Clinical Medicine Insights: Women's Health

Background: Estrogens are thought to possess antioxidant properties in vivo, with estradiol being the most biologically active and available. Unlike ovulatory women, those with polycystic ovary syndrome (PCOS) have a relative steady-state serum estradiol concentration across a typical month. To better understand the antioxidant role of serum estradiol in premenopausal women, we evaluated biomarkers of oxidative stress at two time points in both ovulatory and anovulatory cycles (ie, women with PCOS).

Methods: A total of 16 women (7 PCOS, 9 ovulatory) completed this study. Ovulatory women were tested on cycle day 3, and again on cycle day 21. Women with PCOS were tested at a random time and returned to the clinic 14 days later. At each visit, blood was collected for determination of malondialdehyde (MDA), hydrogen peroxide (H2O2) and Trolox Equivalent Antioxidant Capacity (TEAC). Estradiol, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were also measured.

Results: There were no significant differences observed in any oxidative stress biomarker between ovulatory and PCOS women. Estradiol levels were positively correlated with TEAC in women with PCOS (r = 0.57; P = 0.03), but not in ovulatory women. While not statistically significant, negative correlations were noted between estradiol and MDA and estradiol and H2O2 in women with PCOS but not in ovulatory subjects.

Conclusions: Our data indicate that oxidative stress biomarkers do not differ between PCOS and ovulatory women. The changing estrogen level that occurs throughout ovulatory cycles does not appear to impact overall oxidative status when compared to the relative steady-state estradiol levels in PCOS subjects in our study. Furthermore, estradiol may be associated with antioxidant status and biomarkers of oxidative stress in women with PCOS but not in those with regular menstrual cycles.