The incidence of polycystic ovary syndrome (PCOS) is as high as 5-10%. The main effects of the disease include.
(1) Menstruation and reproductive function.
(2) Glucose metabolism and lipid metabolism.PCOS is a chronic disease that affects women’s health almost throughout their lives and is not curable but can be managed.
I. Hazards of polycystic ovary syndrome
Recent harms: including menstrual disorders, infertility, acne, hirsutism, obesity, etc. Most people’s knowledge of the disease stays in the immediate future and think that adjusting menstruation and curing infertility is the ultimate goal, then you are wrong!
Obstetric harms: 2 times increase in miscarriage rate, 3 to 4 times increase in incidence of gestational diabetes and gestational hypertension. One of my studies found that the prevalence of gestational diabetes in patients with PCOS assisted conception was about 40%, so I’m really not scaring you!
Long-term hazards: including increased incidence of endometrial cancer, diabetes, metabolic syndrome, cardiovascular disease, etc. These are invisible killers lurking in the body of PCOS patients, which come very stealthy and have very serious consequences! Unknowingly you will trip the gun!
Second, 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
Misconception 1: Only testing sex hormones without understanding the changes of metabolic indexes;
Misconception 2: Only regulating menstruation, once diagnosed, it is Daing 35 treatment;
Misconception 3: As long as the infertility is caused by PCOS, once diagnosed, immediately promote ovulation, regardless of whether there are metabolic abnormalities, no matter how high the androgen level is, no matter how great the impact on obstetric complications;
Myth 4: Ignore the long-term health effects of the disease;
Myth 5: The treatment course is random and lack of regular testing;
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.
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.
Individualized treatment plan: Since PCOS patients are highly heterogeneous and each patient behaves differently, individualized treatment is needed according to each individual’s situation and requirements.
Lifestyle modification : including exercise, dietary modification, stress reduction and regular life can help restore ovulation and menstruation, and prevent long-term complications such as cancer and metabolic disorders;
Androgen reduction: Oral contraceptives (OC) are preferred, as well as spironolactone and dexamethasone;
Progestin: used for those with less severe symptoms of hyperandrogenism and regular withdrawal to protect the endometrium from cancer;
Treatment of insulin resistance: metformin is preferred.
Infertile patients: ovulation promotion for pregnancy is indicated for patients with pregnancy requirements.
Timely adjustment of treatment regimen: PCOS patients treatment must be adjusted considering different age stages, different requirements, different disease stages and other issues.
Adolescent patients should pay attention to their specific stage of physiological Kaohsiung, unless androgens are particularly high and excessive intervention is not recommended;
In patients without fertility requirements, the efficacy of treatment should be regularly monitored to determine whether to discontinue, continue, or adjust the regimen;
For those with fertility requirements, ovulation should be promoted as soon as possible after controlling hormonal and metabolic disorders;
Women of childbearing age should continue to be tested and treated regularly after completion of their fertility plan;
Postmenopausal women still need to be aware of the risk of metabolic disorders and should be tested regularly and treated promptly.
Well, the gong whirls around the payroll and wishes to look at the tomb, and the gong is not a good idea.
Although PCOS is complex, variable and affects your whole life, you must not be afraid. The same saying: “Who can not have one or two chronic diseases, from small to rhinitis, hemorrhoids, large to hypertension, heart disease, diabetes, that can be completely cured? So, optimistic face positive control!”