
The Curbsiders Internal Medicine Podcast #198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD
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Mar 9, 2020 AI Snips
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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.
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.
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.
