All right, so let's talk about polycystic ovary syndrome before we get started.

As always, thank you so much for the support.

Thank you.

Thank you.

Thank you so much.

All right, let's talk about polycystic ovary syndrome or picos, as I like to call it.

So polycystic ovary syndrome, the name quite literally means a syndrome of many cysts of the ovaries.

So you might think that that's all this is, but in actuality, you don't even need to have polycystic

ovaries to be diagnosed, and the fluid-filled structures in the ovaries, they're not even true cis,

but we'll talk more about that later. So PICOS is one of the most common endocrinopies in women

of reproductive age. It affects between 6.5 and 10% of all women of reproductive age. Let's go ahead and get started with the patho first. So the patho is pretty complex, multifactorial. There's a lot going on, so we'll keep it focused on what you need to know, some key concepts or trends that we typically see in patients with PECOS. So starting with your LH levels. So PECOS patients have altered LH levels with relatively higher serum lutinizing hormone concentrations relative to FSAH

concentrations. This is just a small component of the whole picture, but a part I think is important

to understand. So let's do a quick review of a normal functioning hypothalamic pituitary ovarian

axis. In a normal HPO axis, the hypothalamus releases GnRH in a pulsatile manner, stimulating the anterior

pituitary to secrete LH and FSAH. LH goes down and acts on the Thika cells in the ovary, promoting

androgen production, primarily andriston-dione, while FSA-stimulates granulosis cells to produce

aromatase.

Romatase is an enzyme that converts these androgens into estrogen, specifically estradiol. So as this process goes on, a dominant follicle

develops, fshaeculates the follicle to develop, rising estrogen levels trigger positive feedback

on the pituitary, leading to a surge in LH, which induces ovulation. Most of this you probably

already know.

After ovulation, progesterone from the corpus luteum provides negative feedback, slowing down

...