Patient's question:
What are the reasons for the multiple bundle-like changes in both ovaries? How is it treated?Doctor's answer:
Hello: The reasons are as follows:① Disruption of the secretion of pituitary gonadotropins The hypothalamus controls the secretion of pituitary gonadotropins through the sustained central and cyclical centers. Under the synergistic action of Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH), the follicles develop, mature, and ovulate. When patients experience hypothalamic dysfunction due to factors such as emotional stress, medication, or illness, the LH/FSH ratio secreted by the pituitary may become abnormal, preventing the follicles from developing and ovulating. Due to the sustained mild stimulation of FSH, the ovaries continuously develop many immature cystic follicles; the sustained high secretion of LH leads to the hyperplasia and luteinization of theca cells, causing polycystic changes in the ovaries.
② Functional defects in the enzyme systems required for ovarian steroidogenesis Some believe that polycystic ovary syndrome (PCOS) may be caused by disruptions in the ovarian enzyme systems, affecting the function of the hypothalamic cyclical center and leading to an imbalance in the LH/FSH ratio.
③ Adrenal cortical dysfunction In some cases of adrenal tumors, adrenal cortical hyperplasia, or Cushing's disease, there is often associated anovulation without the typical manifestations of polycystic ovaries. After treatment, normal cyclical ovulation and menstruation can be restored, suggesting that excessive androgens from the adrenal glands may cause PCOS.
The following methods can be used for treatment:
(1) Clomiphene, also known as Clomifene or Serophene. It is now widely recognized that clomiphene is the first-line treatment for polycystic ovary syndrome. Clomiphene induces the release of gonadotropin-releasing hormone from the hypothalamus, which in turn promotes the release of follicle-stimulating hormone from the pituitary, thereby promoting the normal development of the follicles