I. What is polycystic ovary syndrome (PCOS)?
Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder characterized by persistent anovulation or oligoovulation, hyperandrogenism or polycystic ovarian changes, often accompanied by insulin resistance and obesity, with a prevalence of about 5.6% among Chinese women and an even higher proportion of patients with irregular menstruation and infertility, according to a 2017 survey.
Second, how do you get polycystic ovary syndrome?
The cause of polycystic ovary syndrome is still unclear and may be related to genetic and environmental factors.
How is polycystic ovary syndrome diagnosed? When should I be alerted that I may have polycystic ovary syndrome?
The current common diagnostic criteria for polycystic ovary syndrome are the Rotterdam criteria proposed by the European Society for Reproductive and Embryological Medicine and the American Society for Reproductive Medicine in 2003.
1. Little or no ovulation
Normal ovulation: many follicles try to grow each month, but only one dominant follicle can grow and be successfully expelled.
Polycystic ovary syndrome: all these small follicles are competing to grow, but everyone is at the same level, so no one can grow much, and naturally there is no ovulation.
Ovulation disorders most often manifest as menstrual disorders, i.e., scanty menstruation, menstrual cycle up to 35 days or even 6 months without menstruation, or low menstrual flow, irregular menstrual cycle or menstrual flow, if you are preparing for pregnancy, there is no increase in basal body temperature, and there is no sign of dominant follicle development and ovulation by ultrasound monitoring.
2. Clinical manifestations of hyperandrogenism and/or hyperandrogenemia
Hypertrichosis and acne are the most common manifestations of hyperandrogenism. Hair is abundant and often found in specific areas, such as pubic hair, lower abdomen, upper lip or around the areola, and acne is often accompanied by oily skin because hyperandrogenism promotes the secretion of sebaceous glands. In addition, the skin color deepens in the skin folds and is called acanthosis nigricans.
The obesity shown in the picture is a very important manifestation of polycystic ovary syndrome, and this obesity is usually abdominal obesity (waist/hip circumference ≥ 0.8), and the thin legs and big stomach are typical of polycystic ovary syndrome. You may say: Why am I so thin and still diagnosed with polycystic? There is a special type of polycystic ovary syndrome called slim type, and there are not many related studies, but it is certain that slim type polycystic has better outcome than obese type polycystic.
3. Polycystic ovarian changes
Ultrasound indicates ≥12 small follicles of 2-9 mm in one or both ovaries and/or ovarian volume ≥10 ml.
Any two of the above three points can be diagnosed as polycystic ovary syndrome.
What are the risks of polycystic ovary syndrome?
The most common effect of polycystic ovary syndrome is menstrual disorders. Long-term absence of menstruation and long-term failure to shed the endometrium may increase the chance of endometrial malignancy, so patients with polycystic ovary syndrome have a higher incidence of endometrial cancer compared to non-polycystic ones. Polycystic ovary syndrome also affects metabolism and reduces insulin sensitivity, so there is an increased risk of diabetes and obesity accompanied by various medical conditions such as hypertension, hyperlipidemia and fatty liver.
Due to ovulation disorder, it will lead to infertility of polycystic ovary syndrome patients. Once pregnant, various risks during pregnancy and perinatal period such as gestational diabetes, gestational hypertension, cesarean delivery, preterm baby, huge baby and neonatal asphyxia are significantly increased, and the increase of obese polycystic is more significant.
V. How can polycystic ovary syndrome be treated? Is it curable?
First of all, polycystic ovaries are not curable and can only be improved by lifestyle modification and medication if necessary. Some people can regain ovulation and normal menstruation simply by losing weight and exercising, but if necessary, you should see a professional clinic and rely on medication to intervene. If you have the desire to get pregnant and meet the above-mentioned manifestations, you should be treated systematically to adjust your body to the best condition before pregnancy and reduce the occurrence of complications during pregnancy, so that you and your baby will be healthier!