Patients with polycystic ovary syndrome are common among women of childbearing age, but are less well known to the general public and are often found to have polycystic ovary syndrome only during infertility consultations. The most obvious manifestation of the disease is the appearance of menstrual irregularities during adolescence, including menstrual scarcity and amenorrhea. Therefore, teenage girls and their parents are reminded not to take the phenomenon of irregular menstruation lightly and to go to the hospital early for formal examination if abnormalities are detected so that timely treatment can be provided. Performance is easily confused with puberty Most of these women have irregular menstruation since menarche, but many people do not have the awareness to see a doctor for treatment, believing that the menstrual cycle of adolescent girls is inherently irregular. Indeed, many adolescent women experience irregular periods after menarche. About 80% of women have anovulatory periods within a year of menarche, but most are regular ovulators two or three years after menarche. Women with normal periods ovulate once a month, several eggs at a time, and usually end up with a normally developed follicle containing an egg that is ready for conception. In contrast, polycystic ovaries mean that the ovaries of a patient develop more follicles each month than normal ovaries. Although most follicles become larger, they have difficulty releasing a mature egg and often fail to discharge a normal egg for several months, thus manifesting as sporadic menstruation or even amenorrhea. In addition to irregular menstruation, polycystic ovary syndrome has some other manifestations that can be easily confused with some conditions of puberty, such as acne. Acne is very common in adolescent women, and patients with polycystic ovary syndrome can also have acne, seborrheic dermatitis, and hirsutism. This stems from excessive androgens. In addition to excessive androgens in the body causing excessive body hair in women, obesity also has a relationship with it. The consequences of polycystic ovaries are not limited to this. Yang Dongzi talked about polycystic ovaries as a chronic disease with multiple causes and uneven manifestations. There are many manifestations of polycystic ovary syndrome, with follicular dysgenesis, insulin resistance and androgen excess being the most obvious. Ultimately these manifestations cause patients to have sparse or amenorrheic menstruation, hypertrichosis, and acne, as well as infertility, recurrent miscarriages, gestational diabetes or gestational hypertension syndrome. For women of childbearing age, to put it simply, polycystic ovary syndrome poses the danger of problems with both eggs and ovaries, which means that the seeds and soil are bad, so it is difficult to blossom and conceive and bear children. Without timely treatment, polycystic ovary syndrome can lead to long-term complications, mainly abnormal glucose tolerance, non-insulin-dependent diabetes, obesity, hypertension and cardiovascular disease, which means that patients who are not treated in a timely manner can develop hypertension, diabetes, cardiovascular disease and even endometrial cancer as they enter middle and old age. Yang Dongzi talked about how polycystic ovary syndrome causing cancer is not a scare. Under normal circumstances, in pregnant women, the ovaries will secrete progesterone in large quantities, but if they are infertile, without the protection of progesterone, the endometrium will proliferate for a long time and remain untreated, and the risk of cancer will increase. With the changes of modern life, the incidence of polycystic ovary syndrome has a tendency to increase gradually, and now polycystic ovary syndrome has become another common cause of infertility after tubal obstructive infertility. Girls with sparse or amenorrheic menstruation, fat, hairy, acne and other characteristics may belong to a high-risk group, and doctors recommend further investigation for “polycystic ovary syndrome”. Yang Dongzhi said the following aspects should be looked at: first, to see if the patient has ovulation; second, to check whether the ovaries have polycystic features through ultrasound; third, to draw blood to see the blood hormone levels, which are usually characterized by high androgen levels in polycystic ovary syndrome. The diagnosis of polycystic ovary syndrome can be made when two of the above three tests are met and other causes, such as thyroid disease, prolactin, etc., are excluded. As ovulation is affected for a long time, making it difficult to get pregnant, some patients often simply understand that direct ovulation treatment is sufficient. This is actually a misconception. It is easy to promote ovulation, but the underlying problem is not solved. Even if a patient gets pregnant after ovulation promotion, her embryo may be exposed to an environment of excessive androgens in the uterus, which also has a negative impact on the fetus. According to statistics from Sun Yat-sen Memorial Hospital, if ovulation is directly promoted without treating polycystic ovary syndrome, the miscarriage rate can reach 1/3 or even 50%. The European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine (ESHRE/ASRM) published the latest version (3rd edition) of the PCOS Consensus on Fertility and Infertility, which states that the incidence of gestational diabetes in women with PCOS is 40%-50% and gestational hypertension is 5%, and that the rate of neonatal complications and stillbirths is higher in women with PCOS than in normal women. Don’t neglect weight loss treatment Treatment of polycystic ovaries, said Donzi Yang, reminds patients who have gained weight that it is important to lose weight to achieve a therapeutic effect. Patients should actively exercise, reduce the intake of high-fat and high-sugar foods and lower their body weight. This can induce a decrease in androgen levels, which is beneficial for restoring ovulation. Medication can counteract the effects of androgens and induce ovulation in the ovaries. The main medication used is oral contraceptives, and the medication can also adjust the menstrual cycle. If there is abnormal glucose tolerance, insulin sensitizers should be added. There are still questions about the need for lifelong medication in adolescent PCOS patients, but the persistence of pathophysiological changes in PCOS is certain. Therefore, it is necessary to review the patient regularly and adjust the treatment plan as appropriate. Also, patients may be considered for laparoscopic surgical treatment. Under laparoscopy, the follicles are surgically punctured to bring down the androgen levels for treatment purposes. Patients are usually able to resume ovulation and thus pregnancy after symptoms are controlled. However, some people do relapse, which requires regular check-ups at the hospital. It is important to note that the longer polycystic ovary syndrome persists the more difficult it is to treat and the benefits of early intervention, rather than delaying until the fertile years, are more obvious to the patient. For more mildly affected patients, the effects of delayed treatment may manifest as recurrent miscarriages and infertility. Even if conceived, the risk of developing gestational diabetes and gestational hypertension can be high.