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What is PCOS

a heterogenous disorder in which the ovaries have a thick and fibrotic cortex and are 2x normal size. They contain numerous cystic follicles, have ovulatory dysfunction, androgen excess and obesity (40%).


What role does the increased level of androgens play in this disorder?

It results in premature follicular atresia, multiple follicular cysts and anovulatory state. Also produces more masculine traits in a female (hirsutism), acne and alopecia.


What is the hormonal chain of events in PCOS?

An increased release of GnRH from the hypothalamus resulting in increased LH (and some increased FSH) from the pituitary and therefore increased thecal cell production of androgens arresting follicle growth.


What causes the increased number of GnRH pulses?

Insulin and IGFs. The increased pulsing favors the release of LH. Frequency is not influenced by BMI but amplitude is.


How can PCOS be detected in testing?

increased LH levels in the urine and plasma