Three types of polycystic ovarian syndrome in relation to androgenic function.

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.