What causes polycystic ovary

Polycystic ovary problem is the most common problem affecting female fertility. The causes of polycystic ovary include adrenal dysfunction, insulin resistance, and abnormal regulation of the hypothalamus-pituitary-ovarian axis.

1. Abnormal adrenal function

50% of patients with polycystic ovary syndrome (PCOS) have elevated levels of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS), which are related to increased activity of key enzymes that synthesize prostate hormones in the adrenal glands, as well as increased sensitivity and hyperfunction of adrenal cells to adrenocorticotropic hormone (ACTH). Hyperfunction of the adrenal cortex and excessive secretion of androgens can cause anovulation and symptoms similar to polycystic ovary.

2. Insulin resistance

Insulin resistance and hyperinsulinemia Some patients with polycystic ovary syndrome (PCOS), especially obese patients, may show hyperinsulinemia and insulin resistance, suggesting that it is caused by insulin resistance. There are many causes of insulin resistance. In most cases, it is caused by disorders in the information conduction system after the insulin receptor. There may also be insulin receptor defects. Hyperinsulinemia can inhibit the synthesis of sex hormone binding globulin (SHBG) in the liver and increase free androgens in the body. Androgens can also increase LH secretion through the pituitary insulin receptors.

3. Abnormal regulation of the hypothalamus-pituitary-ovarian axis

Because mental stress, drugs and certain diseases affect the endocrine function of the hypothalamus-pituitary gland, the pituitary gland is more sensitive to Gn-RH, secreting excessive LH and causing dysfunction of cytochrome in the ovaries, which serves as an androgen-forming enzyme, resulting in excessive androgen production by ovarian interstitial and theca cells. High androgen levels in the ovaries inhibit follicle maturation and cause atresia of developing follicles, making it impossible to form dominant follicles, resulting in interruption of the normal estrogen secretion pattern. However, many small follicles still secrete estrogen. Therefore, patients with polycystic ovary syndrome (PCOS) have both high androgen and high estrogen, but the excess androgen is dominant.