Polycystic ovary syndrome in men: Stein-Leventhal syndrome revisited
Med Hypotheses. 2007;68(3):480-3
Polycystic ovary syndrome in men: Stein-Leventhal syndrome revisited.
Kurzrock R, Cohen PR.
Phase I Program, Division of Cancer Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, TX, United States.
Polycystic ovary syndrome (PCOS), also referred to as Stein-Leventhal syndrome, is one of the most common endocrinopathies. It is characterized by hyperandrogenism, hyperinsulinemia, central obesity, polycystic ovaries, and anovulation. However, some of these manifestations, including the polycystic ovaries, are neither specific for the disorder, nor found in all affected individuals.
PCOS appears to be due to one or more primary defects in the upstream gonadotropin/androgen and/or insulin pathway, with the polycystic ovaries being one of many downstream manifestations. Yet, the pathophysiology of PCOS is not completely elucidated.
Since the primary defect underlying PCOS may be an upstream endocrine and/or metabolic disturbance, rather than a defect in the ovaries themselves, we hypothesize that this aberration can also arise in men and that the absence of polycystic ovaries in men with other stigmata of the disorder should not eliminate the diagnosis.
Our hypothesis is supported by the observation that a genetic susceptibility to PCOS exists, and that PCOS-type manifestations are not limited to women. Indeed, male relatives may suffer from insulin resistance, obesity, diabetes mellitus, and cardiovascular disease. Therefore, recognition of this syndrome in men is important, since pharmacologic treatments identified for women with PCOS may alleviate metabolic problems related to insulin resistance and its sequelae in men with a similar underlying defect.
We suggest that first-degree relatives of patients with PCOS should be examined not only for phenotypic features characteristic of PCOS but also for biochemical evidence of hyperinsulinemia and hyperandrogenism.
In addition to examining these individuals for obesity, the women should be evaluated for hirsutism and the men should be screened for early-onset male-pattern alopecia and excess hairiness. Serologic evaluation should included the ratio of fasting levels of glucose to insulin, a glucose tolerance test, the free testosterone level and the sex hormone-binding globulin level.
Finally, both male and female first-degree relatives of patients with PCOS should be tested for the underlying molecular defect(s) of this condition, once it is identified.
As new treatments for PCOS emerge, e.g. insulin-sensitizing drugs, it will be important to determine if these treatments have beneficial effects on the metabolic symptoms and complications in all afflicted patients, regardless of gender.
PMID: 17134841 [PubMed - indexed for MEDLINE]
__________________
Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Kat- My DH's doc does not take PCOS, IR or diabetes seriously. We have not found a new family doc yet (I have a great GYN who treats my PCOS), so DH is going to see his old doc next month. He has had high cholesterol, high BP which is now under control and BOTH his parents, most of ancestors and some of his aunts and uncles have type 2 diabetes. Is there any hope an endo would know anything about male PCOS and treat him for it? He is on a good lower carb diet (less processed stuff, more fresh fruits, veggies, etc.), but I am afraid type 2 is in his future. His doc said he coudl't do a test for IR (though they did for DH and DD eventually) and have blown off any concerns about diabeties, so I'm wondering if any doc would treat male PCOS or a man without IR, but a family history of obesity (both parents, almost all aunts and uncles, etc.), high cholesterol, type 2, etc. with Metformin. Any advice you can give other than finding a new family doctor (which we want to do, but are stumped as who to pick)? As I said he is eating better and once his sleep apnea is under control I hope he will be able to start exercising again.
It sounds like this is in the hypothesis stage. I wonder what kind of research/testing there will be on it, especially in light of the enzyme connection article Kat posted. If the enzyme excess is present in both male and female patients with Insulin Resistant Hyperandrogenism, that would be a huge break through in the search for a "cure," especially if it can be treated through the enzyme inhibition.
Edited to add link
__________________ "Faith is choosing to be fulfilled before you see the miracle."
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
We are pretty sure my grandmother (and possibly great grandmother) had PCOS and my Dad has Type II diabetes. I believe he was insulin resistant a long time before he was diagnosed with diabetes at age 55. He is extremely hairy, and he had trouble controlling his weight in his 30s, 40s and 50s. He has had two blocked arteries that required stents. Is there really any difference between Metabolic Syndrome and Stein-Leventhal syndrome?
I'm pretty sure my Grandmother had PCOS (irregular cycles and 4 years between babies in an era before contraception) my Father also has type 2 diabetes and has the belly etc.
My son is nearly 13 and oozing hormone stew from every pore and we are currently monitoring his blood sugar levels and testing for insulin resistance.
__________________ Where there's a will there's a way To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Two miracle boys, had to wait 9 years to get the second one, but it was worth it! To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
No Medications To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
My mom had similar symptoms after her hysterectomy at age 35? (for a cyst removal that was too large) After that she had "nerve problems" and was listed as a mental patient because of her hormones, she had the skin tag, brown skin spots, weight gain etc... And my dad was diagnosed with diabetes in 2000? and later died of pancreatic cancer that was undetected until he had gallbladder surgery (died within a month of the gallbladder surgery).
Plus, I watch my liver enzymes because my grandmother (on fathers side) died of fatty liver disease.
So I absolutely believe it runs in the families, especially those with any history of diabetes or weight issues.
__________________ DX'd 2007 PCOS, hyperinsulinemia, hypothyroidism
DX'd 2009 Autoimmune Disease **** To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. ****[/font]
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Buddyslim.com To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. buddytslim
My brother started losing his hair at age 17 and at 29 is now nearly bald on top. No diabetes in my family though, but I suspect PCOS in several of my aunts and my mother. Inerestign article.
__________________ Me 30, DH 29, married since 2003.
Langerhans Cell Histiocytosis Survivor
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Forever converted menstrul cup user!
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Not a big suprise here. I know which side of the family I got this from and my father had other gland issues+abdominal obesity+ type 2 diabetes+ ESTROGEN POSITIVE Breast cancer... in a man. Glad somebody is realizing there maybe a male version.
Polycystic ovary syndrome in men: Stein-Leventhal syndrome revisited 
