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. 2022 Jun 14;20:88. doi: 10.1186/s12958-022-00959-6

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 8 — Overview of androgen synthesis pathways in women. Metabolic pathways of androgen synthesis in the adrenal glands and ovarian theca and granulosa cells. In PCOS (pink arrow), steroidogenesis seems to be diverted from adrenal to ovarian metabolic pathways due to CYP11A1, CYP17 and 3𝛽HSD hyperactivity in theca cells, resulting in increased intrafollicular levels of 17OH-pregnenolone, DHEA, ∆4-androstenedione and testosterone. PCOS = Polycystic Ovary Syndrome; DHEA = dehydroepiandrosterone; DOC = deoxycorticosterone