PCOS: an ovarian disorder that leads to dysregulation in the hypothalamic–pituitary–adrenal axis?


      This review focuses on the role of the ovaries in the pathogenesis of the polycystic ovarian syndrome. In particular, the failure of follicular development, hypothalamo-pituitary dysregulation, alterations in adrenal steroid output and derangement of intermediary metabolism are discussed in the context of the ovaries. It is concluded that the central and adrenal alterations associated with PCOS are unlikely to be primary but rather are secondary to the events within the ovary.


      Δ4 pathway (the steroid pathway from P4-17POA4), Δ5 pathway (the steroid pathway from P5-17PE-DHEA), 3βHSD (3β-hydroxysteroid dehydrogenase), 17βHSD (17β-hydroxysteroid dehydrogenase), 17PE (17α-hydroxypregnenolone), 17PO (17α-hydroxyprogesterone), A4 (androstenedione), ACTH (adrenocorticotrophic hormone), DHEA (dehydroepiandrosterone), DHEAS (dehydroepiandrosterone sulphate), E2 (estradiol), FSH (follicle stimulating hormone), GnRH (gonadotrophin releasing hormone), hCG (human chorionic gonadotrophin), IGF-1 (insulin like growth factor 1), LH (luteinising hormone), P4 (progesterone), P450c17 (microsomal enzyme that has both 17α-hydroxylase and 17,20-lyase activities), P5 (pregnenolone), PCOS (polycystic ovary syndrome), T (testosterone)


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