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Xinyu Qi, Chuyu Yun, Baoying Liao, Jie Qiao and Yanli Pang

Introduction Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in women of reproductive age. The prevalence of PCOS is approximately 5–10% ( Norman et al. 2007 ). It is characterized by a

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Sieneke Labruijere, E Leonie A F van Houten, René de Vries, Usha M Musterd-Bagghoe, Ingrid M Garrelds, Piet Kramer, A H Jan Danser, Carlos M Villalón, Jenny A Visser and Antoinette MaassenVanDenBrink

Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and the most common form of hyperandrogenism ( Carmina et al . 2006 ). It has a worldwide prevalence of 5–10% ( Diamanti-Kandarakis et

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C Ortega-González, L Cardoza, B Coutiño, R Hidalgo, G Arteaga-Troncoso and A Parra

Introduction Polycystic ovary syndrome (PCOS) is the most frequent endocrine disorder in women of reproductive age, with an estimated frequency of between 4 and 7% ( Lobo 2003 ), and is characterized by chronic anovulation and

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F González, N S Rote, J Minium and J P Kirwan

Introduction Polycystic ovary syndrome (PCOS) is one of the most common female endocrinopathies, affecting 4–10% of reproductive-age women ( Knochenhauer et al. 1998 , Dunaif 1999 ). The disorder is characterized by hyper

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A. P. Murdoch, P. J. Diggle, M. C. White, P. Kendall-Taylor and W. Dunlop

ABSTRACT

Serum concentrations of LH are increased in polycystic ovary syndrome (PCOS). We have investigated two aspects of LH secretion which have not previously been reported: its reproducibility within individuals and the pattern of superimposed pulses of LH secretion. In nine patients with PCOS the mean concentration of LH was calculated from 24 blood samples taken at 15-min intervals for 6 h on two or three occasions over 1 year. Results showed differences in mean LH between subjects but reproducible concentrations within subjects over that period. It has been shown that LH is secreted in a complicated pattern of superimposed pulses which can be characterized by using the statistical methods of time-series analysis. To evaluate these pulse patterns of LH we studied nine patients with PCOS and compared the results with those of 12 normal women in the early follicular phase of the ovarian cycle. Blood samples were taken at either 5-min intervals for 6 h or 1-min intervals for 1 h. Pulses were detected in both groups at frequencies of about 1 h and 2 to 3 min. There was no significant difference in the pulse frequencies between the patients and controls but the amplitude of both groups of pulses was increased in the PCOS patients.

Journal of Endocrinology (1989) 121, 185–191

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DH Abbott, DA Dumesic and S Franks

Polycystic ovary syndrome (PCOS) is a common but complex endocrine disorder and is a major cause of anovulation and consequent subfertility. It is also associated with a metabolic disturbance, characterized by hyperinsulinaemia and insulin resistance that carries an increased risk of type 2 diabetes in later life. Despite its prevalence little is known about its aetiology, but there is increasing evidence for an important genetic involvement. On the basis of experimental observations in the prenatally androgenized sheep and rhesus monkey, and supported by data from human studies, we propose that the clinical and biochemical features of PCOS can arise as a consequence of genetically determined hypersecretion of androgens by the ovary during, or very likely long before, puberty. The resulting hyperandrogenism results in 'programming' of the hypothalamic-pituitary unit to favour excess LH secretion, and encourages preferential abdominal adiposity that predisposes to insulin resistance. The severity of hyperinsulinaemia and insulin resistance (which has a profound influence on the phenotype of PCOS) is further influenced by both genetic factors (such as polymorphism in the insulin gene regulatory region) and environmental factors, notably obesity. This hypothesis therefore suggests a unifying, 'linear' model to explain the aetiology of the heterogeneous phenotype.

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A. P. SFIKAKIS, D. G. IKKOS and K. N. DIAMANDOPOULOS

SUMMARY

The 24 hr. urinary excretion of oestrone, oestradiol and oestriol was measured during metyrapone administration in six normal women, four patients with primary amenorrhoea, six patients with polycystic ovary syndrome (POS) and three patients with secondary amenorrhoea. In the six normal women the oestrogen excretion on the first and second day of metyrapone administration did not differ from the control values except for a slight, probably significant, decrease in the excretion of oestradiol on the first day. In the patients with primary and secondary amenorrhoea the results were similar to those in the normal women. In the POS group the urinary excretion of oestrogens increased by 11–120% on the first day of metyrapone administration and by 63–140% on the second day. Studies with metyrapone in three patients with POS during dexamethasone suppression and/or ACTH administration suggest that the increased oestrogen excretion after metyrapone depended on the usual feedback mechanism between the adrenal and the hypothalamo-hypophysial system.

Possible reasons for the absence of this increase in the normal subjects are discussed. It is concluded that the abnormal response to metyrapone in patients with the POS was not due to the amenorrhoea per se and the possibility that this response was related to the underlying disorder of POS is considered.

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A. F. Macleod, M. J. Wheeler, P. Gordon, C. Lowy, P. H. Sönksen and J. V. Conaglen

ABSTRACT

In order to investigate the effect of long-term suppression of the gonadotrophin axis in polycystic ovary syndrome, eight affected subjects were given s.c. infusions of gonadotrophin-releasing hormone (GnRH) agonist buserelin for 12 weeks. Hormone measurement and ultrasound studies were carried out weekly, from 6 weeks before to 12 weeks after administration of buserelin. An overnight dexamethasone-suppression test was carried out before and after treatment.

Maximal suppression of LH to below the lower limit of that in normal subjects occurred after 6 weeks of treatment with buserelin. Plasma testosterone and androstenedione fell to normal levels during the infusion but reached pretreatment levels during the follow-up period. There was no effect of buserelin on plasma dehydroepiandrosterone sulphate or sex hormone-binding globulin. Ovarian size decreased significantly during the infusion with the disappearance of cysts in six subjects. After cessation of buserelin therapy, there was rapid and spontaneous ovulation which occurred within 3 weeks in all subjects. The results suggest that treatment with this GnRH agonist facilitates ovulation in this condition.

Journal of Endocrinology (1990) 125, 317–325

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Takeshi Iwasa, Toshiya Matsuzaki, Kiyohito Yano, Yiliyasi Mayila, Rie Yanagihara, Yuri Yamamoto, Akira Kuwahara and Minoru Irahara

Introduction Polycystic ovary syndrome (PCOS) is among the most common endocrine disorders in women of reproductive age, with an estimated prevalence of 5–16% depending on the ethnic and diagnostic criteria ( Lauritsen et al. 2014

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Giselle Adriana Abruzzese, Maria Florencia Heber, Silvana Rocio Ferreira, Leandro Martin Velez, Roxana Reynoso, Omar Pedro Pignataro and Alicia Beatriz Motta

Introduction Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders that affects women in their reproductive age ( Franks 2003 ) and its clinical manifestations often emerge during puberty ( Rosenfield