Patient's question:
Patient Gender: FemalePatient Age: 26
Detailed Medical Condition and Purpose of Consultation: How should polycystic ovary syndrome caused by endocrine disorders be treated? Attached are test results: Testosterone: 1.270. Progesterone: 1.070. Prolactin: 6.31. Luteinizing Hormone: 14.74. Follicle-Stimulating Hormone: 6.98. Estradiol: 134.8. I hope to receive a correct and detailed answer from the expert.
First Follow-up Question: Hello Dr. Li Xuejun: Thank you for your answer. But I meant polycystic ovary syndrome, not...
Doctor's answer:
Hello: The main goal of PCOS treatment is to establish a normal ovulatory menstrual cycle, restore fertility, and eliminate hirsutism. Once a normal menstrual cycle is established, pregnancy can occur, the ovaries no longer produce excessive androgens, and hirsutism also disappears. The methods to restore a normal menstrual cycle are as follows.(1) Clomiphene, also known as chlorophen, isoflavone. It is now widely recognized as the first-line treatment for PCOS. Clomiphene induces the hypothalamus to release gonadotropin-releasing hormone, which in turn promotes the pituitary to release follicle-stimulating hormone (FSH), thereby promoting normal follicular development. Elevated FSH levels are key to inducing ovulation in PCOS patients. Clomiphene treatment can induce ovulation in more than 80% of patients. The specific dosage is 50 mg once daily, starting from day 5 of the menstrual cycle, for 5 consecutive days. Ovulation typically occurs 7–10 days after treatment. If the treatment is ineffective after 1–2 cycles, the dose can be increased to 100 mg per day for 5 days. During treatment, basal body temperature is measured to observe for ovulatory biphasic curves.
(2) Ovarian wedge resection, which involves removing a wedge-shaped portion of the ovary. Before the advent of clomiphene, the treatment for PCOS was ovarian wedge resection. The efficacy was significant. Most patients ovulated and became pregnant shortly after surgery. With the availability of clomiphene, ovarian wedge resection is rarely used today and is reserved only for patients who do not respond to medication.