Glossary

Androgen Excess and PCOS Society - Glossary

Acanthosis Nigricans : Acanthosis nigricans refers to the skin changes commonly associated with insulin resistance. The skin in affected areas takes on a darker pigmentation and is often said to have a velvety appearance. The areas most commonly affected include the neck, groin, and under the breasts and arms.

ACTH : ACTH stands for the Adrenocorticotropic Hormone. ACTH is a hormone secreted by the pituitary, and which stimulates the adrenal gland to produce cortisol and androgens. In the purified form it is used in the adrenal stimulation test.

ACTH stimulation test : See Adrenal stimulation test.

Adrenal Gland : The adrenal glands are located above each of the kidneys. The adrenal glands are responsible for the production of many hormones that are important for normal body functions. Examples of hormones produced by the adrenal glands include, androgens, adrenaline, and cortisol.

Adrenal cortex : See adrenal gland

Adrenal hyperplasia : Adrenal hyperplasia refers to a series of inherited disorders that cause a defect or "block" in the production of hormones by the adrenals. Because of this defect the adrenals enlarges in order to produce enough cortisol and aldosterone, a process called "hyperplasia". The most common type of adrenal hyperplasia is due to 21-hydroxylase deficiency. Because adrenal hyperplasia can result also in the excess production of androgens, and hyperandrogenism, patients suffering from adrenal hyperplasia are often mistakenly thought to have PCOS. When adrenal hyperplasia is diagnosed in adult women it usually is of the "non-classic" or "late-onset" variety (as opposed to the classic type of adrenal hyperplasia which is usually first observed in early infancy).

Adrenal medulla : See adrenals.

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Adrenal stimulation test : The adrenal stimulation test, also called the ACTH stimulation test, is used to detect the presence of adrenal hyperplasia, and involves obtaining blood before and after the injection of ACTH.

Adrenals : The adrenal glands are located above each of the kidneys, and are about the size of large walnuts. The adrenal gland produces many hormones. The adrenal gland is divided into an outer part, the so-called adrenal cortex, that produces among others aldosterone (a salt-preserving hormone), sex steroids (androgens and estrogens), and cortisol. The inner part, called the adrenal medulla, produces such hormones as adrenaline.

Aldosterone : Aldosterone is a steroid hormone produced by the adrenal cortex, and is very important for keeping humans alive. Aldosterone is responsible for preserving salts in our body, keeping fluids in, and maintaining our blood pressure.

Amenorrhea : Amenorrhea refers to the condition in which a woman does not have a menstrual period for six or more months. A woman who has been six months without a menstrual period is said to have amenorrhea, or is said to be amenorrheic.

Androgens : An androgen is a male hormone. There are many different androgens. An example of an androgen is the hormone testosterone. Both men and women produce androgens normally. However, men produce significantly more androgens and thus they are said to be male hormones. Androgens are responsible for producing many of the physical traits we consider male (i.e.: body hair growth, increased muscles mass, and deepening of the voice).

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Androgen excess : See hyperandrogenism.

Androgenic alopecia : Androgenic alopecia refers to the loss of scalp hairs in women that is due to androgen excess, and which results in scalp hair thinning or balding.

Androgenetic alopecia : See androgenic alopecia.

Androstenedion : Androstenedion is an androgen, and in women is produced about evenly by the adrenal glands and the ovaries.

Anovulation : When ovulation does not occur it is called anovulation. Women with PCOS commonly have difficulty becoming pregnant because they do not ovulate on a regular basis. Women who do not ovulate are said to be anovulatory.

Antiandrogens drugs : Antiandrogen drugs are used to block or reduce the effect of androgens. In patients with PCOS or hirsutism they are used to block the action of androgens on the skin, reducing the amount of hirsutism, acne or androgenic alopecia. Examples of antiandrogens include spironolactone, flutamide, cyproterone acetate, and finasteride.

Birth control pills : Common phrase for oral contraceptive pills.

