| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Journal of Clinical Endocrinology & Metabolism, Vol 79, 1328-1333, Copyright © 1994 by Endocrine Society
ARTICLES |
RB Barnes, RL Rosenfield, DA Ehrmann, JF Cara, L Cuttler, LL Levitsky and IM Rosenthal
Department of Obstetrics/Gynecology, University of Chicago, Pritzker School of Medicine, Illinois 60637.
Women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency often have a polycystic ovary-like syndrome, consisting of hyperandrogynism, infertility, menstrual irregularities, and elevated LH levels. This is generally considered secondary to poor control of the congenital adrenal hyperplasia. However, our experience led us to suspect that ovarian hyperandrogenism occurs even when congenital adrenal hyperplasia is well controlled on glucocorticoid therapy. Therefore, we tested the hypothesis that congenital adrenal virilizing disorders result in ovarian hyperandrogenism. We studied eight women with congenital adrenal virilizing disorders, seven with well controlled classic 21-hydroxylase deficiency and one with congenital virilizing adrenal carcinoma removed at 1.7 yr of age. We also studied six women with late-onset 21-hydroxylase deficiency, without signs of congenital virilization. An ovarian source of androgens was assessed after suppressing adrenal function with dexamethasone and then testing pituitary-ovarian function by a GnRH agonist (nafarelin) test. Five women with congenital adrenal virilizing disorders (four with classic 21-hydroxylase deficiency and one with congenital virilizing adrenal carcinoma) and one women with late-onset 21-hydroxylase deficiency had ovarian hyperandrogenism as determined by subnormal suppression of free testosterone after dexamethasone and/or by increased 17- hydroxyprogesterone response to nafarelin while on dexamethasone. All women with congenital adrenal virilization and ovarian hyperandrogenism had elevated LH levels after dexamethasone or elevated early LH response to nafarelin, which suggests that LH excess is the cause of their ovarian hyperandrogenism. This was not the case for the late- onset 21-hydroxylase-deficient woman. Our data are compatible with the hypothesis that congenital adrenal virilization programs the hypothalamic-pituitary axis for hypersecretion of LH at puberty. This is postulated to frequently cause ovarian hyperandrogenism even when adrenal androgen excess is subsequently controlled by glucocorticoid therapy.
This article has been cited by other articles:
 |
|
 |
|
  D. H Abbott, D. K Barnett, J. E Levine, V. Padmanabhan, D. A Dumesic, S. Jacoris, and A. F Tarantal Endocrine Antecedents of Polycystic Ovary Syndrome in Fetal and Infant Prenatally Androgenized Female Rhesus Monkeys Biol Reprod, July 1, 2008; 79(1): 154 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Rosenfield Identifying Children at Risk for Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., March 1, 2007; 92(3): 787 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Robinson Prenatal programming of the female reproductive neuroendocrine system by androgens. Reproduction, October 1, 2006; 132(4): 539 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.K. Blank, C.R. McCartney, and J.C. Marshall The origins and sequelae of abnormal neuroendocrine function in polycystic ovary syndrome Hum. Reprod. Update, July 1, 2006; 12(4): 351 - 361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Xita and A. Tsatsoulis Fetal Programming of Polycystic Ovary Syndrome by Androgen Excess: Evidence from Experimental, Clinical, and Genetic Association Studies J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1660 - 1666. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Manikkam, T. L. Steckler, K. B. Welch, E. K. Inskeep, and V. Padmanabhan Fetal Programming: Prenatal Testosterone Treatment Leads to Follicular Persistence/Luteal Defects; Partial Restoration of Ovarian Function by Cyclic Progesterone Treatment Endocrinology, April 1, 2006; 147(4): 1997 - 2007. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Recabarren, V. Padmanabhan, E. Codner, A. Lobos, C. Duran, M. Vidal, D. L. Foster, and T. Sir-Petermann Postnatal developmental consequences of altered insulin sensitivity in female sheep treated prenatally with testosterone Am J Physiol Endocrinol Metab, November 1, 2005; 289(5): E801 - E806. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.H. Abbott, D.K. Barnett, C.M. Bruns, and D.A. Dumesic Androgen excess fetal programming of female reproduction: a developmental aetiology for polycystic ovary syndrome? Hum. Reprod. Update, July 1, 2005; 11(4): 357 - 374. