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.
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).
@@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!
@@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.
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.
very nice teaching. thanks a lot
Please do more videos ! I can’t believe how I found ur channel !!!!
awesome... really well explained👌
Wow! Thank you ❤
❤❤❤❤❤❤
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.
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).
@@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!
@@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.
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.