Clomiphene citrate : See Ovulation Induction.

Contraception : Contraception is the process of preventing pregnancy. A well-known example is birth control pills, which are often referred to as oral contraceptives.

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Cortisol : Cortisol is a steroid hormone produced by the adrenals, and is very important for keeping humans alive. Cortisol is responsible for maintaining our ability to process sugars, maintain our blood pressure and react to stress and illness.

Cyproterone acetate : Cyproterone acetate is a progestin that also blocks the effect of androgens on the skin. It is very useful for the treatment of hirsutism. A rare side effect is liver problems. Cyproterone acetate is available in oral contraceptive pills (Diane® and Dianette®) and a brand name is Androcur®. It is not available in the United States or Canada .

DHA : See DHEA.

DHEA : Dehydroepiandrosterone (abbreviated DHEA or DHA) is one of the androgens produced by the adrenals. It is metabolized or changed to DHEAS.

DHS : See DHEAS.

DHEAS : Dehydroeipandrosterone sulfate (abbreviated DHEAS or DHS) is one of the androgens produced by the adrenals. It is produced from DHEA.

Diabetes : People who do not produce enough insulin to keep their sugar levels in a normal range are said to have diabetes. In diabetes sugar levels are far higher than normal. Most patients with diabetes also have insulin resistance.

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Dysfunctional Uterine Bleeding : Dysfunctional uterine bleeding (DUB) refers to when a woman has very irregular, unpredictable, and frequently heavy vaginal bleeding. The most frequent cause of DUB is irregular or absent ovulation. By not producing regular shedding of the lining of the uterus, called endometrium, the endometrium tends to thicken excessively and then bleed irregularly and heavily. Because women with PCOS do not ovulate regularly, many of them suffer from DUB. DUB can be treated in most instances by hormonal medications.

Electrology : Electrology is a method of permanently destroying individual hairs, generally using a needle placed into the hair follicle and which transmits a small amount of electricity to destroy the base of the hair. See "Related links" for the web sites of two national electrology associations.

Embryo : An embryo is a pregnancy early in development, which eventually will lead to a fetus (developing child), and hopefully result in the delivery of a live born child.

Endometrium : The inside lining of the uterus, or womb, is called the endometrium. The cells that line the inside of the uterus are referred to as the endometrial lining, or endometrial cells. The area inside the uterus where a pregnancy develops is called the endometrial cavity.

Estrogen : Estrogen is a general term for the large group of female hormones. The majority of estrogen is produced in the ovaries. Although both men and women produce estrogen, women produce far more estrogen than men. Estrogen is responsible for the development of female characteristics such as breast development.

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Estradiol : Estradiol is the principal estrogen.

Estriol : Estriol is an estrogen.

Estrone : Estrone is an estrogen.

Fertility : Fertility refers to the ability to reproduce. Fertilization is the process of combining sperm and egg to create an embryo. The inability to become pregnant is called infertility.

Fertilization : Fertilization is the process whereby sperm and egg combine to create an embryo.

Finasteride : Finasteride is a drug that blocks the effect of androgens on the skin, commonly used for the treatment of prostate disease in men. It is also very useful for the treatment of hirsutism. Side effects are rare, although it can cause birth defects in a male infant. A brand name of finasteride is Proscar®.

Flutamide : Flutamide is a drug that blocks the effect of androgens on the skin. It is very useful for the treatment of hirsutism. Side effects include frequent dry skin, greenish urine, rare liver problems, and can cause birth defects in a male infant. A brand name of flutamide is Eulexin®.

Follicles : A follicle is a small fluid-filled balloon-like area in the ovary where an egg develops. With each menstrual cycle the ovaries produce several follicles, each with its own developing egg. Through a complex process one of these follicles is selected to continue developing to maturity and will ultimately rupture and release its egg. Normal follicles are the most common cause of ovarian cysts seen on ultrasound. Because they are the result of a monthly cycle of development, generally, these cysts will resolve spontaneously over a month or two.

