Patient's question:
How to treat polycystic ovary syndrome (PCOS)? I don't know which medicine to take. Is it better to use Western medicine or traditional Chinese medicine? I'm confused about what to pay attention to, how to treat it, surgery or medication? If taking medication, what medicine is most effective?Doctor's answer:
Clomiphene is the first-line medication 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 hypothalamic-pituitary level, inhibiting estrogen negative feedback and increasing the pulse frequency of GnRH secretion, thereby adjusting the secretion ratio of LH and FSH. Clomiphene also directly promotes the synthesis and secretion of estrogen by the ovaries. After taking this medication, the ovaries may enlarge due to excessive stimulation (13.6%), causing vasodilation with hot flashes (10.4%), abdominal discomfort (5.5%), blurred vision (1.5%), or side effects such as rash and mild hair loss.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, guiding the adjustment of the next course of medication dosage. If ovulation or pregnancy does not occur after 6 to 12 months of clomiphene treatment, additional treatments such as clomiphene combined with HCG or corticosteroids, bromocriptine, HMG, FSH, or GnRH may be administered.