Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic abnormality common in women of reproductive age, characterized by chronic anovulation (disturbance or loss of ovulatory function) and hyperandrogenemia (excess production of male hormones in women), with the main clinical manifestations being irregular menstrual cycles, infertility, hirsutism and/or acne, and is the most common female endocrine disorder. In recent years, the incidence of polycystic ovary syndrome has been increasing, and some young women are even afraid to fall in love or get married, while some couples have strained or divorced due to the disease. Therefore, scientific understanding of this disease is of great significance for the harmony of individual patients and families.
Causes
According to Chinese medicine, the pathogenesis of polycystic ovary syndrome is kidney deficiency, phlegm coagulation, blood stasis, liver depression, and yin deficiency. The deficiency of the kidneys leads to the loss of nourishment of the impulsive veins, resulting in late menstruation or even amenorrhea or infertility.
The etiology of polycystic ovary syndrome is still not clear, and there are two types of research on the etiology of PCOS: non-genetic theory and genetic theory.
1. Non-genetic theory of PCOS
It is believed that the hormonal environment in the uterus during pregnancy affects the endocrine status of individuals in adulthood.
2, PCOS genetics theory
The main basis of this theory is that PCOS is a family cluster phenomenon, and familial ovulatory dysfunction and polycystic ovarian changes suggest a genetic basis for the disease. Hyperandrogenemia and/or hyperinsulinemia may be the genetic characteristics of PCOS family members with the same disease, and the role of insulin in promoting ovarian androgen production is also influenced by genetic factors or genetic susceptibility. The prevalence of hyperinsulinemia in women and premature hair loss in men is increased in families with sporadic ovulation, hyperandrogenemia and polycystic ovarian changes. Cytogenetic findings suggest that PCOS may be inherited in an X-linked recessive, autosomal dominant, or polygenic manner. The largest number of genetic genes associated with PCOS were identified by genome-wide scan, such as candidate genes for steroid hormone synthesis and related functions, androgen synthesis-related regulatory funds, insulin synthesis-related funds, candidate genes for carbohydrate metabolism and energy balance, candidate genes for gonadotropin function and regulation, adipose tissue-related genes, and chronic inflammation-related genes.
In recent years, the incidence of polycystic ovary syndrome has been increasing, which may be mainly related to the following factors.
1. Psychosomatic factors that cannot be ignored: when tension, stress and fast pace lead to a long-term acute or chronic stress in the body, they can inhibit or lead to gonadal axis rhythm and ovarian dysfunction; factors such as long-term mental depression and large psychological fluctuations can directly affect the gonadal axis and ovarian function; when emotional tension or stress leads to a sharp or sustained increase in adrenocortical hormone secretion, resulting in increased blood glucose and The need for insulin increases, and the long period of stimulation may lead to hyperinsulinemia or insulin antagonism; this is also an important basis for the occurrence of polycystic ovary syndrome such as diabetes.
2, Some adolescent students or night shift workers, with disturbed biological clock rhythm, plus long-term tension and mental stress, are more prone to disruption or inhibition of gonadal axis rhythm.
3, some hormonal drugs, such as glucocorticoids prednisone (Bonisone), chorionic gonadotropin, etc., can lead to an increase in blood sugar, increasing the chance of hyperinsulinemia or insulin resistance.
Clinical manifestations
Polycystic ovary syndrome often occurs in adolescence and childbearing years, mainly manifesting as menstrual disorders, sporadic menstruation, low menstrual flow and gradually amenorrhea or irregular uterine bleeding; hirsutism, often mainly around the nipples, pubic area, armpits, upper lip at the corners of the mouth; or prolonged infertility, spontaneous abortion, obesity, oily skin and acne or acanthosis nigricans.
We need to know that polycystic ovaries and polycystic ovary syndrome are two concepts. In some normal women, the ovaries may be polycystic with many follicles, but this is not necessarily 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.
