Polycystic ovary syndrome

Insulin resistance is the metabolic engine of the syndrome

Many women with PCOS have peripheral insulin resistance, and the pancreas compensates by secreting more insulin to keep blood glucose normal. That excess insulin does not stay confined to glucose control: it acts directly on ovarian theca cells to stimulate androgen production, and it suppresses hepatic production of sex hormone-binding globulin (SHBG), raising the proportion of free, biologically active androgen in the circulation.