Link Between PCOS And Testosterone

[haidut]

So it sounds like DHEA is behind excessive body hair, not testosterone, right? I've never fully understood RP' view on DHEA. Can it be high in PCOS to be protective against estrogen?

It is actually DHT, as DHEA gets converted easily into DHT in peripheral tissues like skin. This will not show up on blood tests, if anything is high it will be the DHEA but it is a pro-hormones for DHT and DHT (and maybe T but to a lesser degree) is what causes the surface androgen symptoms like acne and hairiness.

 

[haidut]

Yep, at least in my situation because my testosterone was not super high.......I think high DHEA is one way a hypothyroid body compensates for not having enough thyroid hormone and then my body was converting some excess DHEA to estrogen too because I was very estrogen dominate.

I'm not entirely certain on all of this...it's my best guess based on my labs and my particular pattern. I really don't know anything about PCOS, I guess I thought it involved too much estrogen and cortisol?

It is DHT, not DHEA. DHEA is just the precursor for DHT. On blood test you may see elevated DHEA (but sometimes it is normal) and then that DHEA gets converted into DHT in peripheral tissues. DHEA is a very good pro-hormones for DHT as it can bypass the step where it passes through T before becoming DHT. There is an alternative pathway for DHEA to become DHT and it skips T altogether. See study below.
Dihydrotestosterone synthesis bypasses testosterone to drive castration-resistant prostate cancer

 

[snowboard111]

In one of the podcast, you and Danny talk about how DHEA raise in period of stress. Would you apply that thinking in the case of body hair as well?
Estrogen raise (prolactin, cortisol,etc) -> DHEA raise -> DHT (bodyhair)

 

[Peatit]

It is actually DHT, as DHEA gets converted easily into DHT in peripheral tissues like skin. This will not show up on blood tests, if anything is high it will be the DHEA but it is a pro-hormones for DHT and DHT (and maybe T but to a lesser degree) is what causes the surface androgen symptoms like acne and hairiness.

I can't find it but another thread pointed to this interesting study linking body hair to estrogen not DHT:
Sex hormone levels and body hair growth in !Kung San and Kavango men from Namibia. - PubMed - NCBI

 

[haidut]

I can't find it but another thread pointed to this interesting study linking body hair to estrogen not DHT:
Sex hormone levels and body hair growth in !Kung San and Kavango men from Namibia. - PubMed - NCBI

Estrogen irritates the adrenals and makes them pump out DHEA. So, estrogen is the prime cause of things like chest hair and PCOS but the direct symptoms like acne and chest hair are due to local conversion of DHEA into DHT. Remember, DHT production is upregulated under stress. The mechanism for this is the increased DHEA output concurrent to balance the cortisol/estrogen due to stress. Obviously, I would not advocate stressing yourself in order to increase DHT synthesis.
DHT production depends on stress

 

[Orangeyouglad]

It is actually DHT, as DHEA gets converted easily into DHT in peripheral tissues like skin. This will not show up on blood tests, if anything is high it will be the DHEA but it is a pro-hormones for DHT and DHT (and maybe T but to a lesser degree) is what causes the surface androgen symptoms like acne and hairiness.

So assuming we don’t want acne and hairiness, how would be lower Dhea/Dht locally? Would lowering estrogen help with this?