title: Hyperandrogenism in women with polycystic ovary syndrome persists after menopause.
abstract: BACKGROUND
  Ovarian and adrenal hyperandrogenism characterize premenopausal women with polycystic ovary syndrome (PCOS). Androgens decline with age in healthy and PCOS women.
  
  
  OBJECTIVE
  The objective of the study was to investigate hyperandrogenism in PCOS after menopause.
  
  
  METHODS
  This was a case-control, cross-sectional study.
  
  
  METHODS
  The study was conducted at a university hospital endocrinology unit.
  
  
  METHODS
  Twenty postmenopausal women with PCOS and 20 age- and body mass index-matched controls participated in the study.
  
  
  METHODS
  Serum cortisol, 17-hydroxyprogesterone (17-OHP), Δ(4)-androstenedione (Δ(4)A), dehydroepiandrosterone sulfate (DHEAS), total testosterone (T), and free androgen index (FAI) levels were measured at baseline, after ACTH stimulation, and after 3-d dexamethasone suppression. The ACTH and cortisol levels were measured during the CRH test.
  
  
  METHODS
  Androgen profile at baseline, after ACTH stimulation, and 3-d dexamethasone suppression tests were the main outcome measures.
  
  
  RESULTS
  Postmenopausal PCOS women had higher 17-OHP, Δ(4)A, DHEAS, total T, FAI (P < 0.05) and lower SHBG (P < 0.05) baseline levels than control women. ACTH and cortisol responses during the CRH test were similar in the two groups. After ACTH stimulation, Δ(4)A, DHEAS, and total T levels were equally increased in both groups. After dexamethasone suppression, LH levels did not change in either group; 17-OHP-, Δ(4)A-, and FAI-suppressed levels remained higher in PCOS than in control women (P < 0.05), whereas total T and DHEAS levels were suppressed to similar values in both groups.
  
  
  CONCLUSIONS
  In postmenopausal PCOS women, ACTH and cortisol responses to CRH are normal. Androgen levels at baseline are higher in PCOS than control women and remain increased after ACTH stimulation. The dexamethasone suppression results in postmenopausal PCOS women suggest that DHEAS and total T are partially of adrenal origin. Although the ovarian contribution was not fully assessed, increased Δ(4)A production suggests that the ovary also contributes to hyperandrogenism in postmenopausal PCOS women. In conclusion, postmenopausal PCOS women are exposed to higher adrenal and ovarian androgen levels than non-PCOS women.
authors.affiliation: Second Department of Obstetrics and Gynecology, Athens University Medical School, Aretaieion Hospital, Athens 11528, Greece.
authors.forename: Marios C
authors.initials: MC
authors.lastname: Markopoulos
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.forename: George
authors.initials: G
authors.lastname: Valsamakis
authors.forename: Efthimios
authors.initials: E
authors.lastname: Deligeoroglou
authors.forename: Odysseas
authors.initials: O
authors.lastname: Grigoriou
authors.forename: George P
authors.initials: GP
authors.lastname: Chrousos
authors.forename: George
authors.initials: G
authors.lastname: Creatsas
authors.forename: George
authors.initials: G
authors.lastname: Mastorakos
mesh_terms: D000311:Adrenal Glands / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000728:Androgens / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D003430:Cross-Sectional Studies; D003907:Dexamethasone; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000502:physiology; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D010053:Ovary / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D017698:Postmenopause / Q000502:physiology*; D013268:Stimulation, Chemical
chemical_list: D000728:Androgens; D012739:Gonadal Steroid Hormones; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone