Some have tried to utilize ultrasound to detect IR. Of note, normoglycemic women often have the phenotypic criteria for polycystic ovaries on ultrasound[54], consistent with other data in young adolescents showing that polycystic ovaries by ultrasound appearance often does not correlate with either anovulatory menstrual cycles or metabolic abnormalities[55]. Therefore ultrasound is too non-specific to use with any reliability in measuring IR.
If he was using heroin very heavily, that may well be his starting methadone dose (or close to it.) Methadone has a long half life while heroin has a short one, so avoiding withdrawals can take a lot of methadone, initially. Methadone clinics aren't going to leave someone on a high dose though. They'll titrate up until withdrawal subsides, then taper down over time. I'm guessing he started at the clinic around when he got busted, so it's sus af to me that he'd still be taking 130mg. Or that he ever was. Maybe 100. Possibly.
Other excluded studies investigated the herbal medicines included in this review examining conditions other than PCOS, oligo/amenorrhoea and hyperandrogenism. These included investigations into effectiveness for Vitex agnus-castus for pre-menstrual syndrome [92–97] and mastalgia [98, 99], Cimicifuga racemosa for menopausal symptoms [100] and Glycyrrhiza spp with Paeonia lactiflora libido in males [101].

An animal study compared the effectiveness of Cinnamomum cassia and the pharmaceutical Metformin on hormone concentration in rats with PCOS [48] (Table 1). Both interventions demonstrated significant improvements compared to controls at 15 days for measures of testosterone ng/ml (control 0.747 ± 0.039; metformin 0.647 ± 0.027; Cinnamomum cassia 0.625 ± 0.029); LH ng/ml (control 7.641 ± 0.267; metformin 6.873 ± 0.214; Cinnamomum cassia 6.891 ± 0.221) and insulin resistance (HOMA-IR) (control 10.018 ± 0.217; metformin 7.067 ± 0.184 Cinnamomum cassia 8.772 ± 0.196) (p < 0.05) [48]. The metabolic effects for Cinnamomum cassia were further demonstrated in overweight women with oligo/amenorrhoea and PCOS in a placebo controlled RCT [66] (Table 2). However, although the RCT had low risks for bias, it was a pilot study primarily investigating feasibility. Outcomes were promising for metabolic profile in PCOS however the sample size was small and the authors recommended further studies.
Algunas chicas que padecen un síndrome de ovario poliquístico se deprimen; en estos casos, puede serles de ayuda hablar con un terapeuta u otro profesional de la salud mental. Hablar con otras adolescentes y con mujeres de más edad que padecen la misma afección es una buena forma de compartir información sobre su tratamiento y de obtener apoyo. Tu médico te puede recomendar un grupo de apoyo en tu localidad.

Like >>409129 said, there are non-opioid painkillers. But the chemical component of opioids that relieves pain is not the same component that causes a high anyway. We already have partial opiate agonists (like Suboxone) that people have been on for years. From what I've read about a vaccine like this, opioids could still be administered with the intended effect of substantial pain relief. With no unwanted side effects (high). Someone please correct me if I'm wrong, this prospect really excites me. Something like this could lead to a whole new class of painkilling drugs for people with chronic pain, allowing them to function without being high at all times.
The exact causes of PCOS are unknown; there are probably more than one cause and these may be different between individual girls or women. Androgen excess (male hormone excess), seen in 60-80% of girls and women with PCOS, is a key problem in the disorder and likely comes from ovaries in most women. Insulin resistance or elevated insulin levels may worsen androgen excess. Abnormalities in how the brain or pituitary gland communicate with the ovaries may also lead to androgen overproduction. Other hormones from the ovary or fat tissue may also be involved. 
Progestin therapy. Taking progestin for 10 to 14 days every one to two months can regulate your periods and protect against endometrial cancer. Progestin therapy doesn't improve androgen levels and won't prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device is a better choice if you also wish to avoid pregnancy.
One of the biggest challenges in reviewing the evidence for PCOS treatment is that many manifestations of the condition may be components of other disease processes. For example, there may be a study of medications that are useful for hirsutism, but the patient population in the study did not explicitly have PCOS. Thus, recommendations specific for treating symptoms of PCOS may be lacking. When reviewing a study of the treatment of insulin resistance in a general population, it cannot be assumed that the outcomes would mirror those in women with PCOS.
