M. Ciampelli et al., Hypothalamic-pituitary-adrenal axis sensitivity to opioids in women with polycystic ovary syndrome, FERT STERIL, 73(4), 2000, pp. 712-717
Objective: To evaluate the influence of the opioid system on the hypothalam
ic-pituitary-adrenal axis in women with polycystic ovary syndrome (PCOS).
Design: Controlled clinical study.
Setting: Academic research environment.
Patient(s): Eight lean and 12 obese women with PCOS, and seven lean and 5 o
bese control subjects.
Intervention(s): Each patient received an i.v. bolus of naloxone at a dose
of 125 mu g per kilogram of body weight; 48 hours later, each patient recei
ved 16 mg of loperamide p.o.
Main Outcome Measure(s): Samples were collected for 2 hours for the naloxon
e test and for 3 hours for the loperamide test. Levels of adrenocorticotrop
ic hormone (ACTII) and cortisol were measured in all plasma samples.
Result(s): The obese women with PCOS had a greater ACTII and cortisol respo
nse to opiate blockade than either the lean women with PCOS or the control
subjects, but there was no difference between the lean or obese control sub
jects and the lean women with PCOS. There was no difference in the responsi
veness of the hypothalamic-pituitary-adrenal axis to loperamide between the
PCOS and control groups.
Conclusion(s): The data indicate that the sensitivity of the hypothalamic-p
ituitary-adrenal axis to opioids cannot be altered in women with PCOS. Howe
ver, abnormalities of the hypothalamic-pituitary-adrenal axis in women with
PCOS could be central in origin, as suggested by the effects of naloxone a
dministration, and probably are related to the anthropometric characteristi
cs of these hyperandrogenic patients.