The prevalence of polycystic ovary syndrome (PCOS) is as high as 5-10%.
I. The main effects of polycystic ovary syndrome include.
1. menstruation and reproductive function.
2. glucose metabolism and lipid metabolism.
It is a chronic disease that affects women’s health for almost all their lives. It is not curable, but can be managed.
II. Health hazards of polycystic ovary syndrome
1, recent hazards: including menstrual disorders, infertility, acne, hirsutism, obesity, etc.; most people’s understanding of the disease stays in the recent hazards, thinking that adjusting menstruation and curing infertility is the ultimate goal, then you are wrong!
2, obstetric harm: miscarriage rate increases 2 times, the incidence of gestational diabetes and gestational hypertension increases 3-4 times. One of my studies found that the prevalence of gestational diabetes in patients with PCOS assisted conception was about 40%, so I’m not scaring you!
3, the long-term harm: including increased incidence of endometrial cancer, diabetes, metabolic syndrome, cardiovascular disease, etc., these are invisible killers lurking in the body of PCOS patients, come very stealthy, the consequences are very serious! Unknowingly you will be shot!
Third, the need for long-term management
Because of the far-reaching impact of the disease on women’s health, the disease requires long-term management.
The immediate goal of long-term management is to adjust the menstrual cycle, treat hirsutism and acne, control weight, and assist fertility; the long-term goal is to protect the endometrium to prevent endometrial cancer, prevent diabetes, cardiovascular disease, etc.
Myths of polycystic ovary syndrome treatment
Myth 1: Only testing sex hormones without understanding the changes of metabolic indexes.
Myth 2: Only regulating menstruation, once diagnosed is Daing 35 treatment.
Myth 3: As long as the infertility is caused by PCOS, promote ovulation as soon as it is diagnosed, regardless of whether there are metabolic abnormalities, regardless of how high its androgen level is, and regardless of its impact on obstetric complications.
Myth 4: Ignoring the long-term health effects of the disease.
Myth 5: Arbitrary treatment regimen and lack of regular testing.
V. Long-term management of polycystic ovary syndrome
Long-term management of PCOS includes regular testing, development of a reasonable treatment plan, and timely adjustment of the treatment plan according to the situation.
1.Regular testing
(1) What to test: The test indexes include hormones (FSH, LH, PRL, T, E2, SHBG, etc.), glucose metabolism (OGTT, INS release test), lipid metabolism, changes in liver and kidney function, etc.
(2) When to test: The purpose of pre-treatment testing is to develop an individualized treatment plan; the treatment process is tested once every 3-6 months to understand the effect of treatment; pre-conception testing to determine the presence of obstetric risks and the need for pre-conception treatment.
2. Development of an individualized treatment plan.
As PCOS patients are highly heterogeneous and each patient behaves differently, individualized treatment is needed according to each individual’s situation and requirements.
3.Lifestyle adjustment.
Including exercise, diet adjustment, stress reduction, regular life, etc., which can help restore ovulation and menstruation, and prevent cancer, metabolic disorders and other long-term complications; androgen lowering: preferred oral contraceptives (OC), and spironolactone, dexamethasone, etc.; progestin: used for those with less severe symptoms of hyperandrogenism, regular retreat to protect the endothelium from cancer; treatment of insulin resistance: preferred metformin to prevent long-term Complications.
Infertile patients: ovulation promotion for pregnancy is indicated for patients with pregnancy requirements.
Timely adjustment of treatment regimen.
The treatment of PCOS patients must be adjusted taking into account the different age stages, requirements and stages of the disease.
1. adolescent patients: attention should be paid to their specific stage of physiological Kaohsiung, unless excessive intervention is not recommended for particularly high androgens.
2.Patients without fertility requirements: the treatment process is regularly tested for efficacy to determine whether to discontinue, continue treatment, or adjust the regimen; those with fertility requirements should control hormonal and metabolic disorders and then promote ovulation for pregnancy as soon as possible.
3. Women of childbearing age: regular testing and treatment are still required after completion of fertility planning.
4. Postmenopausal women: they still need to pay attention to the risk of metabolic diseases, and should be tested regularly and treated timely.