Polycystic ovarian syndorme, PCOS (mechanism of disease)

This is a mechanism of disease flowchart for polycystic ovarian syndrome, covering the etiology, pathophysiology, and manifestations of PCOS.
ADDITIONAL TAGS:
Pharmacology / toxicity
Infectious / microbial
Biochem / molecular bio
Mutation
Signs / symptoms
Labs / tests / imaging results
Polycystic ovarian syndrome
Core concepts
Social determinants of
health / risk factors
Hormone changes
Genetics / hereditary
Mass effect
Pathophysiology
Etiology
Manifestations
↑ luteinizing hormone (LH) produced by pituitary
Hyperinsulinemia, peripheral insulin resistance
Hirsutism: hair on chin, upper lip, chest, abdomen, back, butt
Functional ovarian hyperandrogenism
Metabolic syndrome (obesity, DM2)
Prematurely luteinize granulosa cells
Fat accumulation
Stimulate theca cells
↑ estrogens
Infertility
Unknown intrinsic ovarian defects
Stimulated keratinocyte and dermal fibroblast proliferation → epidermal hyperplasia and hyperpigmentation
Acanthosis nigricans
Disrupted LH / FSH balance
↓ FSH
Impaired follicle maturation with cyst formation due to lack of follicle rupture
anovulation / oligoovulation
↑ insulin-like growth factor 1
Endometrial hyperplasia
↑ risk of endometrial carcinoma
↓ SHBG
Sleep apnea
NAFLD
Androgenetic alopecia
Acne vulgaris
Oily skin
Menstrual irregularities (primary or secondary amenorrhea; oligomenorrhea; menorrhagia)
Depression
Anxiety disorders
Gross: brown, small, uniform cysts in circle in subcapsular region of the ovary
Histo: ovarian hypertrophy, thick capsule; enlarged cystic follicles; stromal hyperplasia and fibrosis; hyperluteinized theca cells, smaller granulosa cell layer
Genetic predisposition?
AMH, AMHR, GNAS1, DENND1A
Lifestyle?

Пікірлер: 9

  • @user-bl1zd7bc7r
    @user-bl1zd7bc7r Жыл бұрын

    Please do more videos ! I can’t believe how I found ur channel !!!!

  • @rahafrahaf73886
    @rahafrahaf7388611 ай бұрын

    Wow! Thank you ❤

  • @namrathas4418
    @namrathas44187 ай бұрын

    awesome... really well explained👌

  • @user-ww3yc1jg8z
    @user-ww3yc1jg8z8 ай бұрын

    ❤❤❤❤❤❤

  • @annt2070
    @annt20709 ай бұрын

    How can PCOS be explained when androgens are normal and LH/FSH ratio and estrogen is normal? Because based on the diagnostic criteria - oligomenorrhea + polycystic ovaries are enough.

  • @tchachef

    @tchachef

    9 ай бұрын

    There is a multiple origins to hyperandrogenisme. When you have normale Testosterone , you have to check SDHEA and androstenedione to evaluate other origins , including adrenal. Also, genetic predispositions of hypersensitivity to peripheric receptors to androgens exist. So even with normal androgens, if you have thios transmission or you have obese patients , you may have clinical hyperandrogenism ( cortisol effect included in this pathophysiology).

  • @annt2070

    @annt2070

    9 ай бұрын

    @@tchachef Thank you for the response! The mentioned hormones (SDHEA and androstendione + prolactin, TSH and other hormones) are all normal. The patient is just a little overweight, but admits to a bad diet. No acne, no hirsutism. Just oligomenorrhea + multifollicular ovaries. The hypersensitivity might be a good explanation, but does it mean that there should also be acne/hirsutism? Basically what I don't understand - no hyperandrogenism in labs AND no clinical hyperandrogenism, the complaint is just irregular periods. When I read about PCOS all the pathophysiology mechanisms involve androgens or LH/FSH ratio changes, thats why I was confused how it is explained. But the hypersensitivity is a possible explanation, thanks!

  • @tchachef

    @tchachef

    9 ай бұрын

    @@annt2070 Pcos pathophysiology is extremely complex. All the mentioned features including ratio FSH/LH among others are not constant. What we are sure about is the involvement of the environment in triggering these features. For example , the simple fact of eating a regimen rich in carbohydrate and gaining few kg , are sufficient to trigger at least one criteria of pcos : especially hyperandrogenism. So when you have these crietria, after excluding other diagnosis of hyperandrogenism : the treatment is especially based on healthy life style, sports , good sleep, etc ...medical treatment comes after.

  • @ValentinaD-zy5tj
    @ValentinaD-zy5tj5 ай бұрын

    Totally unexpected, feeling how it began to shrink and eventually disappear within 2 months was so liberating. I followed the steps I mentioned, and within the first 2 weeks the bloating was gone. I simply go'ogled Tilly Strankten's Ovarian Cyst Guide and it's like I hit the feel-good reset button lol.