Polycystic Ovarian Syndrome/Disease (PCOS) is simply a condition that indicates NO ovulation is taking place. Ovulation is the successful maturation of a follicle and the movement of an egg from the ovary and into the tube during the ovulation (mid-cycle) phase.
Let’s delve deeper into how reproductive hormones influence PCOS
Progesterone
This hormone induces/initiates the start of the menses. Women experiencing skipping of menses for days or months could be suffering from low levels of the progesterone hormone.
It is also responsible for the protection of pregnancies and the prevention of miscarriages, especially if the levels do not rise to adequate levels during the 1st trimester of pregnancy.
Follicle Stimulating Hormone (FSH)
It is responsible for the:
Regulation of menstrual flow with an average of 3-5 days
Pre-ovulation: stimulation/enlargement of a follicle up to 3cm, on or about the 12th day after the start of menses, up until the follicle erupts/bursts on or about the 14th day after the start of the menses.
High or low levels can lead to either prolonged menstrual flow or enlargement of the follicle but no eruption (<3cm), leading to either an ovarian cyst or polycystic ovarian syndrome/disease. It also causes an increase in hot flashes in women who are already in menopause.
Luteinizing Hormone (LH)
Luteinizing hormone (LH) is responsible for the movement of the mature egg, after the eruption of the follicle, into the fallopian tube.
High or low levels can lead to PCOS or anovulation (no ovulation) due to the egg not being moved into the fallopian tube.
Estradiol/Estrogen
Estrogen indicates the fertility status of a woman.
It controls the thickening of the endometrium (blood accumulating in the uterine muscle) after menses up to about 6mm and the thinning of the endometrium after ovulation, resulting in blood flowing out of the endometrium.
Levels rise tremendously during pregnancy, allowing for the cervix to be closed and the endometrial muscle to be strong enough to sustain the pregnancy to full term.
High levels indicate ‘false pregnancy’ which can present with symptoms of pregnancy: sensitive and heavy breasts, nausea, delay of menses and bloatedness. High levels can also prevent the ovaries from releasing an egg; one cannot get pregnant when there’s already an “existing pregnancy”, leading to infertility. High levels are also known to cause conditions like fibroids, endometritis ((inflammation of the endometrium (>8mm)), prolonged and heavy menstrual flow, endometriosis (overgrowth of the endometrial tissue in areas outside of the uterine cavity), premature breast milk discharge in non-lactating women, fibroadenoma (non-cancerous fatty breast growth), and certain reproductive related cancers such as ductal (breast) carcinoma,
Low levels on the other hand indicate ‘false menopause’ leading to infertility, disruption of the vaginal PH which in turn can cause recurrent vaginal infections and vaginal dryness, and disruption of bone health (osteoclasts and osteoblasts) causing conditions like osteoarthritis and osteoporosis.
Anti-Mullerian Hormone (AMH)
Anti-Mullerian Hormone (AMH) indicates the quality and number of eggs in the ovaries.
Conclusion
PCOS is not a stand-alone condition but merely an indication of hormonal imbalance that could have resulted from one being genetically predisposed, overweight, improper lifestyle practices and use of drugs or contraceptives that interfere with one’s hormones.
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