The Postmenopausal Ovary Is Not a Major Androgen-Producing Gland
It is currently believed that the postmenopausal ovary remains a gonadotropin-driven, androgen-producing gland. However, the adrenal contribution to circulating androgen levels may explain some conflicting results previously reported. In addition, the steroidogenic potential and gonadotropin respons...
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Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2001-10, Vol.86 (10), p.5060-5066 |
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Sprache: | eng |
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Zusammenfassung: | It is currently believed that the postmenopausal ovary remains a
gonadotropin-driven, androgen-producing gland. However, the adrenal
contribution to circulating androgen levels may explain some
conflicting results previously reported. In addition, the steroidogenic
potential and gonadotropin responsiveness of the postmenopausal ovary
have not been recently reassessed. Plasma T, bioavailable T, free T,
androstenedione (Adione), and dehydroepiandrosterone sulfate levels
were measured in postmenopausal or ovariectomized women with complete
adrenal insufficiency, compared with women with intact adrenals. A
stimulation human chorionic gonadotropin test (on d 0, 3, and 6) was
performed in postmenopausal women with adrenal insufficiency.
Dexamethasone was administered for 4 d in postmenopausal women
with intact adrenals. Intraovarian T and androstenedione were also
measured in homogenates of ovarian tissue from postmenopausal women.
Immunocytochemistry was performed on postmenopausal ovaries and
premenopausal controls to detect the presence of steroidogenic enzymes
(P-450 aromatase, P-450 SCC, 3β HSD, and P-450 C17) and gonadotropin
receptors. Plasma androgen levels were below or close to the limit of
the assay in all women with adrenal insufficiency. They were similar in
postmenopausal and oophorectomized women with normal adrenals. No
hormonal changes were observed after human chorionic gonadotropin
injections in women with adrenal insufficiency. In contrast, a dramatic
decrease of all steroids was observed after dexamethasone
administration in postmenopausal women with intact adrenals.
Intraovarian T and androstenedione levels were negligible in
postmenopausal ovarian tissue. P-450 aromatase was absent from the 17
ovaries studied, and the enzymes for androgen biosynthesis were either
absent (n = 13) or present in very low amounts (n = 4). In
all the postmenopausal ovaries, FSH and LH receptors were completely
absent. In the absence of adrenal steroids, postmenopausal women
have no circulating androgens. This result is consistent with the
immunocytochemical studies showing the almost constantly absent
steroidogenic enzymes and LH receptors in the postmenopausal ovary.
Thus, the climacteric ovary is not a critical source of androgens. The
arrest of androgen secretion after menopause may impact significantly
on women’s health. |
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ISSN: | 0021-972X 1945-7197 |
DOI: | 10.1210/jcem.86.10.7900 |