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Follicle Stimulating Hormone : Follicle Stimulating Hormone is a hormone part of the gonadotropin family, which is secreted by the pituitary and helps regulates ovarian function and ovulation.

FSH : FSH stands for Follicle Stimulating Hormone.

Glucose : Glucose is the scientific name for the most common type of sugar found in the body. The hormone insulin regulates the levels of glucose in the blood, and the use of glucose by various organs including the muscles and the liver.

Gonadotropins : Gonadotropins are the general name for the hormones LH and FSH, which are secreted by the pituitary and regulate ovarian function and ovulation. When these hormones are produced commercially in a purified and concentrated form they can be used in an injectable form for ovulation induction.

Hirsutism : Hirsutism refers to excess hair growth. This hair is commonly coarse, thick, and dark in appearance. It is most commonly noted to grow in areas associated with male pattern hair growth. For example, the face, chest, lower abdomen, thighs, back, and arms. This type of hair growth is caused by the male hormone – androgen.

Hormone : A hormone is a chemical produced on one part of the body that then travels to another part of the body where it produces an effect. Hormones are responsible for regulating nearly every body function. An example of a hormone is estrogen. Estrogen produced by the ovary will travel to the breast where it will lead to female breast development. Another example of a hormone is testosterone. Testosterone is produced by the male testicle and then travels to other parts of the body to produce effects such as male pattern hair growth, and deepening of the voice.

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Hyperandrogenemia : Hyperandrogenemia refers to an excess amount of androgens in blood stream of women, which frequently results in hyperandrogenism and hirsutism.

Hyperandrogenism : Hyperandrogenism, also called androgen excess, refers to the excessive effect of androgens (a.k.a. male hormones) in women which can result in hirsutism, acne, androgenic alopecia, oligo-ovulation, and irregular menstrual bleeding.

Hyperinsulinemia : Hyperinsulinemia refers to high levels of insulin in the blood, frequently resulting from insulin resistance.

Hypertrichosis : Hypertrichosis basically means "excess hair growth." Many physicians however use the word "hypertrichosis" to refer to the excess growth of vellus (fine and soft) hairs, as opposed to hirsutism (the excessive growth of thick dark hairs in a male-like pattern). Many women with hypertrichosis due to the excess growth of vellus hairs to do not have androgen excess or PCOS.

Hypoglycemia : The word hypoglycemia means to have a "low blood sugar level." Hypoglycemic episodes can occur in many patients, and are frequently observed in patients with insulin resistance who consume excessive amounts of high sugars or starches. In these individuals the excessively high insulin levels that are formed after eating sugars or starches leads to a dropping of the blood sugar level below normal within one to two hours after eating. Since many women with PCOS are insulin resistant, hypoglycemia can be observed in many of these patients.

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Idiopathic hirsutism : Idiopathic hirsutism refers to a disorder in which women have hirsutism but ovulate normally with regular menstrual periods, and have normal male hormones (androgens) levels. Patients with idiopathic hirsutism do not generally have insulin resistance and are not generally at risk for developing diabetes.

Infertility : Infertility is the inability to reproduce. In the human, there are many causes of infertility. Infertility can affect both men and women. Women with PCOS commonly have problems becoming pregnant and therefore experience infertility.

Insulin : Insulin is a hormone, produced in the pancreas, which is responsible for regulation of sugar levels. People who don’t produce enough insulin to keep their sugar levels in a normal range are said to have diabetes.

Insulin Resistance : Insulin resistance is a condition in which the body does not respond correctly to insulin. With insulin resistance, the pancreas is forced to produce more insulin to maintain normal sugar levels. With severe insulin resistance, the pancreas can not produce enough insulin to meet the bodies needs and this results in diabetes.

