Book contents
- Frontmatter
- Contents
- List of contributors
- 1 Introduction: Polycystic ovary syndrome is an intergenerational problem
- 2 Introduction and history of polycystic ovary syndrome
- 3 Phenotype and genotype in polycystic ovary syndrome
- 4 The pathology of the polycystic ovary syndrome
- 5 Imaging polycystic ovaries
- 6 Insulin sensitizers in the treatment of polycystic ovary syndrome
- 7 Long-term health consequences of polycystic ovary syndrome
- 8 Skin manifestations of polycystic ovary syndrome
- 9 Lifestyle factors in the etiology and management of polycystic ovary syndrome
- 10 Ovulation induction for women with polycystic ovary syndrome
- 11 Laparoscopic surgical treatment of infertility related to PCOS revisited
- 12 In vitro fertilization and the patient with polycystic ovaries or polycystic ovary syndrome
- 13 Role of hyperinsulinemic insulin resistance in polycystic ovary syndrome
- 14 Novel treatments for polycystic ovary syndrome, including in vitro maturation
- 15 The pediatric origins of polycystic ovary syndrome
- 16 Fetal programming of polycystic ovary syndrome
- 17 Adrenocortical dysfunction in polycystic ovary syndrome
- 18 Polycystic ovary syndrome in Asian women
- 19 Obesity surgery and the polycystic ovary syndrome
- 20 Nutritional aspects of polycystic ovary syndrome
- Index
- References
17 - Adrenocortical dysfunction in polycystic ovary syndrome
Published online by Cambridge University Press: 29 September 2009
- Frontmatter
- Contents
- List of contributors
- 1 Introduction: Polycystic ovary syndrome is an intergenerational problem
- 2 Introduction and history of polycystic ovary syndrome
- 3 Phenotype and genotype in polycystic ovary syndrome
- 4 The pathology of the polycystic ovary syndrome
- 5 Imaging polycystic ovaries
- 6 Insulin sensitizers in the treatment of polycystic ovary syndrome
- 7 Long-term health consequences of polycystic ovary syndrome
- 8 Skin manifestations of polycystic ovary syndrome
- 9 Lifestyle factors in the etiology and management of polycystic ovary syndrome
- 10 Ovulation induction for women with polycystic ovary syndrome
- 11 Laparoscopic surgical treatment of infertility related to PCOS revisited
- 12 In vitro fertilization and the patient with polycystic ovaries or polycystic ovary syndrome
- 13 Role of hyperinsulinemic insulin resistance in polycystic ovary syndrome
- 14 Novel treatments for polycystic ovary syndrome, including in vitro maturation
- 15 The pediatric origins of polycystic ovary syndrome
- 16 Fetal programming of polycystic ovary syndrome
- 17 Adrenocortical dysfunction in polycystic ovary syndrome
- 18 Polycystic ovary syndrome in Asian women
- 19 Obesity surgery and the polycystic ovary syndrome
- 20 Nutritional aspects of polycystic ovary syndrome
- Index
- References
Summary
Introduction
Androgen excess is the most common endocrine disorder of reproductive-aged women, with the majority of patients having a functional abnormality, namely polycystic ovary syndrome (PCOS) (Azziz et al. 2004a). We and others have reported the estimated prevalence of this syndrome to be approximately 6–8% (Knochenhauer et al. 1998, Diamanti-Kandarakis et al. 1999, Asunción et al. 2000, Azziz et al. 2004b), using the 1990 National Institute of Child Health and Human Development (NICHD) conference diagnostic criteria for PCOS (Zawadzki and Dunaif 1992). This conference concluded that the diagnostic criteria of PCOS should include: (1) clinical and/or biochemical signs of hyperandrogenism, (2) oligo-ovulation, and (3) exclusion of other known disorders such as Cushing's syndrome, hyperprolactinemia, and non-classic congenital adrenal hyperplasia (NCAH) (Zawadzki and Dunaif 1992). A recent expert meeting sponsored by the European Society of Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) expanded this definition, noting that PCOS should be diagnosed when at least two of the following three criteria are present: (1) oligo- and/or anovulation, (2) clinical and/or biochemical signs of hyperandrogenism, or (3) polycystic ovaries on ultrasonography, after the exclusion of related disorders (The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2004a, b).
The adrenal androgens (AAs) are primarily secreted by the zonae reticulares of the adrenal cortex, and include dehydroepiandrosterone (DHEA) and its sulfate (DHEAS), Δ5-androstene-3β, 17β-diol (androstenediol), and 11β-hydroxyandrostenedione (11-OHA4).
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- Polycystic Ovary Syndrome , pp. 288 - 315Publisher: Cambridge University PressPrint publication year: 2007