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An Association is Made Between Cycles >45 Days and Elevated Androgens
Title: Prevalence of hyperandrogenemia among nonhirsute oligo-ovulatory women
Author: S.E. Allen et al.
Address: Birmingham, Alabama, USA
Source: Fertility and Sterility 67:567-572, 1997 (March)
Synopsis: This is reportedly the first study that has looked specifically at hyperandrogenemia (elevated blood levels of male hormones) in a group of patients. Thirty-two patients with oligomenorrhea (cycles ³45 days) and who showed no increased hair growth were compared to 37 women with regular cycles by blood levels of Total testosterone (T), androstenedione (A), dehydroepianrosterone (DHEAS), and sex steroid binding (SHBG). About 40% of the oligomenorrheic patients had at least one abnormal blood androgens level. The longer the cycle length, the greater the likelihood of abnormal androgen levels. The authors question the sensitivity of increased hair growth as a marker of hyperandrogenism.
Comment: Hirsutism usually refers to a male pattern of hair growth in a female. The requirements for this type of hair growth are androgens, (which all females have to some degree),and receptors in the skin. The production of andorgens varies vastly among women. Elevated levels androgens are relatively common in women with polycystic ovarian syndrome (PCOS). Despite very high androgens, some women have little increase in hair growth due to lack of receptors for the hormone in skin. Blondes, native Americans, and Orientals tend to have fewer receptors. Others may have hyperandrogenism manisfested as acne rather than hair growth. Men differ from women in the pattern of hair growth. Characteristics of the male pattern hair growth are hair between the umbilicus and pubis, "side-burns", the nape of the neck, mid chest and the lower back, inner thighs. A small increase of hair along the upper lip and around the nipples is not abnormal, and leg and arm hair amount is of little concern. Scoring of hirsutism is often subjective. This study benefits by using the Ferriman-Gallwey scoring system and by requiring a score of zero for inclusion. These findings may broaden the definition of PCOS even more and could have important nonreproductive medical consequences such as in diabetes and heart disease.