Effect of bilateral oophorectomy on adrenocortical function in women with polycystic ovary syndrome

Capsule:
Adrenocortical responses before and after bilateral oophorectomy suggest that ovarian factors have a limited role in the etiology of adrenal androgen excess of polycystic ovary syndrome.

Authors:
Ricardo Azziz, M.D., Wendy Y. Chang, M.D., Frank Z. Stanczyk, Ph.D., Keslie Woods, B.S.

Volume 99, Issue 2, Pages 599-604, February 2013

Abstract:

Objective:
To determine the impact of ovary-secreted products on adrenocortical function in women with PCOS by studying the adrenocortical response to acute adrenocorticotropic-stimulating hormone (ACTH) stimulation before and after bilateral oophorectomy.

Design:
Prospective study.

Setting:
Tertiary care medical center.

Participants:
Fourteen women with PCOS scheduled for bilateral oophorectomy for benign indications, on transdermal estradiol (E2) postoperatively.

Interventions:
Physical examination, blood sampling before and after oophorectomy, measurement of hormone levels; assessment of basal (Steroid0), maximum stimulated (Steroid60), and net increment (ΔSteroid) levels of androstenedione (A4), dehydroepiandrosterone (DHEA), and cortisol (F) before and after ACTH 1–24 stimulation.

Main Outcome Measures:
Preoperative and postoperative basal and ACTH (1–24) stimulated hormone levels.

Results:
Total testosterone, free testosterone, and estrone levels decreased, and FSH levels increased significantly following oophorectomy. No significant differences in E2, DHEA sulfate (DHEAS) or sex hormone binding globulin levels were detected. Basal and ACTH-stimulated A4 levels decreased significantly following oophorectomy, and ΔA4 was significantly increased. No significant differences in DHEA0, DHEA60, or F0 levels were detected; F60 and ΔF levels tended to increase following oophorectomy, but the differences did not reach significance.

Conclusions:
Ovarian factors do not appear to contribute significantly to the adrenocortical dysfunction of PCOS.

  • Manuel Muñoz

    Thank you Dr. Azziz for this nice article. It is very useful to understand the fisiopathology of PCOS. I have a question for you. Despite the small numbers in your study could affect the final results, and even it is not the aim of your study, do you think that oestrogens supplementation after surgery could play any role in the secretion of adrenal androgens?

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