Treatment
How to deal with polycystic ovary syndrome
1. What are the benefits of weight loss for obese patients with polycystic ovary syndrome?
Among patients with polycystic ovary syndrome (PCOS), 67% are obese or overweight. Obesity is not only “unattractive” to PCOS patients, but also brings about metabolic disorders, reproductive health and other hazards. (1) Weight loss or control through diet and exercise can improve hyperinsulinemia, insulin resistance and hyperandrogenemia, thus restoring menstruation and reducing hirsutism and acne. ②Weight loss can greatly increase the chance of conception and decrease the chance of miscarriage. (3) Weight loss also has long-term benefits, reducing the risk of cardiovascular disease, diabetes and endometrial cancer in patients with polycystic ovary syndrome. Therefore, weight loss is the first and most important step in the treatment of polycystic ovaries. Some patients may not be overweight but have a waist thickening (waist circumference ≥ 80cm), that is, “central obesity”, but also to control weight to reduce waist circumference.
2, drink sugar water test results said I have insulin resistance, what is insulin resistance? Will I get diabetes?
Insulin is a substance produced by the pancreas that can lower blood sugar to normal levels. When glucose rises in our blood, the pancreas releases insulin to tell the cells it is time to absorb glucose. Insulin resistance is when cells become less sensitive to insulin and need more insulin to rush the cells to absorb glucose, resulting in hyperinsulinemia. Insulin resistance and hyperinsulinemia are the most important manifestations of abnormal glucose metabolism in polycystic ovary syndrome. Obese patients with polycystic ovary syndrome are more likely to have combined insulin resistance, but it is not exclusive to fat girls; studies have found that insulin resistance is still present in 30% of non-obese patients.
Insulin resistance and hyperinsulinemia can progress to diabetes mellitus without intervention, which is characterized by loss of insulin production and elevated blood glucose. Therefore, early intervention, through exercise, weight loss, scientific and reasonable lifestyle, combined with drug treatment, can slow down the pace of insulin resistance progressing to diabetes, or even reverse its pace.
3.I don’t have diabetes yet, why should I take metformin?
What is metformin? A glucose-lowering drug? No! It is an insulin sensitizer. Diabetic patients often have obesity and insulin resistance, oral metformin can help to properly control weight and increase insulin sensitivity, increasing the effect of glucose-lowering drugs. While polycystic ovary syndrome often has insulin resistance, some of them are also accompanied by overweight or even obesity. By insisting on taking metformin, in order to play a role in treating insulin resistance and preventing a series of distant complications caused by insulin resistance, such as diabetes.
4.Taking metformin according to the instruction, my stomach is very uncomfortable and there is no way to stick to the medication, what should I do?
At the beginning of metformin dosing, especially on an empty stomach can cause gastrointestinal reactions such as nausea, vomiting, diarrhea, etc. Some people also experience dizziness and fatigue reactions. These side effects are often dose-dependent, i.e. the higher the dose taken the more pronounced the side effects. Therefore, it is recommended to take the drug with meals and start with small doses (for example, take the drug once a day with dinner in the first week, which can be increased to once a day with breakfast and dinner in the second week, and once a day with three meals in the third week). Most people in 1-2 months after the drug side effects reduced or disappeared.
5.Isn’t berberine used to treat gastroenteritis? Why did the doctor prescribe this medicine to me?
Berberine is an alkaloid found in many plants in the Berberaceae family. It is also known by its other name “berberine”. It was first used to treat intestinal infections, so people’s perception of it is limited to “medicine for gastroenteritis”. But it is not just a simple plant antimicrobial. With the advancement of medicine, berberine has been proven to regulate blood lipids, lower blood pressure, and increase insulin sensitivity. For patients with polycystic ovary syndrome, berberine improves metabolic disorders and can effectively prevent long-term complications such as type 2 diabetes, endometrial cancer, and cardiovascular diseases. Therefore, when the doctor’s prescription on the prescription of berberine, do not think that it is a careless prescription of the wrong drug.
6, take the pill during the period are on time, stop the pill menstruation is delayed or do not come, then I still need to continue to use the drug?
The irregularity of menstruation after stopping the pill means that you are unable to establish ovulation cycle, lack of certain hormones in your body or disorder in some part of menstrual regulation, endometrium is not peeling off periodically, endometrial hyperplasia is too long, and the risk of endometrial cancer is greater than normal people. Therefore, maintaining cyclic endometrial shedding (i.e. regular menstruation) is necessary for patients with polycystic ovary syndrome. Regular follow-up visits are needed to adjust medication and develop a treatment plan according to medical advice.
7. I don’t have any fertility requirements now, can I ignore my irregular periods and wait until I want to get pregnant before doing treatment?
Polycystic ovary syndrome is not only harmful to women because of irregular menstruation and infertility caused by ovulation disorders, but also requires treatment even if you do not have fertility requirements. If ovulation does not occur for a long time or is rare, the endometrium will be in a proliferative state for a long time, which will easily lead to excessive endometrial hyperplasia, which may lead to endometrial cancer in serious cases; the progressive development of abnormal glucose and lipid metabolism may lead to abnormal glucose tolerance and hyperlipidemia, which may develop into diabetes, coronary heart disease and obesity later if no intervention is made. This is one of the many factors of infertility, difficulty in embryo implantation and high rate of miscarriage.
8, birth control pills are hormonal drugs, eat this kind of drugs will not make me fat?
Most people taking contraceptives will not gain weight, but do not exclude a small number of women will have a slight weight gain. Oral contraceptives are synthetic estrogen and progestin or progestin alone to make up, will not affect fat metabolism. Estrogen and progestin can cause water and sodium retention, and a small amount of excess water and salt in the body cannot be excreted effectively and looks a little swollen. Now there are many new varieties of birth control pills, some of which contain progestins that can counteract the effects of water and sodium retention and hardly lead to weight gain.
9, I have hirsutism, eat a few months of birth control pills how do not see the hair become less?
The principle of treatment for polycystic ovary syndrome combined with hirsutism is to correct the level of sex hormones and slow down or stop the growth of hair. Birth control pills containing anti-androgenic activity are the first choice of medication, new hair follicles will not grow while taking the pill, but the hair already grown will not be “removed” by the pill. It takes some time for the hair growth cycle to change, so it takes at least 6 months of birth control pills to see a reduction in hair, and long-term treatment (≥1 year) will be more effective. Of course some women choose shaving, hair removal agent for rapid hair removal, these methods treat the symptoms but not the root cause, easy to recur. New technology hair ionization and laser hair removal for hairy patients to bring the gospel, generally is in the use of contraceptives for at least 6 months do not see the effect, before considering hair ionization and laser treatment.
10.It is true that there is less hair after using the pill for a period of time, but recently it is easy to lose hair, can the pill cause hair loss?
Oral contraceptive pills have the effect of supplementing estrogen and progesterone, and estrogen is maintained at a high level in women who use the pill for a long time. If you suddenly stop taking the pill, the estrogen level will drop, causing a temporary imbalance in hormone levels, which in turn will cause hair loss. This type of hair loss is similar to postpartum hair loss and does not require special treatment. The body will return to normal after a period of adaptation and self-regulation.
Healthy people have a certain amount of hair loss every day, as long as the average daily total hair loss does not exceed 80 roots, and the hair is not thinning are considered normal, if a large amount of hair loss continues for six months, we should consider other causes of hair loss, such as mental stress caused by baldness, or seborrheic dermatitis resulting in oily scalp top hair loss.