I wonder if you have ever met such a female friend:
Inexplicably began to gain weight , acne breakouts, increased body hair, irregular menstruation… I couldn’t find the reason, and I was embarrassed to tell my family and friends, so I got up early and went to the hospital to line up in the dark. longest.
What I am sharing today is the real situation about “polycystic ovary syndrome”.
the girls who have known this It’s polycystic ovary, will it affect pregnancy?” “Can this be cured? Will I be able to do shameful things harmoniously in the future~”
But in factpolycystic ovary syndrome is not necessarily “polycystic ovary syndrome”! Even if you do have polycystic ovary syndrome, it’s not incurable, or…you have to.
Today we will start from specific symptoms and talk about “Polycystic Ovarian Syndrome” span> those things.
How to distinguish between “polycystic” and “polycystic ovary syndrome”(PCOS )
Polycystic ovary polycysticovary （PCO）is a description of ovarian morphology by ultrasound examination. The number of follicles with a diameter of 2-9mm in one or both ovaries is ≥12 , or ovarian volume ≧10cm3
○ polycystic ovary syndrome Signs:
In clinical work, people with irregular menstruation or infertility in outpatient clinics are obese at first sight, Or those with strong hair, many people belong to polycystic ovary syndrome, referred to as “polycystic”.
>○ Definition of polycystic:
Polycystic is a common endocrine disease in women of childbearing age, characterized by long-term anovulation, hyperandrogenism, and widespread insulin resistance.
< span>It is still unclear so far, which may be related to the following factors:
Researchers found significant familial clustering of polycystic Sex, such as those with a family history of obesity, type 2 diabetes, seborrheic alopecia, hypertension, etc., have a higher probability of developing PCOS.
environmental factors span>
outer environment (such as environmental endocrine disruptors)Some people have found that hyperinsulinemia and hyperglycemia can affect the fetus in utero, resulting in abnormal growth and metabolism after birth. High-sugar, high-fat, and high-calorie foods, or prolonged exposure to high-pressure environments can affect the occurrence and development of PCOS; internal environment (such as intrauterine androgen exposure levels and androgen metabolism levels in different physiological cycles, etc. )
Polycystic Ovarian Syndrome: More Than Infertility !
polycystic ovary syndrome (PCOS)In addition to the ultrasound findings of PCO, there are also There are other clinical manifestations:
Irregular menstrual periods
The age of menarche is generally normal, Disorders often occur after menarche.
○ span>Mostly manifested as oligomenorrhea:The menstrual cycle may be 35 days to 6 months in length, and the amount is small. Secondary amenorrhea (stop menstrual period ≥ 6 months)common;
○ A rare occurrence of menorrhagia or irregular uterine bleeding< /span>:Irregular menstrual cycles or periods or volume. Polycystic ovary syndrome often leads to infertility due to persistent anovulatory state.
Regular sex life without contraception and pregnancy for 1 year, and excluding male and fallopian tube factors, because Rare ovulation or no ovulation leads to infertility.
Clinical/biochemical manifestations are “Hyperandrogenism”
○ Acne: strong>After excessive androgens are converted into more active dihydrotestosterone, it stimulates sebaceous glands to secrete vigorously, causing acne in 15%-25% of polycystic cysts, which are more common in the frontal face, chest and back.
○ Hairy:androgen-dependent hyperhair Growth, such as lip, chin, armpit, chest hair, mid-body hair on the lower abdomen, hair on the perineum, etc.
○ Obesity: predominantly abdominal obesity, waist/hip ratio>0.85. About half of the patients with PCOS have a body mass index (BMI, calculation formula: weight/height 2 is greater than 25), and fat accumulation occurs not only in the abdominal wall, but also between the internal organs of the abdominal cavity Accumulation, long-term lead to metabolic abnormalities, cardiovascular diseases: coronary heart disease, hypertension, etc.
○ Acanthosis nigricans:A skin manifestation of severe insulin resistance, usually in the vulva, groin , The armpits and the back of the neck are gray-brown, velvet-like flaky thickening, and sometimes pigmentation.
