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Three types of polycystic ovarian syndrome in relation to androgenic function
1Department of Gynecology and Obstetrics, Kyoto University Faculty of Medicine, Japan.
Objective:
To re-evaluate the concept of polycystic ovarian syndrome (PCOS) in view of androgenic function.
Design:
Patients were studied endocrinologically and ultrasonographically.
Setting:
This study was performed as a clinical investigation.
Patients, Participants:
Sixty-nine euprolactinemic anovulatory patients with luteinizing hormone (LH) hypersecretion and 18 normal volunteers were selected.
Interventions:
One hundred micrograms of LH-releasing hormone were administered.
Main Outcome Measure(S):
It was possible to divide PCOS patients into three types.
Results:
Patients with neither hirsutism nor elevation of serum androstenedione (delta 4) and/or testosterone (T) were designated as type I PCOS (n = 20). Patients without hirsutism but with elevated delta 4 and/or T were referred to as type II PCOS (n = 33). Patients with both hirsutism and elevation of delta 4 and/or T were defined as type III PCOS (n = 16). Concentrations of delta 4 appeared gradedly increasing in types I, II, and III in that order, whereas T concentrations were significantly higher in types II and III than in control. Ultrasonographically, cystic ovaries were found in 88%, 84%, and 100% of types I, II, and III patients, respectively.
Conclusions:
It is postulated that each type may represent a subset of whole spectrum of PCOS from Stein-Leventhal syndrome to simple anovulation with LH hypersecretion.