Antidiuretic Hormone and PCOS

Antidiuretic hormone, or ADH, is a hormone that is produced in the hypothalamus and released by the pituitary gland. Its primary job is to maintain blood pressure, blood volume and tissue water levels.

Women with polycystic ovarian syndrome, or PCOS, are at risk for high blood pressure and may have an imbalance of ADH.

Also known as vasopressin, ADH promotes smooth muscle contraction and causes the body to retain water, helping to prevent dehydration.

ADH secretion is activated when specialized cells in the brain or heart detect a change in the concentration of the blood or blood pressure.

Once released, ADH travels to the kidneys where it signals specific cells to reabsorb water from urine that is stored in the kidneys, preventing water from being lost through urination. This increases both the blood volume and blood pressure.

High ADH levels can cause water retention. A condition known as Syndrome of Inappropriate Anti-Diuretic Hormone secretion (SIADH) produces excess ADH to be released when it isn’t needed.

Excessively high ADH levels may be a side-effect of certain medications or caused by a disease or tumor in the lungs, hypothalamus or pituitary gland.

Drinking alcohol, on the other hand, inhibits the release of ADH, resulting in an increase in urine production and dehydration.

Symptoms of an imbalance of ADH include nausea, vomiting, muscle cramps, confusion, and convulsions.

Your doctor may order an ADH test if you are experiencing excessive thirst, frequent urination or dehydration, or have abnormal blood sodium levels. The test may also be called AVP or arginine vasopressin.

Getting an accurate measurement of ADH, however, can be tricky, because it is a very small molecule with a short half-life. Doctors sometimes use copeptin as a surrogate for ADH. Copeptin has been linked to atherosclerosis and heart disease, and may be used to identify heart attacks in the early stages.

A recent study published in the Journal of Ovarian Research found higher levels of copeptin play an important role in metabolic response and the development of atherosclerosis in insulin resistant, hyperandrogenemic women with PCOS.

Another study found, in women with PCOS, copeptin levels are higher in obese patients than in those of normal weight, and recommends testing for copeptin to assess cardiovascular risk in PCOS patients.