PCOS

Question 1

Pathphysiology of PCOS

Answer 1

1. Theca cells produce excess LH
2. Stimulates excess androgen production
3. Excess androgen is converted to esterone in adipose tissue
4. Excess LH negatively feedback FSH levels
5. Decreased sensitivity to insulin -> low levels of SHBG

Question 2

High levels of LH cause

Answer 2

1. Low sensitivity to insulin (hyperinsulaemia)
   - > type 2 diabetes
   - > Low levels of sex hormone binding globulin which binds oestrogen and androgen togather, leaving higher levels of both in the blood.
2. Increase androgen release from theca cells and adrenal glands

Question 3

Excess oestrogen in PCOS

Answer 3

1. lower levels of SHBG

2. Testosterone is converted to oestrogen in peripheral fat

Question 4

Impacts of excess oestrogen in the body

Answer 4

1. Excess oestrogen causes adrenal gland hyperplasia

Question 5

Clinical manifestations

Answer 5

1. Amenorrhea - increased oestrogen, lack of FSH prevents ovulation and causes follicular degeneration
2. Hisutism - excess androgen leads to excessive hair growth
3. Cysts develop in ovaries leading to infertility ( polycystic ovaries do not have to be present for diagnosis to be made)
4. Obesity - too much adipose tissue
5. Type 2 diabetes