Which one of the following is NOT a pathological characteristic of polycystic ovarian syndrome (PCOS)?

• A. Excess androgen
• B. Body mass index of 30 or higher
• C. Abnormal insulin resistance
• D. Low luteinizing hormone

Answer: (D)

A hallmark of polycystic ovarian syndrome (PCOS) is the presence of hormonal imbalances, particularly involving androgens, insulin resistance, and other metabolic anomalies. The conditions listed as characteristics of PCOS include excess androgen levels, which lead to symptoms like hirsutism and acne, and abnormal insulin resistance, contributing to metabolic syndrome and increased risk of type 2 diabetes.

Individuals with PCOS often have a higher body mass index (BMI), commonly 30 or higher, due to weight gain associated with insulin resistance and hormonal changes. Hence, options A, B, and C accurately reflect common pathological characteristics of PCOS.

In contrast, low luteinizing hormone (LH) is not a characteristic of PCOS. In fact, women with PCOS typically exhibit elevated levels of LH, often in relation to lower levels of follicle-stimulating hormone (FSH), leading to the clinical features associated with the syndrome. Recognizing the normal hormonal patterns in PCOS is essential for understanding its pathophysiology and guiding proper management.