Polycystic ovary syndrome

　　Excessive androgens under endocrine influence are the main cause.

　　Other causes include the following points:

　　1. Originating from endocrine disorders and hyperprolactinemia;

　　2. Long-term mental stress, drug, and disease influence: Due to mental stress, drugs, and certain diseases affecting the abnormal regulation function of the hypothalamus-pituitary-ovary axis, it leads to excessive production of androgens by ovarian stromal and theca cells; high levels of androgens in the ovary inhibit follicle maturation, thus causing a series of symptoms such as amenorrhea and hirsutism associated with polycystic ovary syndrome.

　　3. Genetic factors: Based on the high familial aggregation shown in the occurrence of polycystic ovary syndrome, genetic factors are an important cause of polycystic ovary syndrome.

　　4. Obesity and hyperinsulinemia: Some patients with polycystic ovary syndrome, especially those who are obese, can present with hyperinsulinemia and insulin resistance, indicating insulin resistance as the cause.

　　5. Abnormal adrenal function: Nearly half of the patients with polycystic ovary syndrome have abnormal adrenal cortical function, often due to hyperfunction of the adrenal cortex, leading to excessive secretion of androgens and symptoms such as anovulation.

　　1. Infertility. Due to menstrual irregularities and anovulation, polycystic ovary syndrome often leads to infertility, accounting for about 75%, with primary infertility being more common.

　　2. Endometrial cancer: Among endometrial cancer patients aged 40 years or younger, 19-25% have PCOS, and 14% of PCOS patients progress to endometrial cancer within 14 years.

　　3. Complications with hyperprolactinemia.

　　4. Complications with absolute (complete) insulin resistance syndrome and hyperinsulinemia.

　　5. Acanthosis nigricans, which is characterized by symmetrical gray-brown pigmentation of the skin in areas such as the neck, back, armpits, under the breasts, and inguinal regions, presenting as velvety, hyperkeratotic lesions.

　　6. Affecting appearance: Patients often have facial acne (pustules), which, if not treated promptly, can leave permanent scars and freckles on the face after suppuration, and the appearance cannot be restored even after treatment.

　　The main symptoms include irregular menstrual cycles, amenorrhea, hirsutism, acne, obesity, infertility, and in severe cases, infertility may occur due to dysfunctions in ovulatory processes.

　　As follows: ⑴ Menstrual irregularity: Oligomenorrhea, menorrhagia, or even amenorrhea, and a few also have the manifestation of menorrhagia.

　　⑵ Hirsutism and obesity: They often occur together, with hair distribution showing male pattern baldness, such as above the upper lip, around the nipples, median abdominal line, around the anus, and on the limbs, with coarse and black pubic hair.

　　⑶ Infertility: Due to menstrual irregularity and anovulation. There may be occasional ovulation or an unhealthy corpus luteum, and if pregnancy occurs, it is easy to have a miscarriage.

　　⑷ Ovarian enlargement: Bilateral symmetrical polycystic enlargement 2-4 times, or 1/3-1/4 of the uterine volume is polycystic. 20%-30% do not increase in size.

　　15. 1. Environmental adjustment: It is not advisable to live in a damp environment; during the rainy season, attention should be paid to the invasion of dampness.

　　14. 2. Physical exercise: For PCOS patients with phlegm and dampness constitution, who are often overweight and easily tired, it is necessary to persistently engage in physical exercise for a long time, such as walking, jogging, ball games, swimming, martial arts, Ba Jin, Wu Qing Xing, and various dances. The amount of exercise should gradually increase, allowing loose flesh to gradually transform into firm and dense muscles. In terms of Qigong, dynamic post-station Qigong, health Qigong, and longevity Qigong are recommended, with an emphasis on Qigong practices.

　　13. 3. Relax and build confidence in treatment, and be patient with treatment. Young women with this disease who have not been treated have a high chance of developing type 2 diabetes in middle and old age. The untreated disease is considered a progressive syndrome that persists for life once it appears.

　　10. 1. Hormone testing: gonadotropins, prolactin, insulin, and melanotropin.

　　9. Gynecological examination: The external genital hair is long and dense, which can extend to the perianal area, lower abdomen, and median abdominal line;

　　8. Ultrasound examination: Bilateral ovarian polycystic enlargement, with thickened capsules and strong echoes. Subcapsularly, there are a large number of cystic follicles with diameters of 3-9mm, with more than 10 on each side or both sides.

　　7. Postperitoneal pneumography and uterine salpingography: The purpose of this examination is to observe the morphological and size characteristics of the ovaries and adrenal glands to differentiate the causes of hyperandrogenism.

　　6. Curettage and endometrial biopsy: Patients over 35 years old should undergo routine curettage and endometrial biopsy to understand the histological changes of the endometrium and to exclude endometrial cancer.

　　5. Endoscopic examination: including laparoscopy and culposcopy, to directly observe the morphological characteristics of the ovaries or to perform biopsies, punctures, wedge resections, and electrocautery treatments.

　　1. The diet of PCOS patients should be light and avoid spicy and刺激性 food. It is necessary to avoid sweets, and it is also best not to eat mung beans, crabs, and persimmons.

　　2. To prevent malabsorption caused by dietary restriction, polycystic ovary syndrome (PCOS) patients should supplement calcium tablets and one comprehensive vitamin containing folic acid daily, and the daily water intake should reach 8 cups; to avoid dyslipidemia, eat less food containing saturated fatty acids and hydrogenated fatty acids, such as pork and beef mince, lard, various poultry and livestock skin, butter, artificial butter, whole milk, fried foods, and Western and Chinese pastries; fish, protein, beans, and nuts are good sources of protein.

　　3. Secondly, choose low glycemic index foods: try to eat unrefined foods, such as rolled oats are definitely better than oatmeal, oatmeal is better than instant oatmeal or flour, brown rice and mixed grain rice are better than white rice, hard mixed grain bread is better than soft mixed grain bread, and soft mixed grain bread is better than white bread; fruits are better than fruit juice; as for cakes, they are a big taboo. The glycemic index of various fruits varies greatly, in addition, do not eat carbohydrates alone, try to combine vegetables and fruits with fiber, protein, or fat, which can reduce absorption speed.

　　3. Women with a history of heart failure and myocardial infarction, severe hypertension, and renal hypertension caused by kidney disease should not take birth control pills.

　　Western medicine treatment: Medication can counteract the effects of androgens and promote ovulation of the ovary. The main drugs used are oral contraceptives, which can also adjust the menstrual cycle. Generally, it takes about 3-6 months to stop taking the medicine after the hormone level test is normal.

　　Surgical treatment: Minimally invasive laparoscopic surgery, that is, ovarian multi-point electrocoagulation biopsy resection, ovarian electrocoagulation, and laser ovarian multi-point vaporization and laser wedge resection. The latest treatment methods are based on treating insulin resistance, so the application of biguanide drugs such as metformin is extremely significant in improving the success rate of treatment and has now been listed as a drug as important as ovulation-inducing drugs. Due to the insufficient understanding of the etiology and pathogenesis of the disease at present, the effect is still far from enough.

　　Other treatments: In the treatment of polycystic ovary syndrome, dietary control and management are very important, and the focus of treatment is to reduce the intake ratio of carbohydrates and fats to curb insulin resistance; to reduce weight to suppress abnormal gonadotropin and androgen secretion. Many patients do not need medication or surgical treatment, and can benefit simply by controlling diet, strengthening exercise and exercise.