Luteinizing hormone & Follicle stimulating hormone
Has your Abuelita ever told you how to make her yummy patacones? Instead of instructions, she just says, "Don't measure too much or too little of this, or three dashes of this, that, and the third is enough." The vagueness of her instructions makes you shrug. You're like whatever, I'll do it my way. Two of the main components are out of balance because of your tweak. You taste your creation, and it's shite. Women with PCOS can experience the same thing when their luteinizing (LH) and follicle stimulating hormones (FSH) are disrupted. When they're balanced, these two hormones help promote follicular growth and ovulation.
The anterior pituitary, which is the body's control panel of the hormonal system, produces LH and FSH, glycoprotein hormones in response to gonadotropin-releasing hormone (GnRH), from the hypothalamus, the body's thermostat. These two compounds are released into the bloodstream by GnRH. Among its many cool features, GnRH is expressed in a rhythmic fashion; low pulse leads to more FSH and high pulse frequencies lead to more LH. When estrogen levels are sufficient, a negative feedback system occurs to stop the secretion of FSH. A side note, endless GnRH secretion stalls ovulation and estrogen production by blocking FSH and LH release from the anterior pituitary.
On a cellular level, LH stimulates ovarian theca cells to secrete androgen, which is then transported to the granulosa cells to generate estradiol. FSH activates ovarian follicle development, while LH promotes follicle development. The teamwork of LH and FSH leads to follicular growth. LH tells an enzyme called 17 hydroxy progesterone to convert progesterone into androgen. Androgen gets turned into estradiol by the enzyme aromatase, which takes orders from FSH and LH. In the same way, these two hormones work together to make estrogen, which is critical for reproductive health. The following are some other benefits of adequate estrogen levels:
Bones and skin - improve calcium and vitamin D levels
Sleep and cognitive - plays a role in brain activity and sleep
Heart - lowers cholesterol
Sexual drive is affected by free testosterone converted to estradiol counts
Low blood sugar due to obesity
Enhances immunity
Women with PCOS usually have a LH:FSH ratio that favors LH counts, which tucks FSH's talent. Estrogen production is affected, resulting in all kinds of problems. It's a double L because LH creates androgen from progesterone. Diets high in sugar and fat can cause excess insulin release, which leads to androgen. Furthermore, fat cells cause insulin to spike. The increase in androgen disrupts the balance between LH and FSH because it creates a stronger network with LH. The opposite can happen when LH levels are higher than FSH, making it superior to FSH and creating more androgen. An example of LH levels exceeding FSH is when GnRH pulses stay high, which also means FSH stays low. It's like a sick cycle. The following symptoms are usually associated with PCOS when you have low FSH:
Infertility
Irregular menstrual cycle
Formation of cyst in the ovaries
Improper oocytes development
Sleep dysfunction
Weight gain
T2DM
Cardiovascular problem
And many more
For androgen to convert to estrogen, you need a balance between the two hormones. Infertility is a consequence of stress since high cortisterone levels cause GnHR to be released, lowering the level of LH and FSH, which leads to anovulation and less fertility. Nutrition can play a huge role, as you already know this information by now. PCOS women have some things they can do to improve their health chances. Again, balance is the key. Balance, balance, balance. It may sound boring, but it holds a lot of truth. Take some time to think about the word Balance this week and we'll discuss the problem of carrying excess weight next week. Until next time, Stay Strong & Stay Vivid.
Reference
Orlowski, M. et Sarao, M.S. (2022). Physiology, Follicle Stimulating Hormone. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK535442/.
Bosch, E. et al. (2021). Reduced FSh and LH action: implications for medically assisted reproduction. Human Reproduction. http://doi:10.1093/humrep/deab065.
Achyuta,G. et al. (2013). Luteinizing hormone and follicle stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation. Journal of Human Reproductive Sciences. http://doi:10.4103/0974-1208.126285.
