The symptoms
of PCOS are associated with abnormalities in some of the hormones that
control the menstrual cycle. These abnormalities typically include:
higher than normal levels of LH and of androgens, and below normal
levels of FSH and progesterone. The most important androgen is
testosterone, which is oroduced by all women from the ovaries.
Testosterone is a normal and essential product of the ovary because most
of it is converted, within the ovarian follicle, to oestrogen, which is
the main female hormone.
Women with PCOS produce higher than average amounts of testosterone from
the ovaries, and it is this that results in many of the symptoms of the
condition. Testosterone is often thought of as a ‘male hormone’, but
this is not the case – it is just that men produce 10 times as much
testosterone as women. Women with PCOS usually have a testosterone
measurement that is either slightly above the female range or at the
upper end of the normal range for women.
It is also thought that another hormone – insulin – may be involved in
the development of PCOS. Insulin is a hormone produced by the pancreas
to regulate the level of glucose in the blood. Many women with PCOS have
been found to have a condition known as insulin resistance, in which
the body’s tissues are resistant to the effects of insulin (particularly
on the ability of insulin to get glucose into muscle tissue), so the
body has to produce more insulin to compensate. It seems that these high
levels of insulin then affect the ovaries, contributing to the abnormal
hormone environment.
Doctors do not yet fully understand what causes these hormonal
abnormalities. It may be that there are several causes, which could
explain why different women have such different symptoms. Much research
is still going on in this area. It is currently thought that there is a
hereditary link, whereby some women inherit a greater chance of having
PCOS, but whether or not these women actually develop PCOS depends on a
number of additional factors. These factors include diet and lifestyle.
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