Auxiliary examination
1.Endocrine examination: It may show increased androgens and estrone, abnormal ratio of gonadotropins, such as LH/FSH>2-3, blood E1/E2>1; fasting blood sugar and insulin are higher than physiological level, abnormal glucose tolerance test; obese people may have elevated triglycerides, etc.
2.B ultrasound: uniform enlargement of bilateral ovaries and ≥12 follicles of 2-9mm diameter in unilateral ovaries.
3, Basal body temperature measurement: shows monophasic, no elevation of body temperature in the second half of menstruation.
This disease needs to be differentiated from the following diseases
1, Cushing’s syndrome: typical manifestations include full-moon face, buffalo back, centripetal obesity, purple skin lines, hirsutism, acne, hypertension and osteoporosis, abnormal glucose tolerance, skin pigmentation, mostly accompanied by masculine manifestations. It is caused by various causes of hyperadrenocorticism. Laboratory tests show loss of the normal circadian rhythm of plasma cortisol and an increase in urinary free cortisol.
2. Adrenal tumors: Both benign and malignant tumors of the adrenal cortex can lead to increased androgens. CT or MRI is sensitive to adrenal tumors and can localize and show atrophy of the contralateral adrenal gland.
3, hyperprolactinemia: patient obesity is usually diffuse obesity, lower body obesity is more obvious. In addition about 20% of women with pituitary prolactin adenoma have hirsutism and acne.
Some characteristics of polycystic ovary syndrome.
1. This disease is an incurable disease. According to research, it is related to an abnormality in a certain gene and therefore cannot be completely cured. However, it is not very clear exactly what gene is wrong, so it cannot be said to be hereditary.
2. The disease is relatively variable in its clinical manifestations, meaning that the patient’s performance varies from person to person, which is the reason why it has long been difficult to diagnose and treat.
3. This disease is progressive in development. High androgens, insulin resistance and ovarian dysfunction without ovulation are mutually beneficial and progressively aggravated. Therefore, active treatment is required. Polycystic ovary syndrome may cause abnormalities in fat metabolism and glucose metabolism, with increased chances of hyperlipidemia and diabetes. In the absence of ovulation, the endometrium cannot be protected by progesterone, and the endometrium is prone to cancer, thus increasing the incidence of endometrial cancer.
In this way, in addition to infertility, cardiovascular disease, diabetes and endometrial cancer are also factors that threaten the health of patients with polycystic ovary syndrome. Therefore, the disease cannot be cured, but it should be treated actively.
In modern society, there are many kinds of pressures around women, both in life and at work, while various diseases are threatening women’s health. If you don’t pay much attention to your health, it’s easy to be unaware of the disease. The earlier polycystic ovary syndrome is detected and treated, the better it is for restoring health, and these benefits include.
1. It can help women regain their beautiful appearance. Many patients with polycystic ovary syndrome have facial acne, and if it is delayed too long, the acne on the face will puss out leaving permanent scars, which is very harmful to women who love beauty.
2, we can early through the adjustment of their diet structure and appropriate exercise to relieve the body’s obesity symptoms. Like some women after obesity will also appear skin cracks, the longer these traces will be more difficult to remove.
3, early treatment can greatly reduce the risk of other diseases, common are diabetes, high blood fat, endometrial cancer, etc.
Early detection and treatment is very helpful to restore normal ovulation.
Chinese medical treatment
1.Diagnosis and dietary therapy
(1) Kidney deficiency
The main symptoms: menstruation is postponed, low in quantity, light in color and thin in quality, gradually becoming amenorrhea, or menstrual cycle is disrupted, with heavy or incomplete menstruation; or infertility after marriage, soreness of the waist and knees, dizziness and tinnitus, lack of color, body fatigue, fear of cold, loose stools; light tongue with thin coating and sunken pulse.
Treatment: Benefiting the kidney and regulating flushing.
Selected formula: Right Return Pill with addition and subtraction.
Food therapy.
① 50 grams of turtle nail, 1 white pigeon. Wash the pigeon, break up the turtle nail, put it into the belly of the pigeon, put it in a tile pot and add water. Stew and season to taste. Take it once every other day, 5 to 6 times a month.
