A 24-year-old woman with polycystic ovary syndrome (PCOS) is prescribed combined oral contraceptive pills for cycle regulation. The estrogenic component of COCPs provides which specific benefit in PCOS?

• A Direct suppression of ovarian theca cell androgen production
• B Enhancement of insulin sensitivity in peripheral tissues
• C Increase in sex hormone-binding globulin (SHBG), reducing free testosterone ✓
• D Inhibition of 5-alpha reductase in the skin

Explanation

Ethinyl estradiol in COCPs stimulates hepatic synthesis of SHBG, which binds circulating free testosterone, reducing its bioavailability and improving hirsutism and acne. COCPs also suppress LH and ovarian androgen production, but the SHBG-mediated reduction of free testosterone is the specific benefit of the estrogen component. Progestins alone do not significantly raise SHBG.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.