Polycystic ovary syndrome remains a difficult gynecologic condition and a hot topic of research. The treatment of PCOS does not have a uniform protocol and, like other difficult diseases, should follow the principle of individualization. The specific analysis of different age, different clinical symptoms, different pathological changes, fertility requirements, etc., to develop a reasonable individualized treatment plan.
I. The current situation
1, the pathogenesis of PCOS is not clear.
2.It is impossible to predict the outcome of PCOS treatment.
3.There is a widespread problem of over-treatment and over-emphasis on hormone therapy in a hurry.
4.Lack of attention to the various physical long-term complications of treatment.
5.The treatment basically uses one model to treat almost all patients with polycystic ovaries, and no individualization is seen in the treatment at all.
II. Clinical characteristics
1. Menstrual changes: it can be manifested as low menstrual flow, scanty menstruation, dysfunctional uterine bleeding, amenorrhea, etc.
2. Infertility and luteal insufficiency: infertility is mostly caused by anovulation.
3, acne and hirsutism: there are often long hairs above the mouth and lips, around the areola, under the umbilicus, midline of the abdomen, inner thighs and around the anus.
4, obesity: about 50% of PCOS patients are obese.
5, acanthosis nigricans: when there is insulin resistance combined with androgen excess, often appear acanthosis nigricans. Acanthosis nigricans can occur on the back of the neck, axillae and labia, gray-brown, thickened skin.
6. The ovaries may be enlarged bilaterally: 2-3 times larger than normal ovaries, with thick envelope and tough texture.
Defects of current treatments
1, drug ovulation promotion: the result is either low response (no eggs) or explosive (multiple eggs at the same time), the end is that not enough 30% of people can conceive, some of them have ovarian transitional stimulation syndrome (serious complications, individuals even have life threatening), also some of them have ovarian hypofunction later.
2, a variety of hormone therapy, commonly used are Daying-35, MaFuLong, etc. These drugs have strict indications and should be used appropriately at the right time, rather than casually.
3.Laparoscopic perforation: it can be said to be a helpless method and should be considered only after receiving ineffective medication. If the patient does not conceive after the operation, the ovaries may quickly return to their original pathological state.
4. The high cost and low success rate of assisted conception techniques make them only a last resort treatment option. If it is unsuccessful, it is likely to leave sequelae that are difficult to recover from.
Chinese medicine has a certain effect, but it requires a long course of treatment, and is not valued because of the long course of treatment.
Fourth, the treatment of PCOS recommendations
1.The disease can not be cured by the current medical technology, and the treatment method is different according to different purposes. For example, if the same two patients with polycystic, the same menstrual irregularities, the same age, but one wants to consider fertility and the other does not, then the treatment ideas or methods may be completely different. But how is it in fact?
2.For those who have obesity, it is recommended to control the weight before receiving treatment (before western medical treatment), only when the weight drops to a certain degree, the body will react to the drug.
3, for adolescents or temporarily do not consider childbirth, the general treatment will be done, from time to time to let menstruation once, rather than the need to use hormones to adjust menstruation to normal, because once the drug is stopped, only individuals can recover, while the vast majority have repeated the previous characteristics, and hormone treatment may have long-term complications.
4. For those who have fertility requirements, they should try to make their ovaries ovulate by all means. Generally speaking, for people with certain estrogen level, western medicine ovulation promotion may be effective, while for those with too low estrogen, super ovulation promotion may not be effective, but there is also the problem of premature ovarian failure later (premature ovarian failure is explained later). However, in reality, doctors basically do not consider these problems, and are happy to prescribe ovulation-promoting drugs, and patients feel happy to receive such treatment. It is recommended that in the happy, quietly think about thinking, medical problems if only the pleasure, the ultimate victim is the doctor and the patient themselves!
5, Western medicine to use, but at what time to use? How long to use? How much? You should communicate with your doctor in detail before receiving treatment, and some types of ovulation medication doctors will ask to sign an informed consent form.
6.There are also various kinds of herbal treatments, different doctors will prescribe different ones, so you should trust whoever you see, it is better not to see this doctor and that doctor, it is hard to see the effect of herbal medicine.
7. Before receiving ovulation promotion, you should consider whether there are other factors affecting fertility, because drug-induced ovulation is transient and there is a problem of drug accumulation, if there are other factors, you should consider whether it is suitable for treatment by ovulation promotion.
V. Suggestions for exercise and diet
1. Appropriate sports can help regulate endocrine secretion, however, there are also rules for sports, which also need to be identified. If it is not done in the right way, it may not achieve the effect and may aggravate the disease. However, including doctors, they only know how to exercise, but it is difficult to provide specific guidance on how to exercise. Among my patients, a few of them are not cured by my medication, but by their own exercise to achieve their goals.
2. For those who are not high in androgens, they can use aerobic exercises, such as running, ball games, aerobics and other positive exercises. For those with high androgens, it is recommended to use yoga, Tai Chi, ballet (body dance) and other feminine forms of exercise.
3, weight loss does not necessarily mean intense exercise, in fact, if you seriously play a set of simplified tai chi, even in winter, you may also sweat. There is also excessive reliance on diet pills or dieting, in addition to being useless for the disease, may also aggravate.
4, there is no fixed diet contraindication, but also depends on the person, the same polycystic ovaries, but, one is low estrogen, another is high estrogen, or combined with high androgen, then the diet is not the same regulation. You may need to talk to your doctor to see what your body condition and endocrine condition are. One thing: there is no such thing as absolutely nothing to eat, and there is no such thing as absolutely everything to eat!