The response of several adrenocortical steroids to the administration of ACTH in hirsute women

Thirty-three women with hirsutism and oligomenorrhea were stimulated with synthetic adrenocorticotropin, as well as 12 controls. Of these test subjects 20 demonstrated significantly greater rises of serum levels of 3,17-dihydroxy-5-pregnen-20-one as well as dehydroepiandrosterone sulfate suggesting an attenuated deficiency of 3 beta-hydroxysteroid dehydrogenase. Five did not show similar rises of these compounds but revealed significant elevations of 17-hydroxyprogesterone as would be expected in 21-hydroxylase deficiency. None of the subjects were virilized. Eight additional hirsute women were not different than the normals. It appears that a subtle deficiency of 3 beta-hydroxysteroid dehydrogenase may be more common as an explanation of a syndrome resembling polycystic ovarian disease than has been previously recognized.