TY - JOUR
T1 - Increased androgen, anti-müllerian hormone, and sporadic anovulation in healthy, eumenorrheic women
T2 - A mild pcos-like phenotype?
AU - Sjaarda, Lindsey A.
AU - Mumford, Sunni L.
AU - Kissell, Kerri
AU - Schliep, Karen C.
AU - Hammoud, Ahmad O.
AU - Perkins, Neil J.
AU - Weck, Jennifer
AU - Wactawski-Wende, Jean
AU - Schisterman, Enrique F.
PY - 2014/6
Y1 - 2014/6
N2 - Context: Hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS) in women with irregular menses, yet the relationship between androgens and ovarian dysfunction remains poorly understood in eumenorrheic women. Objective: The objective of the study was to evaluate whether sporadic anovulation was associated with higher T and anti-müllerian hormone (AMH; marker of ovarian follicle count) concentrations in eumenorrheic women. Design: This was a prospective cohort study from 2005 to 2007. Setting: The study was conducted at the University of Buffalo in western New York state. Participants: A total of 259 eumenorrheic women without a self-reported history of infertility, PCOS, or other endocrine disorder participated in the study. Main Outcome Measures: Total T and AMH were measured five to eight times per cycle for one (n = 9) or two (n=250) cycles per woman (n=509 cycles) with timing of menstrual cycle phase assisted by fertility monitors. Anovulatory cycles were defined biochemically by progesterone and LH concentrations. Repeated-measures ANOVA was conducted on log-transformed data with adjustment for age. Results: Compared with ovulatory cycles (n = 467), sporadic anovulatory cycles (n = 42) had marginally higher total and significantly higher free T [mean 23.7 ng/dL (95% confidence interval [CI] 21.4-26.3) vs 21.6 ng/dL (95% CI 20.9-22.3), P=.08, and 0.36 ng/dL (95% CI 0.33-0.40) vs 0.32 ng/dL (95% CI 0.31-0.33), P = .02, respectively] during menses and also throughout the luteal phase (P.01 for all). Women with higher T had elevated AMH concentrations, increased reporting of a history of acne requiring medical treatment, but not increased hirsutism. Conclusions: Mechanismsofandrogen-relatedovulatorydysfunctionthatcharacterizePCOSinwomen with menstrual disturbancesmayoccur across a continuum of T concentrations, including in eumenorrheic women without clinical hyperandrogenism.
AB - Context: Hyperandrogenism is a hallmark of polycystic ovary syndrome (PCOS) in women with irregular menses, yet the relationship between androgens and ovarian dysfunction remains poorly understood in eumenorrheic women. Objective: The objective of the study was to evaluate whether sporadic anovulation was associated with higher T and anti-müllerian hormone (AMH; marker of ovarian follicle count) concentrations in eumenorrheic women. Design: This was a prospective cohort study from 2005 to 2007. Setting: The study was conducted at the University of Buffalo in western New York state. Participants: A total of 259 eumenorrheic women without a self-reported history of infertility, PCOS, or other endocrine disorder participated in the study. Main Outcome Measures: Total T and AMH were measured five to eight times per cycle for one (n = 9) or two (n=250) cycles per woman (n=509 cycles) with timing of menstrual cycle phase assisted by fertility monitors. Anovulatory cycles were defined biochemically by progesterone and LH concentrations. Repeated-measures ANOVA was conducted on log-transformed data with adjustment for age. Results: Compared with ovulatory cycles (n = 467), sporadic anovulatory cycles (n = 42) had marginally higher total and significantly higher free T [mean 23.7 ng/dL (95% confidence interval [CI] 21.4-26.3) vs 21.6 ng/dL (95% CI 20.9-22.3), P=.08, and 0.36 ng/dL (95% CI 0.33-0.40) vs 0.32 ng/dL (95% CI 0.31-0.33), P = .02, respectively] during menses and also throughout the luteal phase (P.01 for all). Women with higher T had elevated AMH concentrations, increased reporting of a history of acne requiring medical treatment, but not increased hirsutism. Conclusions: Mechanismsofandrogen-relatedovulatorydysfunctionthatcharacterizePCOSinwomen with menstrual disturbancesmayoccur across a continuum of T concentrations, including in eumenorrheic women without clinical hyperandrogenism.
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U2 - 10.1210/jc.2013-3781
DO - 10.1210/jc.2013-3781
M3 - Article
C2 - 24606085
AN - SCOPUS:84902327012
SN - 0021-972X
VL - 99
SP - 2208
EP - 2216
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -