The following hormone is raised in polycystic ovarian syndrome:: (A) 17-OH progesterone, (B) Follicular stimulating hormone, (C) Luteinizing hormone, (D) Thyroid stimulating hormone
Answer is C. Laboratory Tests FSH (Follicle Stimulating Hormone), will be normal or low with PCOS LH (Lutenizing Hormone), will be elevated LH/FSH ratio. This ratio is normally about 1:1 in mensturating women, but with PCOS a ratio of greater than 2:1 or 3:1 may be considered diagnostic Testosterone, total and/or free, usually elevated DHEAS (may be done to rule out a virilizing adrenal tumor in women with rapidly advancing hirsutism), frequently mildly elevated with PCOS Estrogens, may be normal or elevated, reversal of E1:E2 ratio Sex hormone binding globulin, may be reduced Androstenedione, may be elevated Lipid profile (low HDL, high LDL, and cholesterol, elevated triglycerides) Glucose, fasting and/or a glucose tolerance test, may be elevated Insulin, often elevated Fasting Glucose: fasting insulin ratio < 4.5 Non-Laboratory Tests With PCOS, the ovaries may be 1.5 to 3 times larger than normal and characteristically have more than 12 follicles per ovary, with each follicle less than 10 mm (2-9 mm) in diameter. Ovarian volume is usually > 10 cc. Often the cysts are lined just under the surface the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic as they are present in more than 90% of women with PCOS, but they are also found in up to 15-25% of women without PCOS. Hyperinsulinemia can present as a cluster syndrome called metabolic syndrome or dysmetabolic syndrome X. This is a risk factor for cardiovascular disease The presence of three of the following five criteria confirm the diagnosis of metabolic syndrome, and an insulin lowering agent and/or other interventions may be warranted Metabolic Syndrome Diagnostic Criteria Female waist >35 inches Triglycerides >150 mg/dL HDL <50 mg/dL Blood pressure >130/85 mmHg Fasting glucose: 110-126 mg/dL Two-hour glucose (75 gm OGTT): 140-199 mg/dL