All are true regarding PCOS EXCEPT
(B) Metformin is alone the drug of choice# PCOS:> Serum levels of androgens (androstenedione & testosterone) may be elevated. Dehydroepiandrosterone sulfate levels above 700-800 pg/dL are highly suggestive of adrenal dysfunction because DHEA-S is made exclusively by the adrenal glands> Free testosterone level is thought to be the best measure, with -60% of PCOS patients demonstrating supranormal levels.> Free androgen index (FAI) of the ratio of testosterone to sex hormone-binding globulin (SHBG) is high and is meant to be a predictor of free testosterone, but is a poor parameter for this and is no better than testosterone alone as a marker for PCOS, possibly because FAI is correlated with the degree of obesity.> Ratio of LH to FSH is elevated in women with PCOS.> Common cut-offs to designate abnormally high LH/FSH ratios are 2:1 or 3:1 as tested on Day 3 of the menstrual cycle. Pattern is not very sensitive; a ratio of 2:1 or higher was present in less than 50% of women with PCOS in one study. Low levels of sex hormone-binding globulin, in particular among obese or overweight women.> Anti-Mullerian hormone (AMH) is increased in PCOS, and may become part of its diagnostic criteria> Infertility generally results directly from chronic anovulation (lack of ovulation) in PCOS.> Medications for PCOS include both oral contraceptives and metformin.> Oral contraceptives increase sex hormone binding globulin production, which increases binding of free testosterone. This reduces the symptoms of hirsutism caused by high testosterone and regulates return to normal menstrual periods.> Metformin is a drug commonly used in type 2 diabetes to reduce insulin resistance, and is used off label to treat insulin resistance seen in PCOS.> In many cases, metformin also supports ovarian function and return to normal ovulation.
Increased SHBG ratio
Metformin is alone the drug of choice
Increased LH/FSH ratio
Cause of infertility in women
Miscellaneous (Gynae)