At least 1 in 10 mothers who are trying to conceive is unable to conceive a baby because of polycystic ovary syndrome;
At least 2 out of 3 adolescent girls suffer from endocrine disorders.
Polycystic ovary syndrome (PCOS) is the most common gynecological endocrine disorder in women of childbearing age, with a prevalence of about 5.61% in the population of childbearing age in my country [1].
Under normal circumstances, a girl’s ovary volume is less than 10cm, and at least one dominant follicle will actively grow and mature every month, ready to be “discharged” at all times.
The volume of unilateral or bilateral ovaries in polycystic girls will increase by more than 10cm, and there will be ≥12 follicles with a diameter of 2~9L in one ovary, sleeping quietly and not in a hurry The mature follicle becomes the dominant follicle, and the Buddhist system completes the task [2].
When the ovary is lazy, it will be like a “source of plague” that emits a unique atmosphere – androgen, which makes colleagues in various departments who work for the body fall into a state of sluggishness that does not want to work .
1
Ovulation disorders
The most direct result of ovarian laziness is Sparse or no ovulation. (Ovulation is the work of the hypothalamus, pituitary, follicles, and various hormones that cooperate with each other.)
This is because follicles are flooded in a high androgen working environment, and they can only choose to sleep late to avoid maturation, and there is no way to ensure the completion of work tasks (ovulation) [3].
2
Irregular menstrual cycle
It is manifested as oligomenorrhea, amenorrhea, abnormal bleeding, etc.
3
Obesity
High androgen and insulin work together to mess up the working system of fat and produce a lot of “little brother” – free fatty acid.
At the same time, the disordered fat is accumulated in the abdomen, and the abdominal flesh accumulates more and more, which is what we often call the central obesity of the abdomen [5].
There is also a “fat polycystic“, which refers to obesity or obesity after gaining weight suddenly, and then falling in love and killing with polycystic, fat Will be polycystic, polycystic will be fat.
The formation of fat polycysts is closely related to fat metabolism disorders and fat accumulation.
4
Hairy
Hair will not increase due to the high androgen environment, but will thicken and darken under the catalysis of the high androgen environment.
You’ll find a visibly thicker hair on upper lip, chin, chest, abdomen, back, arms, thighs, which is longer in shape and color It is deeper, so that you will not hesitate to pull it out after seeing it.
5
Acne
Under high androgen levels, oil accumulates on the surface of the skin, causing a large number of bacteria to multiply, causing hair follicle infection, inflammation, redness, swelling, itching and other symptoms, mostly on the face and neck and other parts.
6
Insulin resistance(glucose metabolism, acanthosis nigricans, sleep-disordered breathing, fatty liver)
Insulin resistance is also an important concomitant symptom of polycystic disease.
In addition to showing a series of symptoms in combination with androgens, there will also be obstacles to the cyclic work of glucose metabolism.
Causes abnormal increase or decrease in blood sugar, darkening of skin color, thickening of skin in armpits, groin and other parts, breathing and sleep disorders, fatty liver and other functional abnormalities [4,5].
The diagnosis of polycystic ovary syndrome needs to meet the conditions of required + multiple choices:
1
Women who are in need of childbearing and are unable to conceive
Exclude infertility triggers
First rule out the partner’s abnormal sperm quality, female fallopian tube blockage, and then confirm whether the female itself has diseases that cause hyperandrogenemia and ovulation disorders, such as Cushing’s syndrome, premature ovary Insufficiency, thyroid disease, etc.;
And exclude infertility caused by obesity, uncontrolled abnormal glucose tolerance, diabetes and other factors, and carry out targeted weight loss, smoking cessation, control of blood sugar and blood pressure, etc.
Fertility technology
Those who still do not ovulate after improving metabolism and health problems can induce ovulation with drugs, hormones, etc.
For reasons such as advanced age, abnormal tubal function or male factors, in vitro fertilization-embryo transfer, laparoscopic ovarian drilling and other techniques can be used to promote fertility under the advice of the hospital.
