Ok, we did talk a lot about hormones not in balance and periods not being regular. Someone who had studied biology in their higher secondary might comprehend this, but others are left without any clue. As such PCOS leaves us much confused, so I thought I’d write a post that is not actually a biology class but will throw some light on the hormones and their role in periods and what is wrong with us with PCOS.

I found these two images from internet which are by far the best depictions that I’ve seen. Thanks to the sites!!

The first pic shows how the hormones are responsible for having a regular cycle. It is interesting to note here that the Pituitary gland which is located near the brain is responsible for controlling all the hormones that make the ovaries function normally. Pituitary sends the LH and FSH (Luteinizing and Follicle stimulating Hormones) which determine the follicle formation and most important part Ovulation. After getting the signals from pituitary, the ovaries generate estrogen and progesterone. These are responsible for the uterus lining (endometrial thickness) and for menstruation when there is no fertilization of the egg.

The second pic shows the phases in the menstrual cycle and the normal hormone levels during each phase.

What happens to the hormones with PCOS?

In case of PCOS women, the LH is always higher than the normal levels. That means, even on the day one of the cycle, LH is higher than the FSH. As the LH levels are quite high, there is no LH surge meaning no ovulation. Thus the progesterone and estrogen (to be secreted by the follicle post ovulation – Corpus Luteum) levels also go out of balance and hence there is no periods for the cycle. The worst part in all this is that the follicle that failed to ovulate remains as the cyst and continues to produce more male hormone (androgen) causing all the unwanted hair and acne.

Another reason why the male hormone level goes up is the “Insulin Resistance” (this is going to be a separate post). Most of the PCOS women are insulin resistant which means, the level Insulin hormone secreted by Pancreas is high which causes the ovaries to make more testosterone.

I hope this post will be helpful in clarifying the hormones that your doc always keeps talking about at least to some extent. Do let me know if I have missed anything!