Polycystic ovary syndrome is a condition that occurs more frequently in women of reproductive age. Ovulation and menstrual flow in women are regulated by a number of hormones, and problems in any one of these steps can lead to disruptions in the menstrual cycle, ovulation and various hormonal disorders. In addition to estrogen and progesterone, androgens are also secreted by the ovaries. Although androgens are secreted by women, their main role is to have anabolic effects, which are low in women but cannot be absent. The various hormones vary at different stages of the menstrual cycle. Polycystic ovary syndrome is of pubertal onset. Patients with polycystic ovary syndrome have a normal age of menarche and gradually develop various symptoms related to polycystic ovary syndrome around the first menstrual period during puberty, a phenomenon suggesting that endocrine disorders occur before the establishment of cyclic function of the hypothalamic-pituitary-ovarian axis. Dysfunctional uterine bleeding during adolescence, especially anovulatory dysfunctional uterine bleeding, can be identified as a candidate for future PCOS. Polycystic ovary syndrome is heterogeneous, what is meant by heterogeneity, that is to say, all people with polycystic ovary syndrome are different, its clinical manifestations are different, laboratory tests and ancillary tests vary greatly, almost no clinical manifestations are common to all people, this is very different from the traditional somatic diseases that we are familiar with, for example, we are familiar with pneumonia, the common symptoms of pneumonia are chest pain The clinical manifestations of pneumonia are common to almost all pneumonia patients, but this is not the case in polycystic ovary syndrome, for example, the obesity mentioned earlier is not common to all, there are also very thin polycystic ovary syndrome, and laboratory tests, such as androgen levels, are not high in all, only in some people, but not in many. The second characteristic is that this disease is considered to be a genetic disease, although the exact gene is not clear, it is considered to be a polygenic genetic disease. If the disease is not well controlled, the disease will develop progressively, the so-called progressive development is getting heavier and heavier, then the long-term complications are mainly two major aspects, one is the metabolic syndrome, the so-called metabolic syndrome includes abnormal glucose metabolism and lipid metabolism, then abnormal glucose metabolism will certainly lead to diabetes, and abnormal lipid metabolism will lead to coronary heart disease. In addition, another major risk of polycystic ovary syndrome is the infertility caused by non-ovulation, some patients have great difficulty in ovulation and are very stubborn, so it is difficult to carry out ovulation treatment. The diagnostic criteria for polycystic ovary syndrome are not uniform in different countries around the world, but one of the diagnostic criteria is sporadic ovulation or anovulation. This requires basal body temperature measurement or ultrasound follicle monitoring to determine if she is ovulating or not ovulating. The second diagnostic criterion is the presence of hyperandrogenism in clinical or laboratory tests, but of course, in these people with high androgenism, other causes of hyperandrogenemia should be excluded. What do you mean by male type obesity and what do you mean by female type obesity? The greater the difference in circumference, the more beautiful it is from a woman’s aesthetic point of view, which is a female-type physique. If the woman is in a high androgen state, then she gradually becomes a male type of fat distribution, the three circumferences of men are the same, that is to say, the three figures of chest, waist and hip circumference are about the same. In other words, the waist is thicker and the waist-to-hip ratio is higher. From our clinical point of view, the waist-to-hip ratio can be set at 0.85 as a dividing line, and those with a body mass index (weight divided by the square of height) are mainly male obese. The main clinical manifestations of PCOS are menstruation and ovulation abnormalities. Menstrual disorders are mostly seen in adolescent dysfunctional uterine bleeding, sporadic ovulation, amenorrhea, occasional primary amenorrhea and regular menstruation but no ovulation, and a high incidence of endometrial cancer. This is due to the absence of progesterone protection due to anovulation, and the endometrium is subjected to the action of estrogen alone for a long time. With the onset of anovulation, the patient becomes infertile, and anovulatory infertility accounts for one-third of all PCOS cases, and due to abnormally high LH and androgen levels, miscarriage is likely to occur even after pregnancy. Hirsutism is another typical clinical manifestation of PCOS. Hair in the upper lip, jaw, around the nipples, and in the middle of the umbilicus are related to androgen levels. If this area appears thick and dark with long hairs in a woman, we consider her to have hirsutism. Acne is a chronic inflammation of the sebaceous glands of the hair follicles. It is also caused by increased levels of androgens. Obesity accounts for about half of the incidence of PCOS. Weight divided by height squared is a diagnostic criterion for obesity, and 25 is usually used as the diagnostic criterion for obesity. As obesity increases, insulin resistance and leptin resistance develop. Acanthosis nigricans is a cutaneous manifestation of severe insulin resistance. It is often found as gray-brown, flaky hyperkeratosis of the skin in the vulva, groin, under the bottom of the body, and the back of the neck, where there is a lot of movement. This is a skin manifestation that is unique to patients with severe insulin resistance, but is not seen in all patients with insulin resistance. Ultrasound is a common tool we use to examine PCOS. The main findings are increased ovarian volume, increased follicular number, decreased follicular volume and increased interstitial echogenicity. A diagnosis of polycystic ovaries is made when there are more than ten 5-9 mm follicles in one section. Treatment of PCOS. PCOS is a long-term disease that cannot be cured, whether she has fertility requirements or not, these conditions exist, and even if she does not have fertility requirements, she will still have such long-term complications as metabolic abnormalities, such as diabetes mellitus and coronary heart disease, endometrial cancer, all of which are the concern of our obstetricians and gynecologists and endocrinologists. For patients with PCOS without fertility requirements, we must control the symptoms, the so-called symptoms are mainly the presence of hyperandrogenism, acne, hirsutism, etc., whether there are menstrual disorders, to make menstruation regular, this regularity of menstruation is not only to reduce bleeding does not occur meritorious blood, but also to protect the endometrium from endometrial cancer, so we should control hyperandrogenemia, this After the hyperandrogenism is well controlled, all other problems will be solved, and if there is insulin resistance at the same time, we have to solve the problem of insulin resistance. If the patient does not have any other symptoms, only menstrual instability, we can use the method of regular withdrawal of progesterone is enough; if there is an increase in androgen level, we can use a contraceptive pill with anti-androgen activity like Daing-35 to treat it, but obese people have the risk of blood clots and need to lose weight before lowering androgen; if there is If you have insulin resistance, you can use metformin or insulin sensitizers such as rosiglitazone to treat it; throughout the treatment process, you should make lifestyle adjustments, that is, weight control, exercise and diet control. We do not diagnose PCOS prematurely in patients who develop these symptoms during adolescence. However, the treatment measures are basically the same.