The Curbsiders Internal Medicine Podcast

#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD

10 snips
Mar 9, 2020
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INSIGHT

AMH Reflects Follicle Dysfunction

  • AMH is secreted by ovarian follicles and reflects ovarian reserve; levels >1 suggest normal reserve.
  • PCOS patients have elevated AMH due to many immature follicles that fail to mature because of androgen excess.
INSIGHT

Skin Signs Reflect Insulin Resistance

  • Look for physical signs of insulin resistance in PCOS: acanthosis nigricans, skin tags, and follicular keratosis.
  • These skin changes are reversible with improved insulin levels and metabolic control.
INSIGHT

Insulin Resistance Drives PCOS

  • Insulin resistance drives PCOS by stimulating ovarian theca cells to produce excess androgens.
  • Insulin also alters hypothalamic GnRH pulses and reduces SHBG, increasing free testosterone.
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