The biochemical changes in established cases of stein Leventhal syndrome are as mentioned except :
PCOS: Excess androgen production by ovary /adrenals interferes with growth of ovarian follicles. Endocrinological changes are as follows: 1.Estrone/E2 level rises. 2.Increased testosterone,DHEA-S,Androstenedione 3.Increased estrogen causes positive feedback on LH which causes increased LH. FSH levels are not raised. LH/FSH >2.1 -----negative feedback on FSH---decreased FSH -----increased risk of Endometrial hyperplasia,Endometrial cancer. 4.Decreased Sex hormone binding globulin(SHBG) due to hyperandrogenism---increased free estradiol. 5.Fasting Blood Glucose/Fasting Insulin < 4.5 suggests Insulin Resistance 6.Triglycerides>150mg/dl, Hyperlipedemia, HDL < 50 mg/dl 7.Prolactin is mildly raised in 15% cases. 8.Fasting Insulin is more than 10mIU/L 9.Thyroid function tests may be abnormal(hypothyroidism) 10.17 alpha hydroxyprogesterone in the follicular phase >300ng/dl suggests adrenal hyperplasia due to 21-hydroxylase deficiency 11.Urinary coisol<50 micrograms/24hr Ref: Shaw Gynecology 17 e pg 314.
PCOD, hirsutism and galactorrhea
Marked elevation of LH in contrast to FSH
Insulin resistance
Elevation of plasma testosterone
Elevation of sex hormone binding globulin (SHBG) level
Elevation of sex hormone binding globulin (SHBG) level