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The Menstrual Cycle & Progesterone – Part 1

The Menstrual Cycle & Progesterone – Part 1

PCOS (Polycystic Ovary Syndrome)

PCOS is generally an extreme deficiency of progesterone and insulin resistance. It can lead to a host of problems for the female including difficult periods, an absence of periods, irregular periods, frustration with body weight and fat, infertility, miscarriages, mood swings, headaches, and excess hair. Not every female has the same symptoms and some may only have one or two symptoms. In all cases, insulin resistance and low progesterone will lead to some difficulty and eventually to an increased risk of diabetes and breast cancer. A simple lab test can verify the existence if this condition.

PCOS actually does not originate as an ovary problem but from “insulin resistance.” The ovary is merely a target of the process. All normal ovaries also make a little bit of the androgen testosterone, a male sex hormone. The pancreas is an organ that makes the hormone insulin. High levels of insulin can also cause the ovaries to make more of the hormone testosterone which results in increase in hair, weight gain. Testosterone is converted in the fat to estrogen by the enzyme Aromatase.

Often, the lady with PCOS may have good physical strength and even athletic, particularly in her high school days. Again, some are not strong or athletic.

With PCOS, LH levels are often high when the menstrual cycle starts, most likely a genetic trait. The levels of LH are also higher than FSH levels. Because the LH levels are already quite high, there is no LH surge. Without this LH surge, ovulation does not occur, and periods are irregular. With lower levels of FSH many follicles are stimulated but because of no LH surge they are not released but remain evident with ultrasound usually close to the capsule of the ovaries that appear to be a “ring of pearls” due to lack of release of the ovum.

There also may be various degrees of PCOS but all will have to have a reverse LH/FSH ratio to substantiate the diagnosis. There are some women that are not overweight or hirsute but could have PCOS but must be documented by the laboratory studies and not misdiagnosed. Also, one may seen the LH/FSH ratio to be about equal in amounts and have the symptoms of PCOS.

To assume that other female members of a family have had PCOS should be considered suspect only but the deficiency of Progesterone can be documented by symptoms and history without laboratory documentation. That said, many women where it is suspected that their mothers or grandmothers have had PCOS, may have had a significant progesterone deficiency instead which can be associated with infertility, miscarriages, weight gain etc.

If you have any questions about the menstrual cycle or progesterone, please email your question or questions to


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