Premature progesterone rise as a trigger of polycystic ovarian syndrome

Premature progesterone rise as a trigger of polycystic ovarian syndrome

VOLUME 114, ISSUE 5, P943-944


Dmitri I. Dozortsev, M.D., Ph.D., Antonio Pellicer, M.D., Michael P. Diamond, M.D.


Originally described as Stein-Leventhal syndrome, polycystic ovarian syndrome (PCOS) is a very common condition in women of reproductive age, characterized by hyperandrogenism, insulin resistance, the presence of multiple ovarian cysts, and irregular menstrual cycles with accompanying infertility. There is currently a consensus that genetic and epigenetic factors as well as intrauterine environment create a predisposition to PCOS (1). However, there is no agreement on whether the ovarian cysts are the cause or the result of the hyperandrogenism and insulin resistance or even whether the cysts should be used as a part of diagnostic criteria (1). We believe that a recent change in understanding the role of progesterone (P) in ovulation lends credence to the idea that ovarian cysts are the cause of other PCOS presentations and may hold a key to solving the PCOS conundrum.

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I believe that the first to publish evidence that a small rise in progesterone at the end of the follicular phase is what induces an LH surge was Mel Taymor in 1970. See

Serum Levels of Follicle Stimulating Hormone and Luteinizing Hormone and of Plasma Progesterone Related to Ovulation by Corpus Luteum Biopsy MARVIN A. YUSSMAN, MELVIN L. TAYMOR Author Notes The Journal of Clinical Endocrinology & Metabolism, Volume 30, Issue 3, 1 March 1970, Pages 396–399, Published: 01 March 197
Go to the profile of Pandiyan  Natarajan
about 2 years ago

PCOS is a gynaecological enigma.

PCOS despite nearly 9 decades of research remains a gynecological enigma. Most patients with PCOS are either Overweight or Obese. The few who are neither obese nor overweight have had significant abnormal weight gain during adolescence or adulthood.  Though they have normal BMI or less than 18 BMI, they still have had abnormal weight gain. All the symptoms and signs of PCOS are consequences of abnormal weight gain. PCOS is an Epiphenomenon. (1) Abnormal weight gain in children and adults predisposes to PCOS in genetically prone individuals.  (2) Weight loss improves ovulation and restores fertility, besides ameliorating other symptoms clearly indicating cause effect relationship.

  1. PCOS is an Epiphenomenon. Puvithra T, N Pandiyan, Chettinad Health City Medical Journal 2016; 5(3): 106 - 107.
  2. Is weight gain the precipitating factor for PCOS? Puvithra T, Pandiyan N Chettinad Health City Medical Journal 2015; 4(3): 120 - 124.
  1. Professor Dr Pandiyan Natarajan,
  2. Professor and Head of the department of Andrology and Reproductive Medicine,
  3. Chettinad Super Speciality Hospital,
  4. Kelambakkam, Tamil Nadu,
  5. India-603103