FA 2020 654
"Hyperinsulinemia and/or insulin resistance hypothesized to alter hypothalamic hormonal feedback response higher LH:FSH, higher androgens (eg, testosterone) from theca interna cells, and decrease rate of follicular maturation producing unruptured follicles (cysts) + anovulation"
PCOS: Hyperinsulinemia and/or insulin resistance hypothesized to alter hypothalamic hormonal feedback responseLH:FSH,androgens (eg, testosterone) from theca interna cells,rate of follicular maturationunruptured follicles (cysts) + anovulation. Common cause offertility in females. Enlarged, bilateral cystic ovaries A ; presents with amenorrhea/oligomenorrhea, hirsutism, acne, fertility. Associated with obesity, acanthosis nigricans.risk of endometrial cancer 2° to unopposed estrogen from repeated anovulatory cycles. Treatment: cycle regulation via weight reduction (peripheral estrone formation), OCPs (prevent endometrial hyperplasia due to unopposed estrogen); clomiphene (ovulation induction); spironolactone, finasteride, flutamide to treat hirsutism. FA2021 669
submitted by ∗mcl(671)
Patient likely has PCOS. PCOS is associated with elevated levels of LH from the pituitary, which stimulates ovaries to produce increased amounts of sex steroids (including androgens --> hirsutisim). Androstenedione is converted to estrone in adipocytes, which results in still further increased release of LH. Obesity and insulin resistance is associated with PCOS.