Insulin sensitizer : Insulin sensitizers are drugs that improve the action of insulin, and generally result in a lowering of insulin levels and glucose levels in patients with insulin resistance. They are primarily used for the treatment of diabetes, although are also promising treatments for PCOS. Examples of insulin sensitizers include metformin, piaglitazone and rosiglitazone.

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Luteinizing Hormone : Luteinizing Hormone is a hormone part of the gonadotropin family, which is secreted by the pituitary and helps regulates ovarian function and ovulation.

LH : LH stands for Luteinizing Hormone.

Menotropins : See Ovulation induction.

Menstrual bleed : A menstrual bleed normally occurs monthly, when the endometrium sheds. It is also commonly known as a "menstrual period".

Menstrual cycle : The menstrual cycle refers to the period of time between the beginning of one menstrual bleed or period and the next. It usually is 28 to 30 days long, although it can be significantly longer in patients who suffer from oligomenorrhea, such as women with PCOS.

Menstrual period : See menstrual bleed.

Metformin : Metformin is a drug that improves the sensitivity of the body to insulin. It is used in the treatment of diabetes, and is a promising treatment for insulin resistance in PCOS. A brand name of metformin is Glucophage®.

Oligomenorrhea : Oligomenorrhea is a medical term for infrequent menstrual periods. When a woman has a menstrual period at intervals of greater than 35 days she is said to have oligomenorrhea. Women affected by PCOS commonly have menstrual periods more than 35 days apart and are therefore said to have oligomenorrhea, or may be said to be oligomenorrheic.

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Oligo-ovulation : Oligo-ovulation refers to infrequent or irregular ovulation. It frequently manifests as oligomenorrhea.

Oral contraceptive pills : Oral contraceptive pills are a mixture of a progestin and an estrogen. They are used to prevent pregnancy primarily because they also inhibit ovulation. There also used in the treatment of PCOS, where they are used to control irregular uterine bleeding arising from oligo-ovulation and to decrease androgen production by the ovaries.

Ovarian cyst : A fluid filled balloon-like area in the ovary. Ovarian cysts measuring about an inch are usually follicles, although larger cysts may become a concern because rarely they may be tumors or even cancer.

Ovary : The ovaries are two glands located in the pelvis of women that produce hormones, including estrogens, androgens and progesterone; and release an egg or ovum. They are most active hormonally during the reproductive years (approximately 12-50 years of age).

Ovulation : Ovulation is the process of releasing an egg from the ovary. Ovulation must occur in order to become pregnant. When ovulation does not occur it is called anovulation. Women with PCOS commonly have difficulty becoming pregnant because they do not ovulate on a regular basis. Women who do not ovulate are said to be anovulatory.

Ovulation induction : Ovulation induction refers to treatments that improve and regulate ovulation in women seeking to become pregnant, for example women who suffer from PCOS. Common ovulation induction agents include clomiphene citrate (brand names include Serophene®, Clomid®) and human menotropins or gonadotropins (brand names include Pergonal®, Humegon®, Repronex®, Follistim®, Gonal-F®).

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Ovum : Ovum is the medical term for the eggs located in the ovarian follicles, and normally released on a monthly basis during ovulation.

Pancreas : The pancreas is a glandular organ located in the abdomen that is responsible for production of the hormone insulin. When the pancreas is unable to provide adequate insulin to maintain normal blood sugar levels diabetes develops.

PCOS : PCOS stands for the Polycystic Ovary Syndrome. PCOS was previously called Polycystic Ovarian Disease or Stein-Leventhal Syndrome.

Piaglitazone : Piaglitazone is a drug of the thiazolidinedione class that improves the sensitivity of the body to insulin. It is used in the treatment of diabetes, and is a promising treatment for insulin resistance in PCOS. A brand name of piaglitazone is Actos®.

Pituitary : The pituitary is a gland located at the base of the brain that is responsible for regulation of many body functions, including ovulation. Abnormalities in the pituitary can lead to irregular ovulation and symptoms similar to PCOS. Therefore, when diagnosing PCOS it is important to rule-out a pituitary abnormality that could explain irregular periods.

