The postmenopausal ovary is not a major androgen-producing gland

It is currently believed that the postmenopausal ovary remains a gonadotrop in-driven, androgen-producing gland. However, the adrenal contribution to c irculating androgen levels may explain some conflicting results previously reported. In addition, the steroidogenic potential and gonadotropin respons iveness of the postmenopausal ovary have not been recently reassessed. Plas ma T, bioavailable T, free T, androstenedione (Adione), and dehydroepiandro sterone sulfate levels were measured in postmenopausal or ovariectomized wo men with complete adrenal insufficiency, compared with women with intact ad renals. A stimulation human chorionic gonadotropin test (on d 0, 3, and 6) was performed in postmenopausal women with adrenal insufficiency. Dexametha sone was administered for 4 d in postmenopausal women with intact adrenals. Intraovarian T and androstenedione were also measured in homogenates of ov arian tissue from postmenopausal women. Immunocytochemistry was performed o n postmenopausal ovaries and premenopausal controls to detect the presence of steroidogenic enzymes (P-450 aromatase, P-450 SCC, 3 beta HSD, and P-450 C17) and gonadotropin receptors. Plasma androgen levels were below or clos e to the limit of the assay in all women with adrenal insufficiency. They w ere similar in postmenopausal and oophorectomized women with normal adrenal s. No hormonal changes were observed after human chorionic gonadotropin inj ections in women with adrenal insufficiency. In contrast, a dramatic decrea se of all steroids was observed after dexamethasone administration in postm enopausal women with intact adrenals. Intraovarian T and androstenedione le vels were negligible in postmenopausal ovarian tissue. P-450 aromatase was absent from the 17 ovaries studied, and the enzymes for androgen biosynthes is were either absent (n = 13) or present in very low amounts (n = 4). In a ll the postmenopausal ovaries, FSH and LH receptors were completely absent. In the absence of adrenal steroids, postmenopausal women have no circulati ng androgens. This result is consistent with the immunocytochemical studies showing the almost constantly absent steroidogenic enzymes and LH receptor s in the postmenopausal ovary. Thus, the climacteric ovary is not a critica l source of androgens. The arrest of androgen secretion after menopause may impact significantly on women's health.