CORTICOTROPIN-RELEASING HORMONE INDUCES AN EXAGGERATED RESPONSE OF ADRENOCORTICOTROPIC HORMONE AND CORTISOL IN POLYCYSTIC-OVARY-SYNDROME

Objective: To evaluate pituitary-adrenal responsive to corticotropin-r eleasing hormone (CRH) stimulus in polycystic ovary syndrome (PCOS). D esign: Controlled clinical study. Patients: Twelve women aged 17 to 32 years, who had been diagnosed as having PCOS, were studied. Fifteen a ppropriately age- and weight-matched ovulatory patients served as the control. Intervention: In the early follicular phase or after progesti n-induced menses, human CRH was injected at 8:00 A.M. and blood sample s were collected at 0, 15, 30, 60, and 90 minutes after stimulus. Plas ma levels of ACTH and cortisol were measured. Results: Baseline levels of ACTH and cortisol were similar in PCOS and control patients. Both ACTH and cortisol response to CRH were markedly greater in the PCOS po pulation as compared with controls. Moreover, ACTH- and cortisol-stimu lated secretion was prolonged for the whole period of the study in hyp erandrogenic patients with respect to controls, where baseline levels were attained 60 minutes after the stimulus. Conclusions: Our results are consistent with the hypothesis that women with PCOS may demonstrat e hyperfunction of the hypothalamic-pituitary-adrenal axis, which may be involved in the physiopathologic events leading to the complexity o f the syndrome.