What is the Origin of Functional Ovarian Hyperandrogenism?

The term describes a specific pathophysiology—the overproduction of androgens by the ovarian theca cells—that is functional, meaning it is related to an underlying dysregulation rather than a fixed structural lesion. The clinical entity has been recognized since the 1930s, but its functional nature and association with insulin resistance have been clarified through decades of endocrinological research. It is a key diagnostic criterion in modern reproductive endocrinology.

What is the Mechanism of Functional Ovarian Hyperandrogenism?

The core mechanism involves a dysregulated feedback loop where high circulating insulin levels, often secondary to insulin resistance, act synergistically with luteinizing hormone (LH) to excessively stimulate the ovarian theca cells. This over-stimulation leads to the hypersecretion of androgens, such as testosterone and androstenedione. The resulting high androgen levels disrupt follicular development and ovulation, contributing to the characteristic ovarian morphology and anovulation observed in this syndrome.

Functional Ovarian Hyperandrogenism

Meaning

A common endocrine condition in women characterized by excessive ovarian androgen production, typically manifesting as clinical signs of hyperandrogenism such as hirsutism, acne, and menstrual irregularity, but without a detectable ovarian tumor or classical adrenal enzyme defect. This condition is often synonymous with Polycystic Ovary Syndrome (PCOS) and is a diagnosis of exclusion after ruling out other causes of androgen excess. It represents a significant challenge to reproductive and metabolic health.