Dr. Thaïs Aliabadi

But let me tell you what happens in a poor PCOS patient.

That's the problem.

The GnRH, remember, that secretes from the hypothalamus, it starts pulsating super fast.

By doing that, it shifts the FSH-LH balance.

So FSH goes down and LH goes up.

LH stimulates these cells in the ovary.

I don't know if you remember the theca cells in the ovary.

And they start pumping androgens out, right?

And when you have a lot of androgens in the ovaries, the androgens block the growth of that beautiful follicle that's growing to ovulate.

So it freezes the follicle and it prevents it from ovulating, right?

The follicle is still secreting the estrogen, but it never gets to that peak high, right?

And it's still stimulating the lining of the uterus, but the ovulation doesn't happen.

So when the ovulation doesn't happen, polycystic ovary syndrome.

You start seeing these follicles in the ovary.

It's too much LH.

Too much LH.

So in PCOS, the LH-FSH ratio flips.

So the LH is twice as much as the FSH.

So you have this constant secretion of LH that stimulates these thicker cells to just pump androgens out, right?

So the follicle freezes, doesn't ovulate.