Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Med Hypotheses. 2018 Jan;110:42-45. doi: 10.1016/j.mehy.2017.10.019. Epub 2017 Oct 23.
One of the diagnostic features of polycystic ovary syndrome (PCOS) is elevation of the androgen, testosterone. It is known that women with PCOS are more likely to suffer from psychological problems, especially anxiety and depression, than other women. However, little is known of how much of this is due to testosterone, and if so, what the mechanism(s) might be. This study explores the hypothesis that testosterone impacts women with PCOS both directly and indirectly, via testosterone currently in the bloodstream and through prenatal exposure. It is hypothesised that direct effects occur when testosterone acts directly upon receptors; indirect effects occur where the impact of testosterone is mediated via another variable; activational effects are ephemeral and are caused by testosterone in the bloodstream; organizational effects occur prenatally and cause permanent changes. Four pathways are hypothesised in this paper: 1/ a direct and activational pathway which improves mental rotation ability; 2/ an indirect and activational pathway, whereby distress is caused when the physiological symptoms of testosterone are experienced as embarrassing or otherwise disturbing; 3/ an indirect and organizational effect on mood, where elevated prenatal testosterone predisposes women with PCOS to low blood sugar levels and thus low mood; 4/ and finally, it is suggested that the pathway from biology to psychology can be travelled in reverse, with a direct activational effect of relaxation training on the reduction of adrenal androgens. Testing these hypotheses has important implications for our understanding of PCOS, and our ability to treat this condition more effectively.
多囊卵巢综合征（PCOS）的诊断特征之一是雄激素，即睾酮水平升高。众所周知，与其他女性相比，患有 PCOS 的女性更容易出现心理问题，尤其是焦虑和抑郁。然而，人们对导致这种情况的原因有多少是由于睾酮，以及如果是这样，其机制是什么，知之甚少。本研究探讨了这样一种假设，即睾酮通过目前在血液中的睾酮以及通过产前暴露，对患有 PCOS 的女性产生直接和间接的影响。假设直接作用发生在睾酮直接作用于受体时；间接作用发生在睾酮通过另一个变量产生影响时；激活作用是短暂的，是由血液中的睾酮引起的；组织作用发生在产前，导致永久性变化。本文假设了 4 种途径：1/ 直接和激活途径，可改善心理旋转能力；2/ 间接和激活途径，当体验到睾酮的生理症状令人尴尬或其他令人不安时，会导致痛苦；3/ 对情绪的间接和组织作用，升高的产前睾酮使 PCOS 女性易出现低血糖，从而导致情绪低落；4/ 最后，建议生物学到心理学的途径可以逆行，放松训练对降低肾上腺雄激素有直接的激活作用。这些假设的检验对我们理解 PCOS 以及更有效地治疗这种疾病具有重要意义。
