What is polycystic ovarian syndrome (PCOS)?
Polycystic ovarian syndrome (PCOS) is one of the most common and complex forms of hyperandrogenic anovulation in women of adolescent to childbearing age, with a prevalence of 5-10%. Each patient has the basic phenomena of anovulation, hyperandrogenism and polycystic ovaries, but each has its own characteristics. Gu Lin, Department of Gynecology, Nanjing Maternal and Child Health Hospital
Specific clinical features.
1. Anovulatory menstrual abnormalities and infertility
2. High blood androgens, hirsutism and acne
3. Unilateral/bilateral ovarian enlargement with polycystic-like changes
4, insulin antagonism, obesity, abnormal lipid metabolism
5.Sleep apnea syndrome
Why does PCOS occur?
At present, the cause of PCOS is still unclear, the main “root” of the disease is androgen excess, it is presumed that it may be the result of genetic and environmental interaction.
Genetic factors: These patients have a certain family aggregation, many patients’ fathers have hirsutism, acne, seborrheic dermatitis, early baldness, and their mothers and sisters have scanty menstruation and infertility.
Environmental factors: such as geography, nutrition and lifestyle, etc.
Third, what are the hazards of PCOS?
1, the recent harm – abnormal menstruation, infertility, obesity, acne and hirsutism, etc.
2, pregnancy – gestational diabetes, gestational hypertensive disorders.
3, long-term effects – hyperlipidemia, hypertension, type II diabetes, coronary heart disease, endometrial cancer, etc.
4, sleep apnea syndrome —- hypoxia on the whole body and further aggravate obesity.
Fourth, what tests are generally done to suspect PCOS?
1.Sex hormone measurement
2, transvaginal or rectal ultrasound
3, fasting blood sugar or oral glucose tolerance test
4.Insulin level or insulin release test Gu Lin, Department of Gynecology, Nanjing Maternal and Child Health Hospital
5.Other: endometrial biopsy, urinary 17-ketosteroid, thyroid function measurement, etc.
V. How to treat PCOS?
Treatment strategy: individualized treatment with the goals of regulating menstrual cycle, anti-hyperandrogenism, promoting fertility, controlling insulin resistance, treating sleep apnea syndrome, and preventing long-term diseases (e.g. type II diabetes, coronary heart disease, endometrial cancer, etc.) Gu Lin, Department of Gynecology, Nanjing Maternal and Child Health Hospital
VI. Key points in the treatment process
1. Early detection and early treatment – starting from adolescence
2. Emphasize the important role of physical and mental treatment
3.Long-term follow-up