 17-OHP, Δ(4)A, DHEAS, total T, FAI (P < 0.05) and lower SHBG (P < 0.05) baseline levels than control women. ACTH and cortisol responses during the CRH test were similar in the two groups. After ACTH stimulation, Δ(4)A, DHEAS, and total T levels were equally increased in both groups. After dexamethasone suppression, LH levels did not change in either group; 17-OHP-, Δ(4)A-, and FAI-suppressed levels remained higher in PCOS than in control women (P < 0.05), whereas total T and DHEAS levels were suppressed to similar values in both groups. CONCLUSIONS: In postmenopausal PCOS women, ACTH and cortisol responses to CRH are normal. Androgen levels at baseline are higher in PCOS than control women and remain increased after ACTH stimulation. The dexamethasone suppression results in postmenopausal PCOS women suggest that DHEAS and total T are partially of adrenal origin. Although the ovarian contribution was not fully assessed, increased Δ(4)A production suggests that the ovary also contributes to hyperandrogenism in postmenopausal PCOS women. In conclusion, postmenopausal PCOS women are exposed to higher adrenal and ovarian androgen levels than non-PCOS women. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/21177795/Hyperandrogenism_in_women_with_polycystic_ovary_syndrome_persists_after_menopause_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2010-0130 DB - PRIME DP - Unbound Medicine ER -