Interface between reproductive and metabolic dysfunction in polycystic ovary syndrome

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Purpose of review New concepts have emerged regarding how interrelationships of hyperandrogenism and hyperinsulinemia from systemic insulin resistance contribute to the origins of polycystic ovary syndrome (PCOS). Although these androgen-insulin interrelationships are associated with several reproductive and metabolic variables, their specific cause and effect relationships remain unclear. This review examines specific causal relationships between hyperandrogenism and hyperinsulinemia from systemic insulin resistance to understand how these complex interactions contribute to the phenotypic expression of PCOS. Recent findings Clinical interventions for the treatments of hyperandrogenism and hyperinsulinemia from systemic insulin resistance as well as in-vitro studies of androgen and insulin actions on critical target tissues are examined to understand why androgen-insulin interrelationships are central to the origins of PCOS. Summary Bidirectional interrelationships between hyperandrogenism and hyperinsulinemia from systemic insulin resistance in normal-weight PCOS women may have originally evolved as an ancient metabolic adaptation to simultaneously favor fat storage and energy utilization for survival and reproduction during famine. These androgen-insulin interactions in PCOS now predispose to metabolic diseases and pregnancy complications in today's obesogenic environment and

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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