Androgen receptor-dependent myometrial remodeling links hyperandrogenism to prolonged second-stage labor in PCOS

Androgens can influence smooth-muscle function through both transcription-dependent AR signaling and rapid non-genomic pathways. In uterine smooth muscle, acute exposure to high androgen concentrations produces relaxation, in part through effects on calcium flux and contractile signaling.

However, the concentrations used in these experiments are typically in the micromolar range, well above physiological circulating levels, and therefore primarily address acute pharmacologic effects rather than the consequences of sustained androgen excess in vivo.Labor depends on coordinated myometrial excitability and intercellular coupling, which are dynamically regulated by steroid hormones, oxytocin, prostaglandins, calcium signaling, and gap-junction proteins.