Ninatoka
PCOS
PCOS is characterized by ovarian cysts and irregular periods. it decreases fertility and is also associated with androgenic effects such as acne and male pattern hair growth. It is also often accompanied by conditions typically associated with metabolic syndrome, such as obesity, increased risk of diabetes mellitus, hypertension and lipid abnormalities.
In this overview, we explain the mechanics of PCOS.
1. Hyperinsulinemia. Hyperinsulinemia, typically resulting from a high carb diet is the motor of this condition. High glucose boosts insulin production. Chronic hyperinsulinemia leads to insulin resistance.
2. LH. PCOS patients have increased levels of Luteinizing Hormone (LH). In control groups, LH is increased by insulin administration, while this is not the case for PCOS patients. We can conclude that the LH production is disturbed in PCOS patients because of insulin resistance. LH stimulates the theca cells inside of the follicle. These cells are responsible for converting cholesterol into testosterone.
3. IGF-1. Insulin increases free IGF-1, which works as a growth stimulant, and has several effects (see further).
4. Testosterone. The production of testosterone in the theca cell is triggered by IGF. Normally this is a physiological response to the granulosa cell, who's responsible for the conversion of testosterone to estradiol, producing IGF to request more testosterone. While the granulosa cell should be able to keep up with the testosterone production to timely convert it to estradiol, in this case of hyperinsulinemia, this process is out of balance. As a result, PCOS patients have higher testosterone levels.
5. SHBG. Insuline decreases the synthesis of Sex Hormone Binding Globulin (SHBG). The function of SHBG is to bind sex hormones. As a result, the higher levels of testosterone are less bound and can actively have influence, e.g. on the sebaceous glands leading to acne.
6. Ovulation. Ovulation is to be triggered by a surge of LH. However, since LH is chronically elevatedin PCOS patients, this disturbs the process and can cause skipping ovulations.
conditionPolycystic ovary syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a highly prevalent disorder, representing the single most common endocrine-metabolic disorder in reproductive-aged women. Currently there are four recognized phenotypes of PCOS: 1) hyperandrogenism+oligo-anovulation+polycystic ovarian morphology; 2) hyperandrogenism+oligo-anovulation; 3) hyperandrogenism+polycystic ovarian morphology; and 4) oligo-anovulation+polycystic ovarian morphology, each with different long-term health and metabolic implications.
Ref:
Azziz R. Polycystic Ovary Syndrome. Obstet Gynecol. 2018 Aug;132(2):321-336. doi: 10.1097/AOG.0000000000002698. PMID: 29995717.
info@ninatoka.com
2022 by Visualized
Screen mode: desktop