Patient's question:
Upon review, it has been determined that the condition is Polycystic Ovary Syndrome (PCOS). How should it be treated?Doctor's answer:
(1) General TreatmentPatients should actively engage in exercise, reduce the intake of high-fat and high-sugar foods, and lower their weight. This can help decrease androgen levels, which is beneficial for restoring ovulation.
(2) The primary goal of Polycystic Ovary Syndrome (PCOS) treatment is to establish a normal ovulatory menstrual cycle, restore fertility, and eliminate hirsutism. Once a normal menstrual cycle is established, pregnancy becomes possible, 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 Clomifene Citrate or Serophene). 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 facilitating normal follicular development. Elevated FSH levels are key to inducing ovulation in PCOS patients. Clomiphene treatment leads to ovulation in more than 80% of patients. Specific dosage: Start on day 5 of the menstrual cycle, take 50 mg once daily 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 should be measured to observe for ovulatory biphasic patterns.
② Ovarian wedge resection, which involves removing a wedge-shaped portion of the ovary. Before the introduction of clomiphene, ovarian wedge resection was the primary treatment for PCOS, with significant efficacy. Most patients ovulated and became pregnant shortly after surgery. With the availability of clomiphene, ovarian wedge resection is now rarely used and is reserved only for patients who do not respond to medication.
If the above two methods are ineffective, laparoscopic surgery may need to be considered. Under laparoscopic guidance, the surgeon punctures ovarian follicles to reduce androgen levels, thereby achieving the treatment goal.
Generally, patients can restore ovulation and become pregnant after their symptoms are controlled. However, some patients may experience recurrence, requiring regular follow-up examinations. It should be noted that the longer PCOS persists, the more difficult it becomes to treat. Therefore, if any related symptoms appear, patients should seek medical attention promptly to avoid delaying the condition.