SA, JA, CS and AB conceived of the study and participated in its design and coordination. SA carried out the search of the literature. SA, JA and CS participated in study inclusion or exclusion. SA performed data extraction and CS, JA and AB reviewed the quality of data. SA, JA and AB designed and edited the tables. All authors read and approved the final manuscript.
Clomid Active ingredient: clomiphene $0.44 for pill Clomid is a fertility drug, used to stimulate FSH and LH production and hereby the ovaries to produce eggs in ovarian disorders. Metformin Active ingredient: metformin $0.26 for pill Metformin is a biguanide anti-diabetic that works by decreasing the amount of sugar that the liver produces and the intestines absorb.
In PCOS, both ovaries tend to be enlarged, as much as three times their normal size. Eggs that do not mature fully are not released during ovulation and the immature eggs remain in the ovary as pearl-sized, fluid filled sacs. Over the course of time, many cysts may develop into what looks like a string of beads when viewed through ultrasound imaging. In as many as 90% of women with PCOS, an ultrasound of the ovaries will reveal cysts.
Blood tests then can be performed to determine whether the ovaries are functioning normally or producing excess amounts of androgen. An ovarian ultrasound also can be done to measure the size of the ovaries and determine whether they have a polycystic appearance. At the same time, other conditions resembling PCOS, including pituitary, thyroid and adrenal abnormalities and other rare tumors, can be identified. Fasting blood levels of glucose, triglyceride and cholesterol also can be measured, along with another glucose determination obtained 2 hours after ingesting a glucose solution (2-hour oral glucose tolerance test), to predict the risk for developing diabetes and cardiovascular disease.

There's no way she can hide it when she's at his house 2 days out of 7. Her Dad also pays for her phone and utilities, she definitely doesn't try to appear okay to her father. She rang him when she OD'd, he's fully aware all her money goes on heroin. He takes her to thrift stores so she'll have something clean to wear in between her weekly laundry runs.
“When we compared participants with women in the general population, we found significantly higher scores on all of the symptoms evaluated and on corresponding psychological distress measures, particularly for anxiety, depression, somatization (the conversion of psychological distress to physical symptoms), and interpersonal sensitivity,” says lead author Judy McCook, PhD, RN, professor of nursing at East Tennessee State University.
For women who don’t receive timely, appropriate care for PCOS in early adolescence, the development of symptoms such as facial-hair growth can become more challenging to treat. Brandy Cramer, 33, a program officer at The Cameron Foundation, from Midlothian, Virginia says her doctors told her she just wasn’t trying hard enough to lose weight and dismissed her when she requested they run blood tests or suggest alternatives to the birth-control pills that gave her intense migraines. Cramer grew facial hair and has only been able to remove 50 percent of it, even after expensive laser hair-removal treatment.
Altos niveles de andrógenos. Los andrógenos a veces se conocen como "hormonas masculinas", aunque todas las mujeres generan pequeñas cantidades de andrógenos. Los andrógenos controlan el desarrollo de características masculinas, como la calvicie de patrón masculino. Las mujeres con SOP tienen más andrógenos de lo normal. Los niveles de andrógeno más elevados de lo normal pueden evitar el desprendimiento de un óvulo de un ovario (ovulación) en cada ciclo menstrual y pueden causar un crecimiento excesivo de vello y acné, dos signos de SOP.
2. amenorrhoea n = 30. Oligomenorrhoea group: Treatment n = 17. Placebo n = 20. Amenorrhoea group. Treatment n = 16. Placebo n = 14. For oligomenorrhoea: Shortened menstrual cycle of at least 4 days. Earlier ovulation of at least 3 days. For anovulatory oligomenorrhoea: Mid luteal progesterone increase (>50% 5–10 days before menstruation. Secondary clinical outcomes, pregnancy rates and take home baby rates. At 6 months following conclusion of treatment, the take home baby rate with treatment was 18.7% compared to 6.4% in placebo group. Not statistically significant.
Goodman, N. F., Cobin, R. H., Futterweit, W., Glueck, J. S., Legro, R. S. y Carmina, E. (2015). American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome - part 1. Endocrine Practice, 11, 1291–300.

Combination birth control pills — those with estrogen and Prometrium (progesterone) — are frequently prescribed to women with PCOS not looking to get pregnant. If the main concern is irregular periods and the resulting potential health risks, this is a great option. “Birth control pills are very good for protecting the lining of the uterus in women who are chronically anovulatory,” says Dunaif.
