PCOS and Insulin Resistance: The Ovarian-Metabolic Axis and Hyperandrogenism
Understanding Polycystic Ovary Syndrome as an endocrine and metabolic condition driven by hyperinsulinemia stimulating ovarian theca cell androgen production.
Polycystic Ovary Syndrome (PCOS) affects an estimated 8-13% of women of reproductive age, yet it is frequently misdiagnosed as purely a gynecological disorder rather than a primary endocrine-metabolic dysfunction.
How Insulin Directly Drives Androgen Excess
In patients with PCOS, while peripheral tissues like muscle become resistant to insulin, ovarian theca cells remain uniquely sensitive to it. Elevated circulating insulin acts synergistically with Luteinizing Hormone (LH) to upregulate the enzyme CYP17A1, directly converting cholesterol intermediates into androstenedione and testosterone.
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