Patient's question:
Detailed medical condition and consultation purpose: I have had irregular menstruation since I started menstruating at the age of 13. Before starting my job, I didn't take it seriously. Later, I went to the hospital, and the doctor only prescribed some Western medicine for regulation, such as Premarin (I only remember this name). It worked when I took it, but stopped when I stopped. I have never been systematically and seriously regulated.Medical history: Breast hyperplasia (breast discharge)
Previous diagnoses, treatments, and outcomes: I had an ultrasound that showed polycystic ovaries. In April, I underwent cycle regulation, taking ethinyl estradiol tablets, clomiphene, vitamin B6, and progesterone injections. I stopped taking the medication at the end of July. My last menstrual period was on June 29, and I had an examination on August 20.
Doctor's answer:
The main goal of treating Polycystic Ovary Syndrome (PCOS) is to establish normal ovulatory menstrual cycles, restore fertility, and eliminate hirsutism. Once normal menstrual cycles are established, pregnancy can occur, the ovaries no longer produce excessive androgens, and hirsutism also disappears. The methods to restore normal menstrual cycles are as follows.(1) Clomiphene, also known as chlorphen, 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 induces ovulation in more than 80% of patients. The specific dosage is 50 mg once daily, starting from the 5th day of the menstrual cycle, for a total of 5 days. Ovulation typically occurs 7–10 days after treatment. If treatment for one or two cycles is ineffective, the dose can be increased to 100 mg daily 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 introduction 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.
(3) Traditional Chinese Medicine. Using the method of invigorating blood and tonifying the kidneys to induce ovulation has shown good results.