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Steckler, J. Wang, F. F. Bartol, S. K. Roy, and V. Padmanabhan Fetal Programming: Prenatal Testosterone Treatment Causes Intrauterine Growth Retardation, Reduces Ovarian Reserve and Increases Ovarian Follicular Recruitment Endocrinology, July 1, 2005; 146(7): 3185 - 3193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Xita, A. Tsatsoulis, A. Chatzikyriakidou, and I. Georgiou Association of the (TAAAA)n Repeat Polymorphism in the Sex Hormone-Binding Globulin (SHBG) Gene with Polycystic Ovary Syndrome and Relation to SHBG Serum Levels J. Clin. Endocrinol. Metab., December 1, 2003; 88(12): 5976 - 5980. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. Speiser and P. C. White Congenital Adrenal Hyperplasia N. Engl. J. Med., August 21, 2003; 349(8): 776 - 788. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Birch, V. Padmanabhan, D. L. Foster, W. P. Unsworth, and J. E. Robinson Prenatal Programming of Reproductive Neuroendocrine Function: Fetal Androgen Exposure Produces Progressive Disruption of Reproductive Cycles in Sheep Endocrinology, April 1, 2003; 144(4): 1426 - 1434. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. J. Place, K. E. Holekamp, C. L. Sisk, M. L. Weldele, E. M. Coscia, C. M. Drea, and S. E. Glickman Effects of Prenatal Treatment with Antiandrogens on Luteinizing Hormone Secretion and Sex Steroid Concentrations in Adult Spotted Hyenas, Crocuta crocuta Biol Reprod, November 1, 2002; 67(5): 1405 - 1413. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Sir-Petermann, M. Maliqueo, B. Angel, H.E. Lara, F. Perez-Bravo, and S.E. Recabarren Maternal serum androgens in pregnant women with polycystic ovarian syndrome: possible implications in prenatal androgenization Hum. Reprod., October 1, 2002; 17(10): 2573 - 2579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.-N. Cho, M. L. McMullen, L. Pei, C. J. Yates, and K. E. Mayo Reproductive Deficiencies in Transgenic Mice Expressing the Rat Inhibin {alpha}-Subunit Gene Endocrinology, November 1, 2001; 142(11): 4994 - 5004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Veldhuis, S. M. Pincus, M. C. Garcia-Rudaz, M. G. Ropelato, M. E. Escobar, and M. Barontini Disruption of the Joint Synchrony of Luteinizing Hormone, Testosterone, and Androstenedione Secretion in Adolescents with Polycystic Ovarian Syndrome J. Clin. Endocrinol. Metab., January 1, 2001; 86(1): 72 - 79. [Abstract] [Full Text]
|
|
|
|
|
|
C. A. Eagleson, M. B. Gingrich, C. L. Pastor, T. K. Arora, C. M. Burt, W. S. Evans, and J. C. Marshall Polycystic Ovarian Syndrome: Evidence that Flutamide Restores Sensitivity of the Gonadotropin-Releasing Hormone Pulse Generator to Inhibition by Estradiol and Progesterone J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 4047 - 4052. [Abstract] [Full Text]
|
|
|
|
 |
|
 P. C. White and P. W. Speiser Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency Endocr. Rev., June 1, 2000; 21(3): 245 - 291. [Abstract] [Full Text]
|
|
|
|
|
|
J. R. Eisner, D. A. Dumesic, J. W. Kemnitz, and D. H. Abbott Timing of Prenatal Androgen Excess Determines Differential Impairment in Insulin Secretion and Action in Adult Female Rhesus Monkeys J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 1206 - 1210. [Abstract] [Full Text]
|
|
|
|
|
|
L. Poretsky, N. A. Cataldo, Z. Rosenwaks, and L. C. Giudice The Insulin-Related Ovarian Regulatory System in Health and Disease Endocr. Rev., August 1, 1999; 20(4): 535 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Pastor, M. L. Griffin-Korf, J. A. Aloi, W. S. Evans, and J. C. Marshall Polycystic Ovary Syndrome: Evidence for Reduced Sensitivity of the Gonadotropin-Releasing Hormone Pulse Generator to Inhibition by Estradiol and Progesterone J. Clin. Endocrinol. Metab., February 1, 1998; 83(2): 582 - 590. [Abstract] [Full Text]
|
|
|
|
|
|
T. L. Daniels and S. L. Berga Resistance of Gonadotropin Releasing Hormone Drive to Sex Steroid-Induced Suppression in Hyperandrogenic Anovulation J. Clin. Endocrinol. Metab., December 1, 1997; 82(12): 4179 - 4183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Risma, A. N. Hirshfield, and J. H. Nilson Elevated Luteinizing Hormone in Prepubertal Transgenic Mice Causes Hyperandrogenemia, Precocious Puberty, and Substantial Ovarian Pathology Endocrinology, August 1, 1997; 138(8): 3540 - 3547. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. Azziz and S. M. Slayden The 21-Hydroxylase-Deficient Adrenal Hyperplasias: More Than ACTH Oversecretion Reproductive Sciences, November 1, 1996; 3(6): 297 - 302. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
