Patient's question:
Detailed medical condition and consultation purpose: Polycystic ovary syndrome causing irregular menstruation. What treatment should I follow after childbirth? First follow-up question: Can I take progesterone to regulate my menstrual period? Are there any effective medications? Thank you! Second follow-up question: Can I take progesterone to regulate my menstrual period? Are there any effective medications? Thank you!Doctor's answer:
Hello, the main goal of polycystic ovary syndrome (PCOS) 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 Clomiphene Citrate or Serophene. It is now widely recognized as the first-line treatment for PCOS. Clomiphene induces the hypothalamus to release gonadotropin-releasing hormone (GnRH), which in turn stimulates the pituitary to release follicle-stimulating hormone (FSH), promoting the normal development of follicles. Elevated FSH levels are key to inducing ovulation in PCOS patients. Clomiphene treatment can induce ovulation in more than 80% of patients. The specific dosage is 50 mg once daily, starting from day 5 of the menstrual cycle, for 5 consecutive days. Ovulation typically occurs 7–10 days after starting the medication. If treatment for 1–2 cycles is ineffective, 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 pattern.
（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 conceived 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. The method of invigorating blood and tonifying the kidneys to induce ovulation has shown good results.