PCOS Forum

Research in Polycystic Ovary Syndrome Today and Tomorrow

Renato Pasquali; Elisabet Stener-Victorin; Bulent O. Yildiz; Antoni J. Duleba; Kathleen Hoeger; Helen Mason; Roy Homburg; Theresa Hickey; Steve Franks; Juha S. Tapanainen; Adam Balen; David H. Abbott; Evanthia Diamanti-Kandarakis; Richard S. Legro


Clin Endocrinol. 2011;74(4):424-433. 

In This Article

Significance of Adrenal Androgen Production

It has been estimated that 25% of androstenedione and testosterone production is of ovarian origin, 25% is of adrenal origin and 50% is produced in peripheral tissues, while the adrenal cortex accounts almost uniquely for the synthesis of DHEA and dehydroepiandrosterone sulphate (DHEAS) as well as that of androstenediol and 11β-hydroxy androstenedione.[10] In women, androgens serve as precursors of oestrogen biosynthesis, which starts to decrease 3–4 years before menopause.[11] At the same time, basal serum levels of ovarian androgens decrease only slightly and remain relatively stable until menopause, while the decrease in adrenal androgens can already be observed after the age of 30 years.[12] Compared with healthy subjects, women with previous PCOS have an increased adrenal capacity to secrete androgens that remains until after menopause. These results confirm the adrenals contribute significantly to hyperandrogenism in PCOS, and similarly to ovarian androgen secretion capacity, women with PCOS exhibit enhanced adrenal androgen production until their late reproductive years.[13] The pathophysiological mechanisms responsible for increased androgen production by the adrenals in women with PCOS remains, however, poorly elucidated and should require further investigation. Difficulty in obtaining viable and appropriate adrenal tissue has limited in vitro study of human tissue, but long-term culture is possible, and the derivation of stem cell adrenal cortex tissue could significantly enhance studies of this important gland.


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