2
No fertility needs at this time
Use progesterone, short-acting combined oral contraceptives, etc. periodically under the guidance of professional doctors to control menstrual disorders and relieve symptoms of low estrogen, such as progesterone, short-acting combined oral contraceptives, etc.
Adolescent and adolescent women: Generally, there is no need to take medicine or technical treatment, and intervene in life behavior first, such as adjusting lifestyle, controlling sugar and reducing fat, etc.[2] , 4].
The above needs to be diagnosed and treated by a regular professional hospital doctor in order to obtain correct advice and reliable treatment.
2 questions about PCOS:
01. Is polycystic ovary syndrome inherited?
It is inherited, but the mechanism is complex.
Familial need:
1. Females in the immediate family have obvious symptoms of irregular menstruation and reproductive difficulties;
2. Immediate relatives, both male and female, can detect features such as impaired glucose tolerance, decreased insulin sensitivity, and metabolic syndrome.
3. Polycystic ovary syndrome in women and baldness in men share common genetic factors.
4. In addition to genetic factors, the occurrence of multiple polycystic girls in a family may be related to the increasing incidence of polycystic ovary syndrome in recent years [6].
02. What should be paid attention to in life?
Diet control
1. Low-sugar diet: Eat foods with a low glycemic index such as vegetables, whole grains, and oatmeal instead of high-sugar foods such as rice, mashed potatoes, and cakes.
2. Low-calorie diet: Monitoring caloric intake and healthy food choices is a major component of dietary control.
3.High-protein diet: Supplement with appropriate protein, replace a bowl of noodles, a steamed bun, and a fried dough stick with an egg in the morning to increase satiety At the same time, there will be no burden of gaining weight.
4. Diet rules: Change bad eating habits, such as the “three-minute fever” to fight weight loss, and those who are hungry and full are the root cause of obesity , The best way to lose weight is to stick to a regular diet, eat less and eat more often, eat only 70% full every meal, and chew a few more times per meal [2].
(Source: soogif)
Exercise to lose weight
1.Fat Burning: In addition to fast fat burning items such as treadmills and irons, you can also consider skipping rope, Zumba, Pamela aerobics, etc. Energy-consuming training to get yourself moving quickly.
IfIf you don’t like too strenuous exercise, you can also choose relatively mild exercise, such as swimming, brisk walking, jogging, climbing more stairs, etc. to increase your heart rate, and slowly enjoy weight loss in a relaxed mood.
(At least 30 minutes each time, at least five times a week. The training program should be advanced according to the limit of individual physical strength. It is not too much.)
2. Reduce prolonged sitting: Stop sitting when you see this, get up and walk quickly.
Psychological counseling
Under the blessing of negative emotions such as hormone disorders, appearance anxiety, infertility, etc., girls are often under great psychological pressure.
When depression or anxiety occurs, timely psychological counseling is very important for disease control.
Negative emotions will affect the secretion of gonadotropins in the hypothalamus, aggravate infertility and hinder treatment [6].
Reviewer
Guo Xu| Attending Physician, Department of Gynecology, The First Affiliated Hospital of Sun Yat-sen University
References
[1]Yuan Yingying, Zhao Junli. Epidemiological characteristics of polycystic ovary syndrome [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2019,35(03):261-264.
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[2] Chinese guidelines for diagnosis and treatment of polycystic ovary syndrome[J]. Chinese Journal of Obstetrics and Gynecology, 2018,53(01):2-6.
[3]Li Xiaomin, Huang Wenjie, Lu Yongchao. Mechanism of ovulatory disorder in polycystic ovary syndrome [J]. China Medical Journal, 2021,23(07):486-490.
[4] Song Ying, Li Rong. Interpretation of Chinese guidelines for diagnosis and treatment of polycystic ovary syndrome [J]. Journal of Practical Obstetrics and Gynecology, 2018,34(10):737-741.< /p>
[5] Zhu Qian, Ni Hao, Quan Song. Characteristics and management of hyperandrogenism in polycystic ovary syndrome [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2019,35(03): 274-278.
[6] Zhu Di. Review of research progress on polycystic ovary syndrome [J]. Journal of Practical Gynecology Endocrinology (Electronic Edition), 2016,3(14):20-21.< /p>
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