Cortisol and the Polycystic Ovary Syndrome

Authors and Disclosures

Renato Pasquali* and Alessandra Gambineri

Division of Endocrinology, Department of Clinical Medicine, University Alma Mater Studiorum, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy.

Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.

*Author for correspondence
Tel.: +39 51 636 4147 Fax: +39 51 636 3080 renato.pasquali@unibo.it

Sidebar

Key Issues

• A subset of women with polycystic ovary syndrome (PCOS) may present adrenal hyperandrogenesis, although adrenal cortisol production rate appears to be normal.

• Obesity is often associated with PCOS, and its presence may be responsible for alterations of the hypothalamic–pituitary–adrenal axis.

• There are sufficient arguments to suggest that insulin excess may be a factor responsible for alteration of adrenal steroidogenesis leading to increased dehydroepiandrosterone sulfate blood levels.

• It is possible that alterations in the peripheral cortisol metabolism may indirectly favor an increase of adrenal androgen production in a subset of women with PCOS, although the precise mechanisms have not yet been identified.

• PCOS is associated with a list of psychopathological disturbances and disordered eating patterns that may imply a hyperactivation of the hypothalamic–pituitary–adrenal axis in response to chronic stress.