about 50-60% of women is obese...so wont necssarily be obese but majority will be obese. obese cause insulin resistance.
the androgen doesnt cause fat production bt excess fat cells convert the androstenedione to testesterone. so excess testesterone.
why innsulin resitance in the first place? Becase of geentic, deitary and ifestyle like obesoty and smoking etc
oestrogen is needed to grow the endomtrium and then progesterone is needed to stablaise it in its secretory phase and finally when both drops it leads to bleeding.
but in this condition there is chonically increased estrogen which is coming from the chronically increased androgen ...being converted by the aromatase enzyme. so theres only the growth phase of the endometrium..more and more...leaading to delayed and delayed periods....since the syscle is kinda long and distubred...and finally it will outgrow its capillaries and starts bleeding intermettently so will complian of bleeding every few weeks and long term bleeding as well.
need only 2 out of the above 3.
so someone with mentrual cycle abnormalaties an with hiruitsim can be diagnosed with pcos.
and ultrasound itself isnt enough becase 25% of normale women can have cysts too.
LH high isnt needed for diagosis and rotterdams criteria
Congenital adrenal hyperplasia can lead to increase androgen as well = because andrenals are another place where testesterone is produced. ITs a DD and not a cause of PCOS.
obseirty means excess fat cells that can convert testerone to oestrogen
CAH is only common in caucasian women and ashkwenazi jews
but rule out this in young girls at around puberty presenting with these sypmtoms
and diagnose pcos using the rotterdams criteria
2 out of 3
its like causes ovarian supression. the E and P in the pill keeps the uterus lining up.
So it like disconnects the ovarian with the uterine cycle.
same reason why it helps with hirtuim it also decreases the libido.
so both pcos and ocp has increased estrogen level bt with pcod androgen is also increased because increased ovarian activity and oestrogen is increased as a result from conversion from androgen
but in ocp..ovaries is supppressed and effect on sex hormone binders...both reduce androgen and free androgen levels in the body
wont ocp also leads to chronicallyelevated oestrogen levels and chronically levetaed lh levels? ...no..the dosages used here are high and causes inhibition of both fsh by E and LH by P
but not cause disturb follicular growth as for that androgen is involved and not oestrogen
But not ovulation becaause the characteristics oestrogen peak followed by LH srge is needed for that.
but pcos causes chronically elevated LH levels by positive feedback
OCP can be taken for longer duration...even for years at a time..and have ther positive effecrs as well..... is safe for long term use.
Extra stuff important
