I. What is polycystic ovary syndrome
Polycystic ovary syndrome is an extremely complex pathological condition caused by endocrine and glucose metabolism abnormalities, characterized by persistent anovulation, elevated luteinizing hormone levels and hyperandrogenemia, and is one of the main causes of anovulatory infertility. It is one of the main causes of anovulatory infertility and has a prevalence of 5%-10% among women of reproductive age.
Clinical manifestations of polycystic ovary syndrome
1. Symptoms and signs
(1) Irregular menstruation after menarche, with sporadic menstruation being the most common, followed by secondary amenorrhea and dysfunctional uterine bleeding, and occasionally primary amenorrhea and regular anovulatory menstruation. The vast majority of patients are anovulatory, and a few may have sporadic ovulation or luteal insufficiency.
(2) Hyperandrogenic symptoms include: hirsutism (incidence about 70%), acne, occasionally slightly enlarged clitoris, or slightly protruding laryngeal nodes.
(3) Obesity: the incidence is about 50%. Obese people often have insulin resistance (IR), hyperinsulinemia.
(2) Sex hormone changes: elevated serum testosterone (T) level; blood LH/FSH >2.5~3.
3. Ultrasound examination suggests polycystic ovary-like changes.
Diagnostic criteria of polycystic ovaries
The diagnosis can be confirmed if any two of these three criteria are met, except for other diseases that cause hyperandrogenemia. For this reason, in addition to clinical symptoms, basal body temperature should be observed for a period of time to confirm ovulation abnormalities, and blood sex hormone levels should be measured electively.
IV. Treatment objectives.
(1) To achieve normal weight.
(2) To reduce androgen levels.
(3) To induce ovulation in those who desire fertility.
(4) To reduce the risk of cardiovascular disease.
(5) To avoid the serious consequences of hyperinsulinemia.
(6) Protection of the endometrium.
In the treatment of PCOS, symptomatic treatment is advocated due to the lack of a clear pathogenesis.
V. Chinese and Western medicine treatment of polycystic ovaries
1, for obesity and insulin resistance, strengthen physical exercise, regulate diet, control weight, metformin for the treatment of PCOS hairy and restore the menstrual cycle of the first-line drugs, metformin dose 500mg / d, gradually increase to 500mg, tid, Chinese medicine that “spleen deficiency, phlegm and dampness blockage” is the root of obesity, so “strong spleen and stomach” is the key to treatment
2, for menstrual disorders and infertility, Western medicine can use DY-35 weekly treatment, starting on the fifth day of menstruation, take one tablet orally every day for 21 days, repeat after 7 days of discontinuation, a total of 3-6 months, this method can not only counteract the symptoms of excessive androgens, but also adjust the menstrual cycle. At the same time, it can be used to treat the symptoms and to adjust the menstrual cycle. The “kidney regulating method” is one of the important rules for treating amenorrhea and infertility in PCOS patients. Clomiphene can be used to promote ovulation on the 5th day of menstrual cycle, 50mg orally every night for 5 days, ovulation usually occurs 5-10 days after taking the drug, if there is no ovulation, the dosage can be increased to 100mg per day in subsequent cycles. However, long-term use is not recommended to avoid ovarian hyperstimulation syndrome.