What is the role of polycystic ovary syndrome (PCOS) in the etiology of androgen excess?

Updated: Mar 14, 2018
  • Author: Mohamed Yahya Abdel-Rahman, MD, MSc; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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A specific underlying cause can be identified in most patients with androgen excess. [38]

Polycystic ovary syndrome (PCOS)

Approximately 80-90% of women with excess androgens have PCOS. [39, 38] PCOS is the most common endocrinological disorder affecting women in their reproductive years. [40] The prevalence in the United States has been estimated at 5-7% [41] and appears to be rising. Approximately 70% of women with PCOS are found to have mildly elevated free testosterone, and 20-30% have mildly elevated dehydroepiandrosterone sulphate (DHEAS). [42, 43]

Evidence suggests that hyperandrogenemia may be associated with chronic inflammation in PCOS by affecting adipocyte attributes and morphology. [44]

A literature review by Escobar-Morreale and Roldán-Martín suggested that in women with type 1 diabetes mellitus, the prevalences of PCOS and associated traits, including hyperandrogenemia, are greater than in the general population without diabetes. The investigators found that out of 475 adolescent or adult women with type 1 diabetes, the prevalences of PCOS and hyperandrogenemia were 24% and 25%, respectively, while those for hirsutism, menstrual dysfunction, and polycystic ovarian morphology were 25%, 24%, and 33%, respectively. [45]

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