Walang taning na gamot na magagamit sa merkado upang maiwasan ang PCOS. Medikal na eksperto magmungkahi na ang mga apektadong mga kababaihan ay dapat resort sa ilang mga mahahalagang pamumuhay at pandiyeta pagbabago upang makaya sa mga ito. Dahil ito ay una ng isang hormone na may kaugnayan disorder, eradicating ang mga ugat ng hormonal kawalan ng timbang ay maaaring dalhin ang nais na resulta. Ang ilang mga natural na mga remedyo kontrolin ang nakapailalim na mga kadahilanan habang ang ilang mga iba asintahin pag-aalis ng mga sintomas. Hanapin sa ibaba ang mga remedyo sa bahay upang tratuhin ang PCOS.
Hi dok..may tanung lang po ako..kasi po almost 9 months napo akung d nireregla..dati po kasi nagpatingin nku sa ob gyne at niresetahan ako ng contraceptive pills ung diane 35. Siguro po 3 months din ako uminom niregla din nman po ako…tinigil ko lang po kasi un kasi po sabi ng matatanda bat daw po ako umiinom ng pills eh wala pa daw po akung anak at asawa bka daw po mas lalong masira matress ko..ano po ba dapat kung gawin .takot kuna po kasing magpatingin sa doktor ulit…sana rwplayan nyo po ako.tnx pi
besides that, I'm not really sure why it takes so long. American courts in general are notoriously slow. every tiny thing gets adjourned, it's weird. I got into a methadone program while still going to court. I wasn't ordered to or anything. I told my lawyer. he told the judge. the judge said "good job, keep it up, see you next month! adjourned!" and moved on to the next person
When the syndrome was first described in 1935 by American gynecologists Irving Stein, and Michael Leventhal, it was considered a rare disorder. Today as many as five million women in the United States may be affected, according to the Department of Health and Human Services, but researchers are still just beginning to uncover the disorder’s full impact.
First-line medical therapy usually consists of an oral contraceptive to induce regular menses. The contraceptive not only inhibits ovarian androgen production but also increases sex hormone-binding globulin (SHBG) production. ACOG recommends use of combination low-dose hormonal contraceptive agents for long-term management of menstrual dysfunction. [3] If symptoms such as hirsutism are not sufficiently alleviated, an androgen-blocking agent may be added. Pregnancy should be excluded before therapy with oral contraceptives or androgen-blocking agents is started.
Complementary medicine (CM) use by women has increased during the past ten years [7–11] with rates of use ranging between 26% and 91% [8, 9]. One of the popular types of CM is herbal medicine [11, 12]. Herbal medicines are known to contain pharmacologically active constituents with physiological effects on female endocrinology and have been positively associated with reduced incidences of breast cancer, osteoporosis and cardiovascular disease [13–18].
The American College of Obstetricians and Gynecologists (ACOG) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) indicate that lifestyle modifications such as weight loss and increased exercise in conjunction with a change in diet consistently reduce the risk of diabetes. This approach has been found to be comparable to or better than treatment with medication and should therefore be considered first-line treatment in managing women with polycystic ovarian syndrome (PCOS). [2, 3] These modifications have been effective in restoring ovulatory cycles and achieving pregnancy in obese women with PCOS. Weight loss in obese women with PCOS also improves hyperandrogenic features.
Hi dok matagal na ako gusto mag ka anak na pressure na ako sa family ko nag aantay ng baby ko 🙁 posible po bang may PCOS aq dahil ang regla q po ay irregular qng hindi po 2months minsan 4months.. nag pa check up na po ako ultrasound at nag pa inject ng anti cervical cancer ang pina painom lang sa ako Metformin tinigil ko na kc wala pa rin nangyare at hindi na din ako bumalik sa ob ko dahil laki na ng gastos ko.. anu pa ba dapat ko try inomin. salamat dok
Weight loss achieved through dietary changes and exercise can help women with PCOS in several ways. Like men and women without PCOS, losing weight reduces a person's risk of cardiovascular disease and non-insulin dependent (type 2) diabetes. Weight loss also helps to lower the level of insulin in the body which, in turn, reduces the ovaries' production of testosterone.
