What condition is described as ovaries producing excess testosterone, lowering FSH and LH levels, and leading to irregular menstrual cycles?

• A. Polycystic Ovary Syndrome
• B. Endometriosis
• C. Uterine fibroids
• D. Hypothyroidism

Answer: (A)

The key idea is ovarian hyperandrogenism with disrupted ovulation, which fits polycystic ovary syndrome. In this condition, the ovaries produce excess testosterone, driven in part by a relatively high LH signal to the theca cells. FSH tends to be normal or inappropriately low relative to LH, so follicle maturation is impaired and ovulation often does not occur. The result is irregular, often infrequent menstrual cycles, along with signs of hyperandrogenism like acne or hirsutism. The pattern of an elevated LH to FSH ratio with androgen excess explains the cycle irregularity.

Other conditions don’t produce this combination of ovarian androgen excess and anovulatory cycles: endometriosis mainly causes pelvic pain and infertility without hyperandrogenism; uterine fibroids cause abnormal uterine bleeding and bulk symptoms; hypothyroidism can cause menstrual irregularities but not the ovarian overproduction of testosterone driving anovulation.