Which of the following hormones is increased in Polycystic Ovarian Syndrome?

AIIMS Patna NO - 2020

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Patna NO - 2020

Explanation

Polycystic Ovarian Syndrome (PCOS) is characterized by gonadotropic dysregulation, leading to increased pulsatility and secretion of Luteinising Hormone (LH) from the pituitary gland.
This results in an elevated LH to Follicle-Stimulating Hormone (FSH) ratio, which is a classic biochemical marker, often cited as being greater than 2:1 or 3:1.
The persistently high LH levels stimulate the theca cells of the ovary to overproduce androgens, which is a central feature of the syndrome and causes symptoms like hirsutism and acne.

Option A: This hormone is a precursor for cortisol synthesis in the adrenal glands. Its levels are not characteristically elevated in PCOS.
Option C: In PCOS, FSH levels are typically in the normal or low range. The key issue is the high ratio of LH relative to FSH.
Option D: TSH levels are not directly affected by PCOS. This test is part of the diagnostic workup to rule out other causes of menstrual dysfunction.

Clinical Relevance

Nursing practice connection: Knowing Hormonal profile of Polycystic Ovarian Syndrome (PCOS) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding the hormonal profile of PCOS is crucial for nurses in patient education, particularly regarding the link between high LH, androgen excess, and symptoms like infertility and hirsutism.
Nurses play a key role in explaining the rationale for various blood tests and helping patients manage long-term metabolic risks associated with PCOS, such as insulin resistance and type 2 diabetes.
What if? If a patient with suspected PCOS had a very high 17-OH progesterone level (e.g., greater than 200 ng/dL), the diagnosis would shift towards late-onset congenital adrenal hyperplasia (CAH), and the treatment would involve glucocorticoids rather than focusing solely on PCOS management.

How to Approach the Question

First, identify the core concept of the question, which is the hormonal changes in Polycystic Ovarian Syndrome (PCOS).
Recall the classic hormonal pattern associated with PCOS. A key feature is the dysregulation of gonadotropins from the pituitary gland.
Remember the characteristic finding: In PCOS, there is an increased release of Luteinising Hormone (LH) relative to Follicle-Stimulating Hormone (FSH).
Evaluate the options based on this knowledge. LH is expected to be high.
Consider the other options as part of a differential diagnosis. FSH is typically normal or low. TSH and 17-OH progesterone are tested to rule out other conditions (thyroid disease and congenital adrenal hyperplasia, respectively) that can mimic PCOS symptoms.

Concept Tested & Keywords

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