| Abstract: | Over an 8-year period, 75 Stein-Leventhal patients underwent curettage; 47 of them also had a determination of estrogen secretion. Levels were normal for 49, increased for 16 and were below normal for 10. Endometrial proliferation was found in 33 patients with a total estrogen secretion of 13 mcg/24 hours. Of these 33, 18 also displayed hirsutism. 23% or 17 of the 75 patients showed endometrial hyperplasia but their estrogen secretion was within normal values with the exception of 3 women. Hirsutism was seen in 7 of the patients. An atrophic endometrium was seen in 5 patients, one of whom had a moderate hirsutism; their estrogen levels fluctuated from 10 to 16.5 mcg/24 hours. Hirsutism was the dominant clinical sign in 20 patients with an inactive endometrium and an estrogen level of 10 mcg/24 hours. 17-Ketosteroids and their fractions were independent of the hirsutism and within normal levels. In the absence of ovulation, pregnandiol excretion was low. 48% of the patients with hirsutism (36 cases) did not have estrogen secretion values outside the normal. The results confirm that estrogen secretion in the polycystic ovary does not decrease and that the frequent endometrial hyperplasia is even a direct consequence of persistent estrogen action. That these patients also preserved their female phenotype supports the fact of estrogen sufficiency in the case of the polycystic ovary. |
