Many patients often ask me the question whether polycystic ovary syndrome can be cured, because most of them think that polycystic ovary syndrome cannot be cured, according to many experts, doctors, articles or some literature.
First of all, in the women population, polycystic ovary syndrome is less common in adult women, especially in those over 30 or 35 years old. Some cases of polycystic ovary syndrome can also be seen less frequently after childbirth, after the function of the reproductive endocrine regulatory axis and the maturation of reproductive organs and target glands. The occurrence of polycystic ovary syndrome should be mainly related to nutritional overload and the current dietary structure. In particular, the combination of additives and hormones in various types of food, as well as the psycho-psychological aspects due to excessive intake, has resulted in a substantial increase in the occurrence of polycystic ovary syndrome compared to 10 or 20 years ago. The occurrence of this disease, like hypertension, diabetes mellitus, atherosclerosis, etc., is related to life and intake and is the result of a multi-causal, multi-linked pathological change.
Therefore, at its core, polycystic ovary syndrome remains a reproductive endocrine disorder with gonadal (ovarian) dysfunction as the main cause. The important features of the pathology of polycystic ovary syndrome are decreased LH (luteinizing hormone) sensitivity in the ovary, defective LHR (luteinizing hormone receptor) or reduced synthesis, and disruption of the aromatase pathway, which results in excessive synthesis of androgens that cannot be further aromatized to estrogen.
Combination of polycystic ovary syndrome with metabolic syndrome, insulin refusal or hyperinsulinemia, current social overnutrition, excessive energy intake, especially raw materials for sex hormone synthesis, excessive cholesterol intake, increased pancreatic and metabolic burden, enhanced anabolic effects, obesity, etc., exacerbating local ovarian dysfunction.
For the treatment of polycystic ovary syndrome, improvement of ovarian endocrine function is the key, and improvement of metabolic status is the basis.
Fibrosis of the ovarian peritoneum in polycystic ovary syndrome and non-rupture of follicles occur more often during ovulation promotion therapy, which is related to high LH and low female or Kaohsiung state, mainly associated with thickened follicular peritoneum fibrosis.
Successful and stable ovulation is important for patients with polycystic ovary syndrome, if a successful pregnancy can be achieved and carried to term in October, the ovaries also acquire the best and resting process. If the pregnancy is successful and the pregnancy is completed in October, the ovaries have also acquired the best and resting process. The reproductive function matures and becomes perfect, and the chance of reoccurrence of polycystic ovary syndrome is greatly reduced, although if one is still overly obese, obese or insulin-resistant polycystic ovary syndrome can still occur.
Overnutrition, weight gain, obesity, hyperinsulinemia, insulin rejection (abnormal receptors), and abnormal glucose tolerance are the underlying causes of polycystic ovary syndrome. These processes, however, can be completely and effectively stopped or reversed by healthy and rational control of multiple aspects of diet structure, exercise, and lifestyle, the earlier the better the advice. Therefore, attention and clear understanding of the disease and its pathophysiological basis can reduce blindness and is important for countermeasure development.
In many infertile, unmarried or adolescent women, the occurrence of polycystic ovary syndrome is mainly related to long-term anovulation, immature ovarian function and unstable and immature gonadal axis cycle regulation mechanisms.
During pregnancy and postpartum time, excessive weight gain leading to obesity and excessive energy intake can increase the risk of recurrence of polycystic ovary syndrome after delivery, as well as increase the risk of insulin refusal and diabetes. Proper diet, control of excessive intake and prevention of metabolic syndrome are important foundations for the prevention of polycystic ovary syndrome, diabetes and cardiovascular disease.
The use of progesterone and other progestational hormones, as well as the use of packaged contraceptives, should be used with caution. Progesterone preservation during pregnancy and its effects on the offspring in the long term require further evidence-based studies with large samples.
In prolonged anovulation, many women may have polycystic ovaries, but this is not diagnostic of polycystic ovary syndrome.
Prolonged menstrual disorders, menstrual sparing and anovulation can progress to a more complex polycystic ovary syndrome. This leads to increased difficulty in restoring the menstrual cycle and ovulation.
Stable ovulation, regular endocrine regulation, or a successful pregnancy are the better outcomes for polycystic ovary syndrome.
