What is the primary hormone affected in women with PCOS leading to ovulatory dysfunction?

In women with polycystic ovary syndrome (PCOS), the primary hormone that is often elevated and contributes significantly to ovulatory dysfunction is testosterone. This condition is characterized by hyperandrogenism, which means there is an excess of male hormones, with testosterone being the most notable. Elevated testosterone levels can disrupt the normal hormonal balance required for regular ovulation, leading to irregular menstrual cycles or anovulation.

In normal physiology, the ovarian follicle develops under the influence of hormones such as estrogen and luteinizing hormone (LH). However, in PCOS, the overproduction of androgens interferes with the follicular development process, impeding the body's ability to produce eggs consistently and regulate the menstrual cycle. This internal hormonal imbalance is a characteristic feature of PCOS and directly ties into the ovulatory issues that these women experience.

While estrogen and progesterone are vital in the overall reproductive hormonal axis, in the context of PCOS and its association with ovulatory dysfunction, testosterone is central to understanding the pathophysiology of the disorder. Luteinizing hormone, although relevant in the ovulatory process, is influenced by the levels of circulating androgens and does not primarily drive the dysfunction characteristic of PCOS as testosterone does.