REASSESSMENT OF ADRENAL ANDROGEN SECRETION IN WOMEN WITH POLYCYSTIC-OVARY-SYNDROME

Objective: To reevaluate the clinical significance of elevations of ad renal androgens in polycystic ovary syndrome (PCOS). Methods: Thirty w omen with PCOS and ten ovulatory controls were evaluated. Serum dehydr oepiandrosterone (DHEA) sulfate and 11 beta-hydroxyandrostenedione wer e measured before and after 3 and 6 months of GnRH agonist (GnRH-A) th erapy. All controls and 15 women with PCOS received intravenous ACTH b efore and after GnRH-A therapy. Results: Twenty-one (70%) of the women with PCOS had elevations of DHEA sulfate, and 16 (53%) had elevations in 11 beta-hydroxyandrostenedione. Only two women-with PCOS had norma l values of both adrenal androgens. After GnRH-A therapy, only 11 subj ects (37%) had elevated values of DHEA sulfate. Four of 16 women had r eductions in 11 beta-hydroxyandrostenedione. Only those with elevated baseline DHEA sulfate levels had reductions after GnRH-A therapy. The reduction of DHEA sulfate with GnRH-A correlated with the reduction in androstenedione. Of the subjects who had reductions in DHEA sulfate w ith GnRH-A therapy, there was a blunted response of DHEA to ACTH after treatment. Conclusion: Our findings suggest that the ovary may influe nce the prevalence and magnitude of adrenal androgen excess in PCOS.