(2) 1 turtle, 100g lean pork, boil the soup together, season and take it once a day for several days a month.
(2) Qi stagnation and blood stasis evidence
Main symptoms: late menstruation, low volume, purple-red color, blood clots, irregular menstruation or amenorrhea, abdominal pain during menstruation, infertility after marriage, mental depression, irritability, chest distension, breast distension, dense hair, purple dull tongue with stasis, sunken string or sunken astringent pulse.
Treatment: Regulating Qi, promoting stagnation, activating blood circulation and resolving blood stasis.
Preferred formula: Add and subtract Prosperity San and Diaphragmatic Confronting Stasis Tang.
Food therapy.
①Yi Mu Cao 50-100 grams, orange 30 grams, brown sugar 50 grams, decoction in water, once a day for several days a month.
②Chuanxiong 6-9 grams, 2 eggs, brown sugar, add water and decoction, remove the shell and take the eggs after they are cooked, then boil for a few moments, remove the dregs, add brown sugar to taste, eat the eggs and drink the soup. Once a day for 5 to 7 days.
(3) Damp-heat in liver meridian
Main symptoms: scanty menstruation, low menstrual flow, or even closed menstruation, or menstrual disorders, leakage in collapse, dense hair, facial acne, premenstrual pain in the chest and breasts, swelling of the limbs, constipation, yellow urine, excessive amount of hypochondrium, itchy Yin, red tongue with thick yellow coating, sunken string or string pulse.
Treatment: Clearing heat and relieving dampness, draining the liver and regulating menstruation.
Recipe: Danjian Yiyao San and Gentian Diarrhea Liver Soup plus or minus.
Food therapy: Avoid spicy, fatty, sweet and thick tastes, such as tobacco, alcohol and fatty meat. It is better to eat light food, to eat vegetables and fruits.
① Chickpea watermelon drink: 50 grams of lentils, 50 grams of chickpea, boiled and left to cool, then add watermelon juice to drink.
(2) Zelig Coix Rice Porridge: 30 grams of Zelig (decoction), 40 grams of Coix seeds, 40 grams of round-grained rice, boil the porridge for consumption.
(4) Spleen deficiency and phlegm-dampness evidence
Main symptoms: Menstruation is sparse, low in volume, or even closed. The amount of hypogonadism is large, and the marriage is infertile; the body is obese, hairy, dizzy, chest tightness, phlegm in the throat, tiredness of the limbs, fatigue, loose stools, fat tongue, pale color, thick and greasy moss, sunken and smooth pulse.
Treatment: Removing phlegm and dampness, clearing the channels and regulating menstruation.
Recipe: Cang Fu Gui Phlegm Pill with addition and subtraction.
Food therapy.
①Coix rice 30 grams, fried lentils 15 grams, hawthorn 15 grams, brown sugar appropriate amount, four flavors together to cook porridge. Once a day, for 7-8 days a month.
②30 grams of Atractylodes macrocephala, 30-60 grams of japonica rice. Decoction of Atractylodes macrocephala to remove the dregs and extract the juice, and then into the japonica rice porridge, once a day, can be served continuously for several.
2.Acupuncture treatment
On the one hand, acupuncture can regulate the function of hypothalamic-pituitary-ovarian axis to achieve the role of endocrine regulation, and at the same time, acupuncture can also regulate the abnormal glucose and lipid metabolism to improve insulin resistance, as well as weight loss and fat reduction; and this effect of acupuncture is generated by stimulating the intrinsic function of the body’s own tissues and organs, which can adjust the endocrine function of the human body from multiple pathways and targets, reduce serum androgen, insulin levels This effect is produced by stimulating the internal functions of human tissues and organs, which can adjust the endocrine function of human body in multiple ways and targets, lowering serum androgen and insulin levels, lowering LH levels or normalizing LH/FSH ratio, thus restoring normal ovulation function of ovaries.
