Pituitary-Ovarian Relationships in Polycystic Ovary Syndrome

Abstract

The spontaneous pattern of pituitary gonadotropins and ovarian steroids and their response to dynamic tests were measured in 12 women with polycystic ovarian syndrome (PCO) and the results compared to those from 6 normal women during the early follicllar phase of the cycle (controls). As judged by serial measurements of urinary total estrogen and pregnanediol over a 12-week period, in PCO patients 75% of cycles were anovulatory (anovulatory PCO) as compared to 100% ovulatory in controls. The basal concentrations of LH, androstenedione and estrone were significantly higher and the concentration os FSH significantly lower in anovulatory PCO than in the controls (P less than .05). In PCO patients the concentration of LH was lower following an ovulatory cycle than that following a period of anovulation. Negative and positive feedback responses to an estrogen provocation test (200 microgram ethinyl estradiol per day for 3 days) were normal in anovulatory PCO although the LH peak occurred 24 h earlier than in the controls. The amplitude of the pulses of LH was significantly greater in anovulatory PCO than in the controls and was suppressed in both groups after ethinyl estradiol. The peak release of LH in response to 56 microgram LRF in ovulatory PCO was similar in controls but LH responses in anovulatory PCO were significantly greater. It is suggested that the abnormalities in gonadotropin secretion in PCO are secondary to excessive and prolonged extraglandular production of estrogen from androstenedione.

Augmented frequency and mass of LH discharged per burst are accompanied by marked disorderliness of LH secretion in adolescents with polycystic ovary syndrome

“…time (usually 6-12 h) confirmed a marked increase in mean serum LH concentration related to augmented pulse amplitude in PCOS women compared with the early or mid-follicular phase of the menstrual cycle in normal women (3,(5)(6). Later studies in which more intensive blood sampling was implemented and the duration of sampling was extended to 24 h demonstrated an increase in LH pulse frequency as well as pulse amplitude in many patients with PCOS (7)(8)(9).…”

Accelerated Episodic Luteinizing Hormone Release Accompanies Blunted Progesterone Regulation in PCOS-like Female Rhesus Monkeys (Macaca Mulatta) Exposed to Testosterone during Early-to-Mid Gestation

“…In contrast, adult female monkeys exposed to naturally occurring [36] or experimentally induced [33,61] fetal T excess retain the ability to demonstrate ovarian E 2 -induced LH (and likely GnRH) surges and ovulatory menstrual cycles. Women with PCOS [86], and with known exposure to fetal T excess [87], also demonstrate E 2 -induced LH surges or ovulatory menstrual cycles. In fetal rhesus monkeys, GnRH neurons initiate their migration from embryonic origins in the nasal epithelium about 32-36 days of gestation and complete their distribution in the hypothalamus by ~60 days [88], closely emulating GnRH neuronal embryonic progression in humans at 6-7 weeks of gestation [85], and approximating the gestational ages encompassed by experimentally induced T exposure of PCOS-like monkeys in the present study.…”

Effects of vitex agnes castus on hormonal imbalances in Polycystic Ovary Syndrome

“…This relative increase in unbound concentrations of DHEAS and testosterone is clinically related with hyperandrogenism of hirsutism. 6,7 Herbal therapy was highly effective in controlling the levels of testosterone and DHEAS. This was reflected in the levels of testosterone (0.95±0.17) and DHEAS (218.28±2.13) in group III and it was highly significant (p <0.001).…”