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 abnormal, and there is no clear 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 the active treatment approach of Western medicine for polycystic ovary syndrome. The main goal of this treatment is to establish a normal ovulatory menstrual cycle, restore fertility, and eliminate hirsutism. Once a normal menstrual cycle is established, conception 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 as the first-line treatment for polycystic ovary syndrome. Clomiphene induces the hypothalamus to release gonadotropin-releasing hormone, which in turn promotes the pituitary to release follicle-stimulating hormone, thereby promoting the normal development of follicles. An increased concentration of follicle-stimulating hormone 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 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 the treatment is ineffective after 1–2 cycles, the dosage can be increased to 100 mg daily for 5 days. During treatment, basal body temperature is measured to observe for an ovulatory biphasic curve.
（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 shortly 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.