Bushell Aiden, Crespi Bernard J
Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada.
Front Reprod Health. 2024 Sep 30;6:1475132. doi: 10.3389/frph.2024.1475132. eCollection 2024.
Polycystic ovary syndrome (PCOS) exhibits high prevalence and heritability despite causing negative impacts on fertility and fecundity. Previous hypotheses have postulated that some PCOS-associated traits, especially above-average levels of testosterone, were associated with benefits in ancestral environments. As such, PCOS would represent, in part, a maladaptive extreme of adaptations related to relatively high testosterone. To evaluate this hypothesis, we conducted a series of systematic literature reviews on the associations of testosterone levels, and prenatal testosterone metrics, with measures of strength, robustness, muscularity, and athleticism in females. We also systematically reviewed the literature on associations of testosterone with dominance in females and reviewed archaeological evidence concerning female strength and muscularity and its correlates. The main findings were fivefold: (1) elevated testosterone levels were generally associated with higher strength, muscularity and athleticism in females; (2) females with PCOS showed notable evidence of increased strength, muscularity, and athleticism compared to controls; (3) females with higher testosterone levels exhibited clear evidence of high dominance, (4) despite evidence that higher testosterone is linked with higher bone mineral density in healthy females, PCOS was not clearly associated with this phenotype; and (5) archaeological evidence from osteology, and data from some current small-scale societies, indicated that females often exhibit substantial levels of muscularity. Overall, the hypothesis that relatively high levels of testosterone are associated with benefits to females in some contexts was largely supported. These results provide evidence for the "maladaptive extremes of adaptation" model, with implications for treatment of females with PCOS and for future research.
多囊卵巢综合征（PCOS）尽管对生育能力产生负面影响，但发病率和遗传性都很高。以往的假说推测，一些与PCOS相关的特征，尤其是高于平均水平的睾酮，在祖先环境中具有益处。因此，PCOS在一定程度上可能代表了与相对较高睾酮水平相关的适应性的一种适应不良的极端情况。为了评估这一假说，我们对睾酮水平以及产前睾酮指标与女性力量、强健程度、肌肉量和运动能力的测量指标之间的关联进行了一系列系统的文献综述。我们还系统地回顾了关于睾酮与女性支配地位关联的文献，并审视了有关女性力量和肌肉量及其相关因素的考古证据。主要发现有五点：（1）睾酮水平升高通常与女性更高的力量、肌肉量和运动能力相关；（2）与对照组相比，患有PCOS的女性表现出力量、肌肉量和运动能力增加的显著证据；（3）睾酮水平较高的女性表现出明显的高支配地位的证据；（4）尽管有证据表明，在健康女性中较高的睾酮与较高的骨密度有关，但PCOS与这种表型并没有明显关联；（5）来自骨学的考古证据以及一些当前小规模社会的数据表明，女性通常表现出相当程度的肌肉量。总体而言，相对较高水平的睾酮在某些情况下对女性有益这一假说在很大程度上得到了支持。这些结果为“适应的适应不良极端情况”模型提供了证据，对PCOS女性的治疗和未来研究具有启示意义。
