Patient's question:
Hello:I am a typical patient with polycystic ovary syndrome (PCOS). I have been undergoing treatment for over a year. Initially, I used Western medicine, and later switched to traditional Chinese medicine. However, my YJ (menstruation) is still irregular, and there is no obvious ovulation. What should I do? I really hope to get pregnant this year. Is traditional Chinese medicine better than Western medicine? Thank you.
Doctor's answer:
Hello: It is recommended to adopt Western medicine's active treatment for polycystic ovary syndrome. The main purpose of this 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 that clomiphene is the first-line treatment for polycystic ovary syndrome. Clomiphene can induce the hypothalamus to release gonadotropin-releasing hormone, which in turn promotes the pituitary to release follicle-stimulating hormone, thereby promoting normal follicular development. An increase in follicle-stimulating hormone levels is key to inducing ovulation in patients with polycystic ovary syndrome. Clomiphene treatment can induce ovulation in more than 80% of patients. The specific dosage is to start on day 5 of the menstrual cycle, take 50 mg once daily, for 5 consecutive days. Ovulation usually occurs 7–10 days after medication. If treatment for 1–2 cycles is ineffective, the dose can be increased to 100 mg daily for 5 days. During treatment, basal body temperature should be 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 polycystic ovary syndrome was ovarian wedge resection. The efficacy was significant. Most patients ovulated and became pregnant soon after surgery. Now that clomiphene is available, ovarian wedge resection is rarely used and is reserved only for patients who do not respond to medication.