bluestar
Forum Guru
Topics: 236
Posts: 724
|
Dear Sakaki, I don't have a gyn book in hand. but could you plz summarize the vicious cycle you mentioned? starting from increased androgen...
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| Sakaki-
Forum Senior
Topics: 1
Posts: 238
|
It seems like every book has a slightly different take on PCOS... and I'm really not that interested in making a lot of sense out of it. After all, I'm not researching PCOS. ^_^
Increased androgen production -> increased acyclic estrogen production -> Increased pulsatile release of GnRH -> increase in GnRH receptors -> increase in pituitary LH sensitivity to GnRH -> increase in LH pulses -> decreased aromatase and increased theca cell stimulation -> increased androgen production -> decrease in follicular maturation -> increased inhibin -> decreased FSH -> decreased aromatase and increased theca cell stimulation (...) (blah blah blah)
In this mechanism, they propose a decreased hypothalamic inhibition as the primary cause. This "take" on PCOS doesn't even take the high levels of insulin into account.
I frankly think that your little blurb above with the summary does a much better job than this mess...
You'll be able to find it in an endocrinology textbook as well...but bleh...
|
| bluestar
Forum Guru
Topics: 236
Posts: 724
|
alright, this PCOS is causing me headache  Let's just close this chapter now.
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| Sakaki-
Forum Senior
Topics: 1
Posts: 238
|
Haha. Agreed. 
|
| Bela
Forum Guru
Topics: 76
Posts: 412
|
So, what's the treatment?
___________________
La vita e bella!
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
oops, its getting even more complex!! BRS patho says that
insulin resisitance--->incresed androgen synthesis in ovary ----> increased LH
how does it sound now? can anybody explain??
___________________
Sincerity and hard work are the keys to success!
|
| Sakaki-
Forum Senior
Topics: 1
Posts: 238
|
Some experiments have supported that hyperinsulinemia may cause hyperandrogenism (basic and clinical endocrinology, Greenspan, 7th ed). It goes on to state that insulin has a stimulatory effect on CYP17(alpha) in the ovary.
And the androgen synthesis might lead to the estrogen formation, which stimulates GnRH and increases LH pulses, as I stated earlier.
Treatment mainly involves estrogens (in the form of oral contraceptives), which decrease bioavailable androgens (via ovarian suppression and increased SHBG levels).
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
treatment options are wieght loss, OCPs, gonadotropin analougues and surgery
___________________
Sincerity and hard work are the keys to success!
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
ok lets leave the hormonal changes and believe that there is increased androgens, LH and decreased FSH. now lets explain how do these changes lead to:
1. amenorrhea
2. infirtility
3. obesity and
4. hirsutism
___________________
Sincerity and hard work are the keys to success!
|
| Gul
Forum Elite
Topics: 9
Posts: 259
|
In the treatment, I have seen physicians giving 'only' antidiabetics (the sole treatment) recently.........., any comments?
|
| Sakaki-
Forum Senior
Topics: 1
Posts: 238
|
The antidiabetics are to counteract the hyperinsulinemia, assuming that hyperinsulinemia is the primary defect (or at least partially responsible). It has been suggested that hyperinsulinemia and the elevated LH levels together potentiate the disordered folliculogenesis responsible for anovulation. But oral contraceptives may decrease the risk of endometrial cancer in the long run by counteracting the estrogenic environment.
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
come on guys, lets contribute.
___________________
Sincerity and hard work are the keys to success!
|
|
| |
| | | | | | | | | | | | |
