Hormone responses to buserelin in polycystic ovary syndrome and in eumenorrheic women with hyperandrogenism/hyperandrogenemia, and the relationship of these responses with insulin resistance.
Benvenga. Salvatore S; Russo. Michele M; Famà. Fausto F; Forte. Gianpiero G; Unfer. Vittorio V
Key Findings
- Insulin‑resistant PCOS women had higher weight, BMI, testosterone and lower SHBG than non‑insulin‑resistant PCOS women.
- Insulin resistance amplified androgen responses to buserelin in PCOS more than in hyperandrogenic non‑PCOS women.
- Across 35 hormone and glucose measures, 80% were similar between PCOS and hyperandrogenic women regardless of insulin resistance.
Practical Outcomes
- For most biohackers, the findings don’t change day‑to‑day protocols. It suggests that managing insulin resistance may be especially important for women with PCOS to keep androgen levels in check, but the study doesn’t provide new dosing or treatment steps.
Summary
The study looked at how women with PCOS and women with high androgen levels but normal cycles react to a hormone‑stimulating drug (buserelin) and how insulin resistance changes those reactions. It found that insulin resistance makes the hormone spikes and androgen production worse in PCOS than in the other group, but overall the two groups behaved similarly in most measures.
Abstract
We compared 37 women with polycystic ovary syndrome (PCOS) with 24 women with eumenorrhea plus hyperandrogenism and/or hyperandrogenemia without ultrasound evidence of PCO morphology (EuHyperA) to assess their hormone responses to a GnRH-agonist (buserelin). Following our recent paper on PCOS and EuHyperA, we selected patients who performed the 2 h-oral glucose tolerance test (OGTT), and stratified them according to presence/absence of insulin resistance (IR), <i>viz.</i> HOMA-index ≥ 2.5. IR impacted on the PCOS group since IR-yes-PCOS women had significantly higher body weight, BMI, total testosterone (TT), free androgen index (FAI), and 17-hydroxyprogesterone (17-OHP), borderline higher delta-4 androstenedione (Δ4-ASD) and ovarian volume, and significantly lower sex hormone-binding globulin (SHBG) <i>vs</i> IR-no-PCOS. IR-no-EuHyperA had significantly higher follicle-stimulating hormone (FSH), borderline higher dehydroepiandrosterone sulfate (DHEAS) and borderline lower 17-OHP <i>vs</i> IR-no-PCOS. IR-yes-EuHyperA had significantly higher DHEAS, borderline lower TT and FAI <i>vs</i> IR-yes-PCOS. The insulin curve was significantly higher in the IR-yes <i>vs</i> IR-no-PCOS, and IR-yes <i>vs</i> IR-no-EuHyperA. Compared to PCOS, EuHyperA had insignificantly lower glucose and insulin responses regardless of IR status. After steroidogenic ovarian stimulation (24 h-buserelin test), IR presence <i>vs</i> IR absence impacted on 4 curves in PCOS (significantly higher TT, borderline higher 17-OHP, significantly lower Δ4-ASD and DHEAS), and only one curve in EuHyperA (significantly higher TT). IR-no-EuHyperA had two curves significantly lower than IR-no-PCOS (Δ4-ASD and TT). Instead, IR-yes-EuHyperA had significantly lower Δ4-ASD, TT and 17-OHP curves, and significantly higher DHEAS curve <i>vs</i> IR-yes-PCOS. In conclusion, of 35 parameters (baseline, OGTT-related, buserelin-related), 28 (80%) were statistically similar in EuHyperA <i>vs</i> PCOS regardless of IR status. However, IR presence impacted on more parameters in PCOS than EuHyperA. Given the known ovary sparing by IR in PCOS, it appears that IR exacerbates androgen production of PCOS women more markedly than EuHyperA women.
Study Information
pubmed
2025
2025-10-06T00:00:00.000Z
10.1016/j.jcte.2025.100420
18