A obese female having hirsutism on laboratory investigation has high level of LH and androgens. Likely cause is-
**Core Concept**
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in women of reproductive age characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. It is associated with elevated luteinizing hormone (LH) and androgens, leading to clinical features like hirsutism and obesity.
**Why the Correct Answer is Right**
In PCOS, there is a relative LH excess due to disrupted hypothalamic-pituitary-ovarian axis, resulting in increased androgen production by the ovaries. This leads to hyperandrogenism and hirsutism. Obesity is a common comorbidity, and the condition is often diagnosed in women with signs of hyperandrogenism, irregular cycles, and elevated LH levels. The combination of obesity, hirsutism, and elevated LH and androgens is classic for PCOS.
**Why Each Wrong Option is Incorrect**
Option B: Exogenous steroid ingestion can cause hirsutism and elevated androgens, but it typically presents with acute onset and is associated with steroid use history, not a chronic, idiopathic pattern.
Option C: Turner syndrome (monosomy X) presents with primary amenorrhea, short stature, and lack of ovarian function, not hyperandrogenism or elevated LH.
Option D: Kleinfelter syndrome (XXY) causes infertility, gynecomastia, and low estrogen, not hyperandrogenism or hirsutism in females.
**Clinical Pearl / High-Yield Fact**
PCOS is the most common cause of hirsutism in women, especially in obese individuals with elevated LH and androgens. A key diagnostic clue is the presence of oligomenorrhea or amenorrhea in addition to hyperandrogenism.
✓ Correct Answer: A. PCOS