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Can anyone explain to me how LH increase in PCOS? im a bit confused with regards the pathophysio of PCOS. thanks.
its kinda complicated process happens mainly in women with genetic predilection. its mostly about not only obesity or peripheral fat converts to estrogen via aromatase enzymes, but also the high insulin level (mainly) misses up the feedback of hypothalamic-pituitary-ovarian axis leading to this syndrome. Hyperinsulinemia increases GnRH pulse frequency, LH over FSH dominance, increased ovarian androgen production, decreased follicular maturation. to get out of any confusion and make it simple, Id say this;
High Insulin level, and peripheral fat both stimulate High androgen production (mainly Testosterone) thats would lead to the male s/s like hirsutism and virilization.
high estrogen (from the periphery) leads to feedback inhibition of FSH, so low FSH level.
now, when you have NO ovulation------> no progesterone ---------> Stimulation to LH (+FB) from the ant. pituitary.
High LH, low FSH = High LH/FSH ration.
both high LH, and Hyperinsulinemia lead to high testosterone level? why not progesterone? cuz no mature follicules to do so! so, it goes the other way.
hope that helps.
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