Polycystic ovaries : Polycystic is a term that simply means 'many cysts'. Because women with PCOS do not ovulate well the ovaries of these women usually contain many small follicles that have failed to ovulate, located just below the surface (a.k.a. cortex) of the ovary. The presence of these ovarian cysts leads to the typical "polycystic" appearance of the ovaries in PCOS, although this appearance can also be seen in other disorders that cause irregular or abnormal ovulation. [attach sono pix and bivalved ovary pix of PCOO ovary].

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Polycystic Ovary Syndrome : See " What is the Polycystic Ovary Syndrome (PCOS)?"

Polycystic Ovarian Disease : See PCOS

Progesterone : Progesterone is another female hormone. The ovary produces progesterone after ovulation occurs. Progesterone is responsible for creating an environment within the uterus that is receptive to a developing embryo. Progesterone also prevents the abnormal build-up of the endometrium. Progesterone is important for both pregnancy and protecting the endometrium against the development of cancer.

Progestins : Progestins usually refer to man-made progesterone-like hormones.

Prolactin : Prolactin is a hormone produced by the pituitary, a gland located in the brain behind the middle of the forehead. When prolactin is produced in excess, a condition called hyperprolactinemia, this can result in irregular or infrequent ovulation and oligomenorrhea in women. Therefore, when diagnosing PCOS it is important to measure prolactin levels that could explain the irregular periods.

Rosiglitazone : Rosiglitazone is a drug of the thiazolidinedione class that improves the sensitivity of the body to insulin. It is used in the treatment of diabetes, and is a promising treatment for insulin resistance in PCOS. A brand name of rosiglitazone is Avandia®.

Spironolactone : Spironolactone is a mild diuretic (a diuretic is a drug that increases ones ability to urinate and lose water from the body). Spironolactone also blocks the effect of androgens on the skin. It is very useful for the treatment of hirsutism. Side effects include frequent urination, excess thirst, low blood pressure, feeling tired or faint, dry skin, heart burn, and can cause birth defects in a male infant. A brand name of spironolactone is Aldactone®.

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Stein-Leventhal Syndrome : See PCOS

Sterility : Sterility is the inability to become pregnant. Sterility can be used in place of the term infertility. However, sterility is commonly used to describe a situation of more permanent infertility. For example, having ones tubes tied is a means of creating permanent sterility.

Testosterone : One of the principal male hormones or androgens .

Thyroid : The thyroid is a gland located in the neck. The thyroid gland produces thyroid hormones, which are responsible for regulating the metabolic rate. Abnormal production of thyroid hormones can lead to irregular menstrual periods. Thus, when evaluating for PCOS, it is important to rule-out the possibility of a thyroid disorder as a cause for irregular periods.

Uterus : The uterus is a muscular organ sitting above the vagina that is lined by endometrium, and is designed to carry a pregnancy. When not pregnant the uterus also causes the monthly vaginal bleeding, called menstrual bleeding or periods.

Uterine : Uterine refers to something involving the uterus, or womb. For example, the inner uterine lining is called the endometrium. Cancer of the uterus is commonly called uterine cancer. Another common example is fibroids, which are frequently called uterine fibroids.

Vaniqa® : Vaniqa® is a facial cream made of 13.9% eflornithine hydrochloride and marketed by Bristol Myers-Squibb and the Gillette Company. It has been found to decrease hair growth in women having "unwanted facial hair." It may be very useful for women with hirsutism, although hirsute women have not been specifically studied. In addition, the use of Vaniqa® on body parts other than the face has also not been studied, although it is very likely that it would work in these areas. It should be noted that it may take up to three months for the effects of Vaniqa® to be observed, and in order to observe a continued effect the cream must be used on a continuous basis. See "Related links" for more information on this cream.

Womb : Common name for the uterus.

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