PCOS: Two Key Hormonal Mechanisms Most Women Are Not Told About

🔹 Mechanism #1: Insulin → LH → Androgen Pathway

• Elevated insulin levels stimulate the pituitary gland

• This leads to an increase in Luteinizing Hormone (LH)

• LH travels to the ovaries and activates theca cells

• Theca cells respond by producing excess androgens (male hormones)

📌 Result: Higher androgens → irregular cycles, acne, hair issues, ovulatory dysfunction

🔹 Mechanism #2: Insulin → Liver → SHBG Reduction

• The liver produces SHBG (Sex Hormone Binding Globulin)

• SHBG acts as a buffer, keeping androgens inactive

• High insulin levels suppress SHBG production

• Less SHBG = more free (active) testosterone in circulation

📌 Result: Hormonal imbalance even when total testosterone appears “normal”

PCOS is not caused by “high androgens alone.”
In many women, insulin dysregulation is the upstream trigger that fuels both pathways.

Addressing insulin sensitivity is not optional—it is foundational for long-term PCOS recovery.

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