The catch is that it’s not safe in pregnancy, as it can cross the placenta and harm a fetus. For that reason, doctors prescribe spironolactone along with combination estrogen-progesterone birth control pills. If a woman doesn’t want to take these, they have other options, like a progesterone-releasing intrauterine device (IUD). The benefit of using combination birth control pills and spironolactone is that they work even better together, she says.
 “We were surprised to find that menstrual abnormalities in women with PCOS was the strongest predictor for mental health issues, particularly when there are so many other symptoms—like beard growth and infertility—that can make a woman feel unfeminine,” says senior author Nancy Reame, the Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion at Columbia Nursing. “The study findings suggest that we can’t treat PCOS effectively unless we pay close attention to any signs of mental distress.”
Polycystic (say: pah-lee-SIS-tik) ovary syndrome (PCOS) is a common hormone imbalance that affects about 1 in 10 women. Girls as young as 11 can get PCOS. Do you have PCOS or common signs of PCOS? Read answers to commonly asked questions about PCOS below, or go straight to our Living Well With PCOS [ PDF 459K] guide and PCOS Fitness Worksheet [ PDF 504K].
A diet patterned after the type 2 diabetes diet has been recommended for PCOS patients. [81] This diet emphasizes increased fiber; decreased refined carbohydrates, trans fats, and saturated fats; and increased omega-3 and omega-9 fatty acids. However, in some obese patients with PCOS, weight loss has improved menstrual regularity. [82] Omega-3 fatty acid supplementation has been shown to reduce liver fat content and other cardiovascular risk factors in women with PCOS, including those with hepatic steatosis, although these effects have not yet been proven to translate into a reduction in cardiometabolic events. [83]
You just found out you have polycystic ovary syndrome (PCOS). Now what? The condition, which affects five million women in the U.S. alone, can wreak havoc on your hormones and still doesn’t have a known cure. While many women successfully manage their symptoms solely with medication and hormone therapy, some prefer to supplement traditional treatments with more holistic remedies, while some opt for entirely natural alternatives.
Clinically speaking, the hyperandrogenism seen in PCOS is associated with hirsutism more than acne or alopecia and therefore hirsutism is an impetus for young women seeking care[2]. Many PCOS women are also overweight (BMI > 25kg/m2) or obese (BMI > 30kg/m2), although adiposity is not a defining criteria for PCOS. Obesity is highly prevalent in the general population and in PCOS women and is an independent risk factor for CAD[3]. Obesity in adolescents is correlated with insulin resistance (IR) and dyslipidemia[4]. PCOS related ovulatory dysfunction in adolescents often correlates to adolescent obesity[5]. Genetic predisposition to PCOS has been suspected for many years[6] and data link obesity and metabolic disturbances in PCOS with genetic polymorphisms[7,8]. Even male first degree relatives of women with PCOS have a higher incidence of metabolic syndrome (MS), the closest corollary to PCOS in men[9].
Unfortunately, awareness of the condition is not widespread and many physicians do not perform the necessary diagnostic tests or recognize that PCOS has broad and potentially devastating consequences. According to the non-profit support organization, PCOS Challenge, Inc., PCOS awareness and support organizations receive less than 0.1 percent of the government, corporate, foundation, and community funding that other health conditions receive.
Complementary medicine (CM) use by women has increased during the past ten years [7–11] with rates of use ranging between 26% and 91% [8, 9]. One of the popular types of CM is herbal medicine [11, 12]. Herbal medicines are known to contain pharmacologically active constituents with physiological effects on female endocrinology and have been positively associated with reduced incidences of breast cancer, osteoporosis and cardiovascular disease [13–18].

PCOS contribuye a equilibrar los niveles hormonales, ayudando por ejemplo a la regulación de los ciclos y disminuyendo visiblemente otros síntomas como el crecimiento de vello o el acné. Ten en cuenta que el vello que ya tenías no desaparecerá por sí mismo aunque regules tus niveles hormonales, pero sí que se atenuará el ritmo con el que sale el vello y podrás recurrir a métodos para eliminar el que quede, como por ejemplo la depilación láser.