Successful pregnancy is also the best treatment for polycystic ovary syndrome. No drug can compare with an October pregnancy in that one aspect further intensifies the maturation of ovarian function, another aspect makes the ovary fully resting, three aspects increase the development of the ovary and the synthesis and refinement of various receptors, four aspects improve the blood supply to the ovary and completely stop the follicular peritoneal fibrosis and instead facilitate the degradation of the stroma or collagen, and five aspects completely reverse the local inflammatory fibrotic process of the ovary.
However, it is never the case that all problems are solved when a woman with polycystic ovary syndrome becomes pregnant. If she remains obese, insulin refusal, and metabolic syndrome during pregnancy and postpartum, all are prone to recurrence and treatment difficulties.
The treatment of polycystic ovary syndrome is very subtle. Progesterone, emergency contraceptives, etc. mostly have androgen-like effects and are sometimes used to induce menstruation, which more than pays for itself, but may exacerbate the Kaohsiung state or future easier amenorrhea.
The adequate transformation of the endometrium is also very important. In many cases of polycystic ovary syndrome, Kaohsiung, low estrogen or both are present. Promoting the production of ovarian-derived estrogen is one of the important steps in treatment.
In my clinical practice, I usually do not use or use progesterone to promote menstruation, but mostly use herbal methods to promote follicle development. In some cases, menstruation comes sooner, sometimes it takes longer, mainly to promote follicle development from the beginning; in some cases, after a long period of amenorrhea, ovulation occurs again through herbs, and only after that, menstruation comes. These methods, in my personal experience, are better than progesterone preparations to promote menstruation.
Caution is also needed when treating polycystic ovary syndrome with ovulation promotion. One aspect is to avoid LUFS (follicular unruptured luteinization syndrome); a more important aspect is to evaluate the ovaries before ovulation promotion, and also during the use of ovulation promotion, to avoid OHSS (follicular hyperstimulation syndrome).
In fact, I have more experience and feelings about polycystic ovary syndrome and menstrual disorders, and I also have some new ideas about aromatase, insulin rejection and LH rejection, as well as the etiology of polycystic ovary syndrome, which are being studied by my group. Hopefully, some good progress will be made to meet the expectations.
Polycystic ovary syndrome is a relatively complex disease that requires multiple aspects to be taken into account when treating it, and it is often difficult to achieve expectations with simple approaches. There should also be an evaluation regarding the use of Daimler 35 and MaFuLong. And they should not be used in a general way. Especially in the case of unmarried or adolescent women or postpartum menstrual disorders and polycystic ovary syndrome, the use of Daing 35 or MaFuLong should be evaluated comprehensively and used with caution. Excessive suppression of the gonadal axis does not yield the desired rebound effect.
Chinese medicine treatment, which is effective, with reasonable formulae, especially in-depth evidence rubbing, in the regularity to be followed, has an important role in the improvement of the polycystic ovary syndrome syndrome combined state, the success of follicle development, the success rate of ovulation, and the increase of conception rate.
The combination of Chinese and Western medicine is unique in the treatment of polycystic ovary syndrome. It should be taken seriously and relevant norms should be developed.
There are various diseases that can manifest as symptoms of polycystic ovary syndrome, especially when Kaohsiung is present, which requires differential diagnosis and requires physicians to have knowledge in many aspects, especially in the discipline of Western medicine endocrinology. Without a clear and explicit diagnosis and accurate grasp of the pathophysiological state, blind treatment, in some cases, does not yield better expectations.
In endocrine therapy, the knowledge related to modern pharmacology and even molecular pharmacology, the knowledge of pharmacology of herbal components, and the knowledge and progress related to molecular pathophysiology are important guidance for the treatment of polycystic ovary syndrome. Having this knowledge can further reduce the blindness and ambiguity in the treatment process of doctors. Blind belief in some prescriptions or lack of in-depth pathophysiological analysis and judgment, just purely herbal prescriptions for treatment, sometimes with slower efficacy. Follicular development and dominance, as well as the relationship between multiple links with endocrine, metabolic base state, and overall state improvement need to be clear, orderly, and gradually reversed, which is difficult to achieve results in a short time.
During the treatment process, it is equally important for the doctor to be very clear and for the patient to generally understand the program flow, for cooperation and long-term treatment.
Hormone level check should be tested without taking hormones for more than one month, otherwise it does not really reflect the real situation of hormones. After progesterone to induce menstruation, or after taking Daing 35, the hormone level check is actually a temporary illusion. Only when stable restoration of follicles develops in an orderly manner and stable ovulation occurs, menstruation is stable and normal, and polycystic ovaries will be corrected.