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Polycystic ovary syndrome (PCOS) is an ovarian disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Perhaps the most common female endocrinopathy. PCOS affects young women with oligo-ovulation (which can cause oligomenorrhea), infertility, acne, and hirsutism. It also has important metabolic consequences, including the risk of diabetes and cardiovascular risk factors, and long-term treatment.


Diagnostic criteria

first urine and then serum, researchers noted gonadotropin abnormalities with elevated LH levels, and then as androgen dosages evolved, elevations in androgen levels.

Etiology and pathophysiology

There are three general theories for the etiology of PCOS:

Primary Disorders of Gonadotropin Secretion

The first biochemical abnormality identified in women with PCOS is irregular gonadotropin secretion, with a relative preponderance of LH over FSH. When the theory of two ovarian salts developed, that is, thecal salt can only produce LH stimulating androgens, while the granulosa salt can only aromatize androgens from salt to estrogen under the influence of FSH, this LH preponderance is considered to be the main etiology of the syndrome. Excess LH causes thecal development salt and excess androgen production, but when insufficient FSH stimulation salt granulosa development and aromatase production, the androgen is not converted to estrogen, which causes various disorders. This theory explains the morphology of the ovary, hirsutism, and anovulas. An excess of androgens leads to the arrest of ovarian follicles in the preantral stage because estrogen is important for the development and selection of dominant chant follicles. The ovary contains numerous small preantral follicles due to continuous processes and increased central stroma due to thecal hyperplasia and excess stroma from irregular gonadotropin exposure. Finally, excessive circulating androgens cause pilosebaceous unit stimulation, increase sebum production, cause terminal hair differentiation, and in rare cases on the scalp cause pilosebaceous unit atresia and androgenic alopecia.


Obesity tends to reduce early LH levels and GnRH stimulation levels in women with PCOS although their responses remain elevated when compared to age- and weight-matched control women. The ontogeny of irregular gonadotrophin secretion may be present in pubertal hyperandrogenemia, because the GnRH pulse generator shows insensitivity to progesterone feedback in hyperandrogenic obese adolescent girls, thus maintaining the state of irregular gonadotropin secretion.

Primary Ovarian and Adrenal Hyperandrogenism.

 Since most of the diagnostic criteria support the idea that PCOS is an ovarian disorder, it is the main target that causes the syndrome. Ovarian steroidogenesis is disturbed in a syndrome with increased circulating androgen levels that is frequently noted in women with PCOS stigmata. Intrafollicular androgen levels are more likely to increase in the antral follicles, supporting insufficient granulosa aromatase activity. Family studies also support a high prevalence of hyperandrogenemia and hyperandrogenism in first-degree relatives of women with PCOS. Finally, 20-30% of women with PCOS have evidence of adrenal hyperandrogenism, mainly based on high levels of DHEAS, an androgen marker of adrenal function, which indicates that the defect in steroidogenesis mainly affects the androgen secretion glands, that is, the ovaries and the adrenals.

Ovarian factors other than dysregulated steroidogenesis can cause PCOS.

Major Disorders of Insulin Resistance

 Women with PCOS show various abnormalities in insulin action. Dynamic studies of insulin action, including hyperinsulinaemic euglycemic pincers and intravenous glucose tolerance tests, which are often sampled, show that women with PCOS are more insulin resistant than weight-matched control women, with defects mainly in skeletal muscle. At the beginning of the ontogeny syndrome, as in the ontogeny of type 2 diabetes, it is characterized by increased production of insulin beta salt pancreatic chant to control the level of glucose around. Thus, many women with PCOS experience fasting and mealtime hyperinsulinemia.

Finally, increased insulin levels are associated with peripheral availability of sex steroids through impacting sex-binding hormone circulating globulin (SHBG).

Obesity per se is associated with insulin resistance and compensatory hyperinsulinemia. Obese women may be ovulating but having a longer chant follicular phase and longer chant menstrual cycle may cause them to be misdiagnosed as oligo-ovulatory. In addition, as mentioned above, obesity can reduce circulating SHBG levels,

leading to higher levels of free or bioavailable testosterone and leading again to a potential misdiagnosis of PCOS.



Clinical presentation


Women with PCOS commonly experience menstrual disturbances (from amenorrhea to dysfunctional uterine bleeding) and infertility, as has been the case since the syndrome was first described. PCOS usually appears during or after menarche. Premature pubarche occurs in girls with hyperinsulinemia and high DHEAS levels.

Women with PCOS have elevated testosterone levels compared to controls, suggesting that mild elevations may be familial and persistent.

Skin disorders, mainly due to peripheral androgen excess, such as hirsutism and acne, and to a lesser extent androgenic alopecia, are common in women with PCOS.



• Infertility due to Chronic An ovulation

• Skin disorders: Androgenic alopecia, acanthosis Nigerians,

• Gynaecological Cancer: ovarian, breast, and endometrial carcinoma.

• sleep apnea

• Non-alcoholic fatty liver disease (NAFLD)

• Type 2 Diabetes Mellitus.

• Cardiovascular Disease.

• mood disorders.



Nutritional intervention is a promising approach for the treatment of PCOS. Omega-3 and polyunsaturated fatty acids (PUFAs) have been found to be beneficial, as they are anti-inflammatory and have an effect on insulin sensitivity, cell differentiation, and ovulation function. A moderate reduction in dietary carbohydrates reduces fasting and post-challenge insulin concentrations among women with PCOS, which, over time, may improve reproductive/endocrine outcomes.

Seed cycles have often been used to help a woman's hormones provide the nutrients she needs in certain phases of her cycle.

The seed cycle involves eating certain seeds to support the key hormones of each phase of the menstrual cycle. This activity is considered a "food is medicine" exercise. The seeds provide an incredible supply of zinc, which aids in testosterone production. Women need testosterone too. However, it must be balanced. Too much testosterone can be a problem, and this imbalance is usually seen in women with PCOS. which is commonly experienced.

 The seed cycle includes supplements with four unique seeds: pumpkin seeds, flax seeds, sesame seeds, and sunflower seeds. These seeds are eaten daily, not cooked and ground. Whole seeds may not break down completely in the gut, so grinding them allows the body to extract additional nutrients from the seeds. They can be PCeaten alone or added to different meals like smoothies and salads. The recommended routine has two phases. Follicular Phase During the main phase of the menstrual cycle (follicular phase), pumpkin seeds and flax seeds help increase estrogen levels. Flax seeds contain high levels of lignans that bind extra estrogen. Pumpkin seeds are rich in zinc which enables the production of progesterone in the second phase of the menstrual cycle. Luteal Phase During the second phase of the menstrual cycle (luteal phase), sesame seeds and sunflower seeds help increase progesterone production. Sesame seeds are an excellent source of zinc that helps boost progesterone production and also contain lignans that help block extra estrogens when progesterone rises. Sunflower seeds are an excellent source of vitamin E and selenium. Vitamin E helps boost progesterone production, while selenium enables liver detoxification of extra estrogen. Effects of flaxseed supplementation on metabolic status in women with polycystic ovary syndrome. Research has proven that women who consume flax seeds have a more beneficial range of androgens.


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