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.
Marked elevation of LH in contrast to FSH
Insulin resistance
Elevation of plasma testosterone
Elevation of sex hormone binding globulin (SHBG) level
PCOD, hirsutism and galactorrhea