(1) Acupuncture for ovulation: Starting on the 14th day of menstruation, acupuncture is applied to Guan Yuan, Zhong Ji, Zi Gong and San Yin Jiao. The needles are applied once a day for three times, and each time the needles are left for 30 minutes.
(2) Acupoint embedding: acupoints were selected in two groups: Liver Yu, Spleen Yu, Kidney Yu, Yanglingquan, Sanyinjiao, and Fenglong; and Zhonggui, Hypochondrium, Tianshu, Guilai, Guan Yuan, Zi Gong, and Yinlingquan. Each treatment was performed with a single group of acupuncture points, alternating between the two groups, once a week, with discontinuation during menstruation. This method is more suitable for patients with obese PCOS.
(3) Moxibustion: Guan Yuan, Zhong Ji, Foot San Li, and San Yin Jiao. Choose 3-4 acupuncture points each time, once a day.
(4) Ear acupuncture: kidney, adrenal gland, endocrine, ovary, Shen Men. Choose 4-5 acupoints at a time, 2-3 times a week.
Self-regulation
1, learn to reduce stress for yourself: combine work and rest, do not make more demanding or extravagant demands on study and work, improve mental tolerance to reduce the inhibition of ovarian function by stress.
2, adjust the diet: diet is the most common method of treating obesity, the advantage is that the weight can be reduced in a short time. However, while dieting, attention should be paid to: do not skip the main meals; eggs are better in the morning; fruits should not be eaten on an empty stomach. It is recommended that the total energy intake of patients should not be less than 5021kj/d, of which 15%-30%d of energy comes from fat, 15% from protein and 55%-60% from sugar. Patients should not snack, eat less or no sweets, fried foods and foods containing high fat, drink less coffee, black tea and other high caffeine drinks, increase fresh vegetables and fruits, eat more fish and shrimp, intermittently eat coarse grains, which are not absorbed in the small intestine and promote fermentation and laxation, and have the effect of reducing fatty acid absorption and postprandial blood sugar and insulin levels; when drinking milk, choose skim milk or milk with less fat content. In addition, the daily diet should also ensure the provision of sufficient vitamins and trace elements; insulin-resistant people should avoid sweets; diabetic people should be diabetic diet; should not eat spicy and frozen food.
3, adhere to more than half an hour of aerobic exercise per day: the traditional concept is that patients should recuperate well after illness and exercise is prohibited, but for patients with polycystic ovary syndrome, more exercise will help patients with polycystic ovary syndrome recover. Patients should adhere to long-term physical exercise, walking, jogging, ball games, swimming, martial arts, eight jins, five birds play, and various dances, can be chosen. The amount of activity should be gradually increased, so that the loose skin and flesh can be gradually transformed into strong, dense muscles. In terms of qigong, dynamic pile work, health care work and longevity work are appropriate to strengthen the luck work method. Polycystic ovary syndrome is a female endocrine system disease, the patient’s endocrine disorder has caused a number of lesions, reflected in the body, is the fat metabolism disorder, leading to obesity, sebaceous gland system imbalance leading to acne, as well as the body hormone secretion, resulting in hairy body surface, menstrual disorders, ovarian imbalance in the secretion of various hormones leading to ovarian lesions. Exercise can, firstly, re-establish the virtuous cycle of the endocrine system, improve the immunity of the body, and promote the normalization of the endocrine system in the patient’s body. Second, it can help control weight and prevent some complications due to excessive obesity, and clinically, there are many patients with polycystic ovary syndrome due to obesity.
4, keep 8 hours of sleep: it is known that short-term lack of sleep can lead to increased blood sugar, sympathetic and vagal imbalance, and even slowed heart rate; long-term lack of sleep can lead to metabolic malfunction, premature aging and depression.
5.Avoid and stay away from all pollution as much as possible.
6.Be confident and actively cooperate with treatment: polycystic ovary syndrome involves imbalance of at least three major systems: neurological, endocrine and metabolic. It is necessary to really grasp the different conditions of each body in order to find the right cause and target. Doctors are attentive, patients and family members need to be patient, and mutual positive cooperation will surely lead to better results.