I. What is polycystic ovary syndrome?
Polycystic ovary syndrome is a syndrome characterized by chronic anovulation, amenorrhea or scanty menstruation, infertility, obesity, hirsutism and polycystic enlargement of the ovaries. It was first discovered by two doctors, Stein and Leventhal.
Why does polycystic ovary syndrome attract the attention of doctors so much?
1. the etiology is unknown.
2. differences in clinical manifestations.
3. inconsistent diagnostic criteria.
4. no exact incidence information, but there is a large patient population
5. Treatment needs to vary for different needs.
Third, the characteristics of polycystic ovary syndrome.
1. heterogeneity: that is to say, different clinical manifestations, laboratory tests and auxiliary examinations vary greatly.
2. incurable: polycystic ovaries are hereditary diseases and need to be controlled with drugs for a long time.
3. Progressive development: metabolic syndrome will occur, causing diabetes, hyperlipidemia, hypertension, etc., and eventually cardiovascular disease; long-term non-ovulation will cause endometrial cancer; and infertility.
IV. Physicians’ concerns.
1. diagnostic criteria.
2.Etiology.
3.Gene.
V. Concerns of patients.
1. menstrual disorders.
2. hirsutism and acne.
3. obesity.
4, infertility.
VI. What patients do not know.
Long-term complications: risk of metabolic syndrome (diabetes and hyperlipidemia) and risk of endometrial cancer.
VII. Diagnostic criteria.
1. manifestations of ovarian polycystic.
2. ovulation disorders (amenorrhea or scanty menstruation).
3. hyperandrogenemia or manifestations of hyperandrogenism: recurrent acne, hirsutism.
Any two of the above criteria should be met, while other causes of hyperandrogenism or amenorrhea should be excluded. It should also be noted that.
1. people who have menstruation do not necessarily ovulate.
2. If the menstrual cycle is greater than 35 days, it is considered diluted menstruation.
VIII. Treatment of polycystic ovary syndrome:
1. treatment of insulin resistance grade obesity.
2. treatment of hyperandrogenism.
3. adjustment of menstruation.
4.Ovulation promotion treatment.
9. Importance of lifestyle adjustment
Adjustment of lifestyle, weight reduction in the treatment of this disease has a pivotal role. There have been many experiments to prove that the initiating factor of this disease is insulin resistance. Insulin resistance has a genetic basis and is inevitably linked to obesity. Lifestyle modification is the choice of a healthy lifestyle. Reduce energy intake and increase energy release, in other words, eat less and exercise more. Many patients, by simply adjusting their lifestyle and reducing their weight, are able to have normal menstrual periods, less acne on their faces, and less hair.
Eating less is also about science. First of all, eating less does not just mean eating less or not eating carbohydrates. Many people understand that carbohydrates and fats are carriers of energy, so a diet first carbohydrates, fats off, replaced by a high-protein diet. In fact, I do not know that protein is also a carrier of energy, when carbohydrate intake is insufficient, burning carbohydrates to obtain energy, producing more toxic metabolites, increasing the burden on the liver and kidneys, more detrimental to the body. Often also aggravate the high androgen.
Secondly, eating less is not not to eat. One does not eat the next, this is a common mistake of many people who lose weight, excessive dieting, weight loss requirements are too high, in fact, it is not easy to achieve the goal, often make people give up the goal. Excessive dieting may also occur anorexia nervosa, a disease that is difficult to cure. Eating less means that the daily intake of energy to maintain the normal life and work required. The initial stage of weight loss, because of the amount of exercise, energy intake, to be less than needed, weight loss to a predetermined weight, energy intake, to maintain the need to ensure that the weight of the same.
Ten, commonly used drugs.
1. daing-35. this drug itself is a contraceptive, because the progestin component inside has a very good androgen-lowering effect, so it is widely used in the treatment of polycystic ovary syndrome. Other contraceptives also have a hypoandrogenic effect, but the effect is not as good as Da-Ying-35. Birth control pills are also good at controlling the menstrual cycle. Sporadic menstruation or after all this is related to the ovulation disorder of this disease. Without ovulation, there is no production of progesterone and the endometrium will overproliferate without shedding to produce menstruation, while the pill contains progesterone and when the pill is stopped, progesterone suddenly decreases and menstruation comes, which mimics the normal menstrual cycle. At the same time, it makes the endometrium shed regularly, which prevents the excessive proliferation of the endometrium and therefore also plays a role in preventing endometrial cancer.
2. Gevalt: Also known as Metformin. This drug was originally used to treat diabetes. Its role is to increase the sensitivity of insulin. The cause of polycystic ovary syndrome is insulin resistance, which means that the body is insensitive to insulin. With increased sensitivity and reduced appetite, some people will lose weight and have a natural menstrual cycle. Or for those who are insensitive to ovulation-promoting drugs, the success rate of ovulation will also be improved.
XI. Different treatment needs for different groups of people
1. Before marriage during puberty: mainly to reduce androgens to maintain menstruation, not to promote ovulation and to protect ovarian reserve.
2. Post-marital with fertility requirements: ovulation promotion and fertility promotion.
3. Women after childbirth: prevention of distant complications is the main focus.
12. Lifelong medication is not scary. What is scary is the distant complications.