What is the relationship between polycystic ovary syndrome (PCOS) and SHBG levels?

In polycystic ovary syndrome (PCOS), there is typically a decrease in sex hormone-binding globulin (SHBG) levels. This reduction can be attributed to the hyperandrogenic state often present in individuals with PCOS. Elevated levels of androgens can suppress the production of SHBG in the liver, leading to lower circulating levels of this protein.

SHBG plays a critical role in regulating the availability of sex hormones, particularly testosterone and estradiol, by binding to them and preventing their action. When SHBG levels are low, there is an increase in the free, biologically active form of these hormones, which can contribute to the symptoms associated with PCOS, such as hirsutism, acne, and menstrual irregularities. This relationship underscores the importance of assessing SHBG levels in the clinical evaluation of patients with PCOS, as it provides insights into their hormonal balance and can guide treatment strategies.

Understanding the dynamics between PCOS and SHBG is crucial for managing the condition effectively, particularly in regard to addressing metabolic and reproductive health concerns that arise from this hormonal imbalance.