POS
occurs in 3% of adolescents and adults,increased risk of endometrial cancer.increased pituitary synthesis of LH and decreased synthesis of FSH.
increased LH increases androgen synthesis-hirsutism occurs more often than virilization.androgens are aromatized to estrogen in the adipose cells .increased estrogen increases risk for endometrial carcinoma .increased estrogen has positive feedback on LH and negative feedback on FSH.suppression of FSH causes follicle degeneration.
Oligomenorrhea is the most common compliant, POS manifest with hirsutism,infertility,obesity.LH:FSH ratio >2,increased serum testosterone and androstenedione ,increased serum estrogen
TREATMENT-weight reduction in obese women,low-dose OCPs or medroxyprogesterone (suppress ovarian steroidogenesis and LH),spironolactone if OCPs unacceptable (block androgen receptors on hair follicle),LH-releasing hormone analogues (inhibit ovarian androgen production),clomiphene- for womens who want to get pregnant