Polycystic ovary syndrome is a condition present in approximately 5 to 10 percent of women of childbearing age. Diagnosis can be difficult because the signs and symptoms can be subtle and varied. These may include hirsutism, infertility, menstrual irregularities, and biochemical abnormalities, most notably insulin resistance. Treatment should target specific manifestations and individualized patient goals. When choosing a treatment regimen, physicians must take into account comorbidities and the patient's desire for pregnancy. Lifestyle modifications should be used in addition to medical treatments for optimal results. Few agents have been approved by the U.S. Food and Drug Administration specifically for use in polycystic ovary syndrome, and several agents are contraindicated in pregnancy. Insulin-sensitizing agents are indicated for most women with polycystic ovary syndrome because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Metformin has the most data supporting its effectiveness. Rosiglitazone and pioglitazone are also effective for ameliorating hirsutism and insulin resistance. Metformin and clomiphene, alone or in combination, are first-line agents for ovulation induction. Insulin-sensitizing agents, oral contraceptives, spironolactone, and topical eflornithine can be used in patients with hirsutism.
Lifestyle change is considered the first-line treatment for infertility in obese women with PCOS. Preconception counseling, administering folic acid to reduce the risk of fetal neural tube defects, encouragement of physical activity and identification of risk factors, such as obesity, tobacco use and alcohol consumption, should be performed. A 5 to 10% loss in body weight over a period of six months regardless of body mass index may be associated with improvement in central obesity, hyperandrogenism and ovulation rate 9. However, no studies with the proper methodology have assessed the live birth rate, which is the primary reproductive outcome 10.
PCOS son las siglas en inglés del síndrome de ovario poliquístico, una afección común en mujeres adolescentes y adultas. PCOS ocurre cuando hay un desequilibrio hormonal. Además de estrógeno (la principal hormona femenina), las mujeres también producen una pequeña cantidad de testosterona (la principal hormona masculina). Las muchachas y mujeres con PCOS producen un poco de testosterona adicional.

Side effects: Some people who are allergic to ragweed and other plants in the same family are also allergic to milk thistle so taking this herb might cause an allergic reaction. Occasionally people taking milk thistle will complain of gastrointestinal issues but this is rare. I t may also lower blood sugar levels so if you have hypoglycemia or diabetes you might want to try another herbal .
Certain lifestyle changes, such as diet and exercise, are considered first-line treatment for adolescent girls and women with polycystic ovarian syndrome (PCOS). [41] Pharmacologic treatments are reserved for so-called metabolic derangements, such as anovulation, hirsutism, and menstrual irregularities. Medications for such conditions include oral contraceptives, metformin, prednisone, leuprolide, clomiphene, and spironolactone.
Following the electronic and manual searches of bibliographies, forty six clinical studies were identified for inclusion/exclusion assessment (Figure 1). A pre-requisite for the inclusion of clinical studies was identified laboratory evidence explaining the mechanism of effect in reproductive endocrinology. Fifteen met the inclusion criteria [54–68]. Eight were randomised controlled trials (RCTs) including 762 women [61–68] (Table 2). Thirty one studies were excluded for the following reasons; investigation of isolated herbal chemicals (n = 3); inclusion of male subjects (n = 4); no pre-clinical evidence (n = 11) and conditions different to those specified (n = 13).
Ano nga ba ang PCOS? Ito ay isang hormonal disorder kung saan nagkakaroon ang babae ng mga maliliit na cyst sa kanyang obaryo. Naglalaman ang mga cyst na ito ng mga immature egg cells na hindi kayang mag-trigger ng proseso ng obulasyon. Ibig sabihin, bababa ang lebel ng female hormones tulad ng estrogen at progesterone, at tataas ang lebel ng male hormones katulad ng androgen. Ang imbalance na ito ay magdadala ng iba’t ibang sintomas at epekto sa katawan.
Aunque el síndrome de ovario poliquístico (que antes se llamaba "síndrome de Stein-Leventhal") se identificó por primera vez en la década de los años treinta del siglo XX, los médicos todavía no conocen sus causas con certeza. Las investigaciones sugieren que puede estar relacionado con un aumento de la fabricación de insulina en el cuerpo. Las mujeres con síndrome de ovario poliquístico es posible que produzcan demasiada insulina, lo que estimula a sus ovarios a liberar un exceso de hormonas masculinas. El síndrome de ovario poliquístico parece darse por familias, de modo que si lo padece alguna pariente tuya, tú podrías ser proclive a desarrollarlo.

The Androgen Excess and Polycystic Ovary Syndrome Society recommends lifestyle management as the primary therapy for metabolic complications in overweight and obese women with PCOS. [67] A moderate amount of daily exercise increases levels of IGF-1 binding protein and decreases levels of IGF-1 by 20%. Modest weight loss of 2-5% of total body weight can help restore ovulatory menstrual periods in obese patients with PCOS. A decrease of 500-1000 calories daily, along with 150 minutes of exercise per week, can cause ovulation.

