title: Endometrial Expression of Estrogen Receptors and the Androgen Receptor in Women With Polycystic Ovary Syndrome: A Lifestyle Intervention Study.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is a common cause of anovulation. It may also negatively affect the endometrium, which could lead to implantation failure and proliferative aberrations.
  
  
  OBJECTIVE
  Our objective was to study sex hormone receptors in the endometrium of women with PCOS.
  
  
  METHODS
  This is a cross-sectional study and lifestyle intervention.
  
  
  METHODS
  Clinical and laboratory research unit was undertaken at a university hospital.
  
  
  METHODS
  Twenty overweight/obese women fulfilling all three PCOS criteria (anovulation, hyperandrogenism, and polycystic ovaries), 10 body mass index-matched regularly menstruating controls, 11 normal-weight women with PCOS, and 11 normal-weight controls.
  
  
  METHODS
  Intervention for this study included dietary management and physical exercise.
  
  
  METHODS
  mRNA levels and immunostaining of estrogen receptor α (ERα) and β (ERβ), nongenomic estrogen receptor α36 (ERα36), and G-protein-coupled estrogen receptor-1 (GPER), and the androgen receptor (AR) on cycle days 6-8 and cycle days 21-23.
  
  
  RESULTS
  Before intervention, mRNA levels of ERα, ERα36, and the ERα/ERβ mRNA ratio were lower in proliferative endometrium of overweight/obese PCOS women compared with controls (P < .05). After intervention, ERα protein and the ERα/ERβ protein ratio in proliferative endometrium increased and were higher in PCOS women with improved menstrual function than in those without improvement (P < .05). In the subgroup of PCOS women with restored ovulation, only higher protein levels of GPER were found in secretory endometrium (P < .01). However, PCOS women who remained anovulatory had higher protein levels of ERα, GPER, and AR on cycle days 21-23 than controls (P < .05).
  
  
  CONCLUSIONS
  Lifestyle intervention alters, but does not fully restore, ER and AR expression in proliferative and secretory endometrium of obese women with PCOS.
authors.affiliation: Division of Obstetrics and Gynecology (M.H., Å.N, A.L.H.) and Pediatric Endocrinology Unit (M.H. L.S.), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; National O. Bohomolets Medical University (M.H.), Kyiv, Ukraine; Department of Clinical Nutrition and Dietetics (Å.N.), Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mariana
authors.initials: M
authors.lastname: Hulchiy
authors.affiliation: Division of Obstetrics and Gynecology (M.H., Å.N, A.L.H.) and Pediatric Endocrinology Unit (M.H. L.S.), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; National O. Bohomolets Medical University (M.H.), Kyiv, Ukraine; Department of Clinical Nutrition and Dietetics (Å.N.), Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Nybacka
authors.affiliation: Division of Obstetrics and Gynecology (M.H., Å.N, A.L.H.) and Pediatric Endocrinology Unit (M.H. L.S.), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; National O. Bohomolets Medical University (M.H.), Kyiv, Ukraine; Department of Clinical Nutrition and Dietetics (Å.N.), Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Sahlin
authors.affiliation: Division of Obstetrics and Gynecology (M.H., Å.N, A.L.H.) and Pediatric Endocrinology Unit (M.H. L.S.), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; National O. Bohomolets Medical University (M.H.), Kyiv, Ukraine; Department of Clinical Nutrition and Dietetics (Å.N.), Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Angelica Lindén
authors.initials: AL
authors.lastname: Hirschberg
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004717:Endometrium / Q000378:metabolism*; D047628:Estrogen Receptor alpha / Q000096:biosynthesis; D047629:Estrogen Receptor beta / Q000096:biosynthesis; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008019:Life Style; D008597:Menstrual Cycle / Q000378:metabolism; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000178:diet therapy / Q000378:metabolism* / Q000628:therapy*; D011944:Receptors, Androgen / Q000096:biosynthesis*; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D055815:Young Adult
chemical_list: D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta; D011944:Receptors, Androgen; D011960:Receptors, Estrogen