Androgen Excess Is the Key Element in Polycystic Ovary Syndrome

In 2003, Ricardo Azziz conducted a study arguing that androgen excess, rather than insulin resistance, was the primary factor in Polycystic Ovary Syndrome (PCOS), an endocrine disorder affecting approximately 4% of reproductive-aged women. The study emphasized that despite many women with PCOS having insulin resistance and hyperinsulinemia, it was the androgen excess that directly influenced their endocrine symptoms, such as irregular ovulation, hirsutism, acne, or alopecia. The study also pointed out that around 20% of patients with PCOS, diagnosed by the 1990 National Institutes of Health conference criteria, had normal androgen levels, indicating potential problems with the measurement and interpretation of androgen levels. The study concluded that androgen suppression was the primary treatment for patients with PCOS not seeking immediate fertility.