Acne and extra hair on your face and body can happen if your body is making too much testosterone. All women make testosterone, but if you have PCOS, your ovaries make a little bit more testosterone than they are supposed to. Skin cells and hair follicles can be extremely sensitive to the small increases in testosterone found in young women with PCOS.

This is A LOT of benzodiazepines. I remember the last batch she got too, and it wasn't that long ago. She's using more than I am, and I'm using them legally for a partial spinal cord injury. The FUCK, Luna. Being dependant on heroin isn't enough for you or something? This bothers me more than the heroin, honestly. The withdrawal from benzos can actually kill you, unlike heroin. Not to mention that using multiple CNS depressants together is dangerous af. Narcan won't bring you back from that shit.

Sin tratamiento, el endometrio que se vuelve cada vez más grueso puede pasar a ser cáncer endometrial. PCOS también está relacionado con otras enfermedades que se presentan después de algunos años, como resistencia a la insulina, diabetes tipo 2, colesterol alto, endurecimiento de las arterias (aterosclerosis), presión alta y enfermedades del corazón.
The ultimate goal is to prevent metabolic disease. Metformin (1500 mg per day) compared to placebo in a prospective 12 wk randomized control trial decreased arterial stiffness (by peripheral pressure waveforms in the brachial artery) and endothelial function (measured by augmentation index). Metformin did not reduce HOMA-IR[82]. The study population was obese but young (mean age 30 years), demonstrating the ability to reduce CAD risk even in very young women. Metformin has reduced both carotid intimal media thickness and endothelin levels in obese PCOS women[83]. In many studies metformin has reduced both total cholesterol and LDL cholesterol levels[84-86], triglyceride levels[84] and increased HDL levels[87,88]. Animal studies have shown that acarbose given to insulin resistant rats decreased carotid intimal hyperplasia and blood flow velocities[89]. Taken as a whole, the ability of metformin (and likely other insulin sensitizing agents) to elicit an overall reduction in the risk for CAD may be easier than the ability to produce consistent measureable improvements.
Cirugía. La intervención quirúrgica también es una opción y generalmente se recomienda solo si las otras opciones no generan resultados. La capa exterior de los ovarios (llamada corteza) se vuelve más gruesa en el caso de las mujeres con SOP y se cree que esto puede estar relacionado con la anulación de la ovulación espontánea. La incisión ovárica es una cirugía en la cual el médico realiza varias "perforaciones" en la superficie del ovario mediante láser o con una aguja muy fina la cual se calienta con electricidad. La cirugía suele restablecer la ovulación, pero solo durante 6 a 8 meses.
One time when I was in a&e this junkie was having withdrawals and literally shitting and puking everywhere. The stench was unreal to the point they had to move other patients out of the area, as it was making people sick. The nurses were fucking pissed off and disgusted, of course they couldn't say anything in front of him, but they were bitching about it when they came into my room. The world is not there to entertain and 'ooh' and 'aww' over your projectile shit, Tuna. Stop being a disgusting adult baby.
Oh FUCK no. Someone please let the woman know; it's a matter of saving an animal from a lifetime of misery and despair. Siamese cats are much harder to properly keep than the average housecat and needs a household where they'll be stimulated and properly trained so they don't get aggressive. There's no way two lazy dirty junkies could take care of one.
The genetic component appears to be inherited in an autosomal dominant fashion with high genetic penetrance but variable expressivity in females; this means that each child has a 50% chance of inheriting the predisposing genetic variant(s) from a parent, and, if a daughter receives the variant(s), the daughter will have the disease to some extent.[24][26][27][28] The genetic variant(s) can be inherited from either the father or the mother, and can be passed along to both sons (who may be asymptomatic carriers or may have symptoms such as early baldness and/or excessive hair) and daughters, who will show signs of PCOS.[26][28] The phenotype appears to manifest itself at least partially via heightened androgen levels secreted by ovarian follicle theca cells from women with the allele.[27] The exact gene affected has not yet been identified.[7][24][29] In rare instances, single-gene mutations can give rise to the phenotype of the syndrome.[30] Current understanding of the pathogenesis of the syndrome suggests, however, that it is a complex multigenic disorder.[31]