In addition to polycystic complications, in addition to endometrial cancer, there are obesity, diabetes, Hypertension, hyperlipidemia, etc. These are all associated with insulin resistance, which leads to diabetes, lipid metabolism disorders, hypertension, and coronary heart disease.
pimg> p>The above introduction about polycystic, at this point, I believe many people also understand, polycystic is a kind of endocrine and metabolic disorder caused by genetic factors and environmental factors Diseases require lifelong management and intervention. There is no cure, but it can be controlled. Although polycystic disease can lead to infertility, it is not without medical intervention.
How to do PCOS self-assessment and effective treatment
Polycystic individual differences are relatively large, I believe writing this , Many people have begun to sit in the right seat. Don’t worry, the most basic conditions for the diagnosis of polycystic are hyperandrogenism and ovulation disorders. According to Chinese academic circle standards:
PCOS can be diagnosed by meeting any two of the above three items. PCOS is difficult to diagnose, and the diagnosis still requires a doctor Help, and then intervene and treat early.
Take a case recently contacted by Dr. Shao: our hospital accepted a 300-pound young man Endometrial cancer patient, age 40, never had children.
Why do you say she is special, because most endometrial cancers occur after menopause, this patient eats 5-6 meals a day, has long-term obesity without weight management, and has irregular menstruation. He was infertile, and he did not seek help from a doctor. He let it go. After admission, the blood sugar was measured and it was found that he was a diabetic patient. Under the diagnosis of ultrasound and serum hormone levels, he was finally admitted to the hospital for surgery because of the diagnosis of endometrial cancer.< /p>
This is a typical case of polycystic disease, without medical attention and long-term management intervention, an adverse event eventually occurred.
If you want effective treatment, clinically whether there are fertility requirements can be divided into basic treatment As well as fertility treatment, and treatment of complications.
span>1. Basic treatment: mainly for menstrual disorders, hyperandrogenism, insulin resistance and obesity.
○ Menstrual disorders:
Regularly taking progesterone or taking short-acting oral contraceptives to control the menstrual cycle and avoid the long-term effects of estrogen on the endometrium.
○ Weight loss:
This is a common topic. Keep your mouth shut and open your legs. A low-fat and low-calorie diet can be effective for a long time. Appropriate exercise can increase the sensitivity of skeletal muscles to insulin. , can alleviate the problem of insulin resistance to a certain extent.
○ Hyperandrogenemia: strong>Those with moderate to severe acne, hirsutism and exuberant skin oil secretion can take short-acting oral contraceptives that reduce males, such as Diane-35 and Yasmin.
○ Insulin resistance: You can take insulin sensitizers, metformin, and it can also suppress appetite and has a certain effect on weight loss.
p>2. If there is a fertility requirement, some medical measures such as ovulation induction or assisted reproduction can be taken after the above-mentioned basic treatment intervention.
Clinically, some people intervene for a period of time through basic therapy After that, you can ovulate on your own, menstruation returns to normal, and you can get pregnant normally after trying to conceive. If you are still unable to conceive normally after basic treatment intervention, go to the assisted reproduction center as soon as possible.
Because polycystic patients have insulin resistance, gestational diabetes, gestational hypertension, and premature The risk of morbidity such as perinatal death increases, so in addition to basic treatment interventions before pregnancy, weight management, strengthening management and monitoring are also required during pregnancy.
3. Treatment of complications
○ Endometrial lesions:Endometrial proliferative lesions can be treated with high-efficiency progesterone locally or orally , regular inspection and follow-up. If it has progressed to endometrial cancer, surgery is required.
4 .Metabolic syndrome treatment: For those who have developed diabetes, hypertension, hyperlipidemia, etc., related departments of internal medicine should be treated together at the same time.
Most of the outpatient polycystic patients can recover ovulation by themselves after the simplest basic treatment, weight loss and exercise, so the fundamental of basic treatment is Medical intervention is required only after basic treatment fails.
There is no girl who doesn’t love beauty. Taking weight management as a long-term task can naturally become a habit. 70% of weight loss is eating, and 30% is moving.So diet management is more important, Add some exercise as appropriate, and you can do more with less.
In addition to improving menstruation and solving infertility treatment, polycystic disease is also very important to prevent complications, which requires long-term management. Cancer patients, if early medical intervention, may not have endometrial cancer so early.
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