Patient's question:
Problem Description: I am a patient with polycystic ovary syndrome. I have been undergoing treatment for infertility, and for the past two years, I have been experiencing severe hair loss every day. When I wash my hair, a lot of hair falls out, and they fall out root by root. I am very frustrated, frustrated. I haven't taken too many medications, only Dian 35 and some medications for regulating my period. I don't know if it's related or if it's a skin condition. Please guide me, professionals.Doctor's answer:
The exact cause of polycystic ovary syndrome (PCOS) is unclear. Currently, it is believed that the condition results from excessive androgen production by the ovaries, which is a consequence of abnormal synergistic interactions among multiple endocrine systems in the body. For women with PCOS who desire pregnancy, the first-line medication for ovulation induction is clomiphene citrate at a dose of 50-100 mg/day for 5 days. This option is favored due to its simplicity and high success rate (75% ovulation rate, 35%-40% pregnancy rate).For women with PCOS who are anovulatory, do not have hirsutism, and do not desire pregnancy, intermittent progesterone therapy (e.g., medroxyprogesterone acetate at 5-10 mg/day orally for 10-14 days every 1-2 months) or oral contraceptives should be administered to reduce excessive endometrial hyperplasia, tumor risk, and androgen levels in the blood. Oral contraceptives should only be prescribed to premenopausal women who are non-smokers and do not have other significant risk factors. Women receiving intermittent progesterone therapy should use contraception, as these hormones may (though not proven) potentially contribute to neonatal malformations if exposure occurs during early pregnancy.
For anovulatory women with PCOS who have hirsutism and do not desire pregnancy, physical treatments such as bleaching, electrolysis, extraction, waxing, or depilation should be encouraged. Oral contraceptives are the first-line treatment for mild hirsutism, as they reduce bioactive free testosterone levels. However, the effects may take several months to become apparent. If oral contraceptives are unsuitable or contraindicated, oral progesterone (medroxyprogesterone acetate at 5-10 mg/day) can be used.
Other medications for managing hirsutism include cyproterone acetate, a potent progestin and anti-androgen that controls hirsutism in 50%-75% of affected women. Spironolactone, a mild diuretic, inhibits androgen biosynthesis and competes with androgens for their binding sites in target tissues. A daily dose of 100-200 mg is effective for treating hirsutism.