Acne and hirsutism in polycystic ovary syndrome: clinical, endocrine–metabolic and ultrasonographic differences

Abstract

The aim of this study was to investigate whether the absence or presence of acne or hirsutism in 248 women with polycystic ovary syndrome was associated with different clinical, endocrine, metabolic andultrasonographic factors. Patients were divided into three groups: 96 (38.7%) without any androgenic symptoms; 94 (37.9%) with only hirsutism; and 58 (23.4%) with only acne. The cycle alterations (oligomenorrheaor amenorrhea) and the echographic ovarian morphology (polycystic or multifollicular ovaries) showed no significant differences between the three groups. Hirsutism was associated with a greater incidenceof obesity and insulin resistance, with an increase of 17-hydroxyprogesterone, ovarian and adrenal androgens, 3α-androstanediol glucuronide, insulin, insulin-like growth factor-I and low luteinizinghormone, sex hormone binding globulins and insulin-like growth factor binding protein-1 levels. Acne was associated only with the lowest 3α-androstanediol glucuronide levels. Therefore, twodifferent pathogenetic mechanisms may play a role in the onset of acne and hirsutism.