Prolactin and thyroid stimulating hormone affecting the pattern of LH/FSH secretion in patients with polycystic ovary syndrome: A hospital-based study from North East India

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is one of the most important endocrinal diseases in reproductive age group, clinically manifested by hyperandrogenism and anovulation and different other metabolic disturbances that may have important implications for long-term health. Aim and Objective: The aim of this study was to determine the incidence of abnormal luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio in women with polycystic ovary and to assess the influence of prolactin and thyroid-stimulating hormone (TSH) in the elevated LH/FSH ratio. Study Design: Retrospective observational study. Materials and Methods: Eighty-five women in reproductive age diagnosed with PCOS between June 2012 to June 2014 at the Department of Obstetrics and Gynecology in a tertiary care hospital were selected for the study. Serum LH and FSH levels were determined and LH/FHS ratio (normal range ≤2) calculated in the study subjects. They underwent a detailed clinical, hormonal, and metabolic evaluation, which was performed between the second and third days of a natural or induced menstrual period. Results: Elevated LH/FSH ratio was found in 60 women (70.58%). Normal gonadotropin ratio was detected in 25 women (29.41%). Statistically significant differences in serum TSH levels were noted between groups with normal and elevated LH/FSH ratio. However, no statistically significant difference was noted in other endocrine parameters. Further analysis revealed a slight negative correlation of TSH with prolactin in the study subjects of PCOS with an ‘ r ’ value of − 0.3. Conclusions: LH/FSH ratio is one of the characteristic attribute of PCOS women. In the present study, this abnormality was detected in 70% of patients. Hypothyroidism was a common endocrinal abnormality and prolactin was inversely correlated to TSH levels in PCOS patients.

Common endocrine disorders associated with the polycystic ovary syndrome

“…In addition, Nath et al . [ 8 ] and Banaszewska et al . [ 16 ] also reported an elevated LH/FSH ratio in PCOS women.…”

“…The non-diagnosed SCH of the PCOS women converted to overt hypothyroidism with further increase in BMI. Consequently, the overt hypothyroidism, produces anovulation, and increased severity of PCOS symptoms [ 8 ].…”

“…Fifty-six percent (56%) of the PCOS women had evidence of hypothyroidism [ 8 ]. The elevated thyrotropin-releasing hormone (TRH) in hypothyroidism acts as dopamine antagonist with subsequent hyperprolactinemia [ 9 ].…”

Lifestyle intervention towards Mediterranean Diet, physical activity adherence and anthropometric parameters in normal weight women with Polycystic Ovary Syndrome or Hashimoto’s Thyroiditis – preliminary study

“…Evidence has also shown that central fat distribution carries a greater risk of cardiovascular diseases and type 2 diabetes than gynoid fat distribution. This adipose tissue topography tends to change in middle-aged, post-menopausal women, when there is a change in the distribution of android fat, while women with PCOS tend to accumulate fat centrally, also in the fertile period [9,13]. Systemic hyperinsulinism can be endogenous (such as in obesity, gestational diabetes, type 2 diabetes) or exogenous (such as in type 1 diabetes) [11].…”

Association between baseline LH/FSH and live-birth rate after fresh-embryo transfer in polycystic ovary syndrome women

“…In China, patients prefer fresh-embryo over frozen-embryo transfer; therefore, there are no exact indicators to which patients with PCOS are suitable for fresh-embryo transfer. Although E2 and P4 on the trigger day and the number of oocytes retrieved are commonly used for determining cut-off points, they are not precise 5,6,16,[20][21][22][23] .…”