What are the treatment options for polycystic ovary?

If a female friend has problems such as infrequent ovulation or inability to complete ovulation, or too much male hormone in the body, she may be suffering from polycystic ovary syndrome. Possible symptoms include irregular menstruation or amenorrhea. Infertility, excessive hair or acne, etc., if severe, may also cause excessive proliferation of the uterine membrane, which will increase the risk of endometrial cancer. Its treatment is also not very easy and requires specific analysis. I will briefly talk about several methods below.

1. Obesity and insulin resistance

Increase exercise to lose weight, correct endocrine and metabolic disorders aggravated by obesity, reduce insulin resistance and hyperinsulinemia, reduce IGF-1, increase IGfBP-1, and at the same time increase SHBG to reduce free androgen levels. Losing weight can restore ovulation in some obese women with PCOS and prevent the occurrence of type 2 diabetes and cardiovascular disease. Metformin treatment can be used for patients with or without diabetes. It can effectively reduce body weight, improve insulin sensitivity, lower insulin levels, reduce hair loss, and even restore menstruation (25%) and ovulation. Since obesity and insulin resistance are the main causes of PCOS, any drug that can reduce weight and increase insulin sensitivity can treat this syndrome.

2. Drug-induced ovulation

(1) Clomiphene is the drug of choice for PCOS, with an ovulation rate of 60% to 80% and a pregnancy rate of 30% to 50%. Clomiphene competes with endogenous estrogen receptors at the hypothalamus-pituitary level, inhibits estrogen negative feedback, increases the pulse frequency of GnRH secretion, and thus adjusts the secretion ratio of LH and FSH. Clomiphene also directly stimulates the ovaries to synthesize and secrete estrogen. After taking this drug, the ovaries may enlarge due to overstimulation (13.6%), vasodilation may cause hot flashes (10.4%), abdominal discomfort (5.5%), blurred vision (1.5%), or side effects such as rash and mild hair loss may occur.

During treatment, it is necessary to record the basal body temperature of the menstrual cycle, monitor ovulation, or measure serum progesterone and estradiol to confirm whether ovulation occurs and guide the adjustment of the dosage for the next treatment course. If there is still no ovulation or conception after 6 to 12 months of clomiphene treatment, clomiphene plus HCG or glucocorticoids, bromocriptine or HMG, FSH, GnRH, etc. can be given.

(2) Combination of clomiphene and human chorionic gonadotropin (HCG): HCG should be added on the 7th day after discontinuation of clomiphene.

If patients with polycystic ovary are too fat, they need to lose weight scientifically. First of all, the daily calorie intake should be 500 calories less than before. In addition, they need to optimize their diet. Depending on the situation, they need to supplement about 500 milligrams of calcium and vitamins every day. They should drink at least eight glasses of water a day. Some foods containing trans fatty acids should not be eaten too much. Finally, they should insist on moderate exercise.