Hormonal
Androgen excess drives metabolic dysfunction in PCOS by promoting visceral adiposity, inducing insulin resistance through adipocyte hypertrophy and reduced adiponectin, and suppressing brown adipose tissue thermogenesis.
For women with PCOS, metabolic issues like insulin resistance and visceral fat accumulation are strongly linked to high androgen levels, not just diet. Treating the hormonal imbalance (e.g., via anti-androgens or insulin-sensitizers) may be necessary to address metabolic health, as lifestyle changes alone may be insufficient if androgen excess persists.
Androgen excess plays a prominent role in the development of metabolic disturbances associated with PCOS, with a discernible impact on key peripheral metabolic tissues, including the adipose, liver, pancreas, and muscle, and very prominently the brain, contributing to the constellation of metabolic complications of PCOS, from obesity to insulin resistance.
Why this rating
Based on a systematic review of multiple preclinical models (rodents, sheep, primates) and human observational data.
Source
Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies
Miguel A. Sánchez-Garrido et al. · Molecular Metabolism · 2020
DOI 10.1016/j.molmet.2020.01.001
More from this paper
- Insulin resistance in PCOS is characterized by selective ovarian insulin resistance (hyper-sensitivity) alongside peripheral resistance, which exacerbates androgen production.Good
- Androgen excess reduces brown adipose tissue (BAT) thermogenesis by downregulating UCP-1, contributing to the metabolic profile of PCOS.Moderate
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