Irregular menstruation, excessive hair growth, and acne may be caused by polycystic ovary syndrome

Author: Liu Yiwen Tangshan Central Hospital, Hebei Province

Reviewer: Wang Jian, Chief Physician, Kailuan General Hospital, Tangshan City, Hebei Province

With the continuous development of the economy, the roles played by women in social activities are becoming more and more diverse. The dual pressures of work and life have left many women overwhelmed, yet some women still have to face the troubles of endocrine problems.

There may be such female friends around us, who have long-term irregular menstruation and acne on their faces. Some women even find that their body hair becomes more and more vigorous and their weight increases with age, which makes women who are already "stressed" more anxious and even develop mental symptoms such as insomnia and depression. Many women begin to put their hopes on various health products, expensive cosmetics or weight loss training camps, but often to no avail.

In fact, women with long-term irregular menstruation, excessive hair growth, and acne need more than just simple conditioning, because these may be manifestations of polycystic ovary syndrome, commonly known as "polycystic". Many people are terrified by the term "polycystic", and there are a large number of health products on the market that claim to cure "polycystic". Many women spend a lot of money to buy and use these products, but not only do the problems not get solved, but the symptoms become more severe.

In the final analysis, people are so panicked and anxious largely because they don't really understand the disease "polycystic". It is actually not as scary and terrifying as imagined. Today, let us uncover its true face.

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1.What is polycystic disease?

The full medical name of "polycystic ovary syndrome" is "polycystic ovary syndrome (PCOS)", which is a common endocrine and metabolic disorder syndrome in clinical practice. Studies have reported that the prevalence of the disease is 10% to 13% worldwide [1]. Its typical clinical manifestations include abnormal menstruation, infertility, hirsutism, acne, obesity, etc., and may also be accompanied by a series of metabolic disorders such as insulin resistance, hyperinsulinemia, and abnormal glucose and lipid metabolism.

2. How to diagnose polycystic ovary syndrome?

"Polycystic" seriously endangers women's health, so timely detection and intervention are particularly important. So how should we diagnose it?

There are many diagnostic criteria for polycystic ovary syndrome in the world. The most recognized standard is the Rotterdam criteria established at the 2003 European Society of Human Reproduction/American Society of Reproductive Medicine (ESHRE/ASRM) annual meeting: ① oligomenorrhea or amenorrhea; ② hyperandrogenism or clinical manifestations of hyperandrogenism; ③ ultrasound examination shows polycystic ovary changes. If two of the above three criteria are met and other diseases that may cause hyperandrogenism, such as congenital adrenal hyperplasia, Cushing's syndrome, and androgen-secreting tumors, are excluded, polycystic ovary syndrome can be diagnosed.

It should be emphasized that "polycystic" is a disease with multiple causes, diverse clinical manifestations and great heterogeneity. It requires a reproductive physician to complete relevant examinations and combine medical history to make a clear diagnosis. Therefore, if female friends experience the above symptoms, they should seek help from a professional doctor in time to avoid unnecessary anxiety. Self-diagnosis or even self-medication should be avoided.

3.What impact does polycystic ovary syndrome have on women?

The impact of polycystic ovary syndrome on women's life cycle spans a wide range. During adolescence, it mainly manifests as menstrual disorders, hirsutism, acne, and the resulting anxiety and inferiority complex seriously affect the physical and mental health of adolescents; during the childbearing age, most women will have difficulty conceiving due to long-term anovulation or infrequent ovulation. At the same time, endocrine and metabolic disorders affect the microenvironment of follicle development, leading to a decline in egg quality. The risk of fetal growth retardation and spontaneous abortion in women after pregnancy will increase significantly.

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What is more serious is that polycystic patients will suffer from hypertension, diabetes, cardiovascular and cerebrovascular diseases due to long-term metabolic disorders. Due to long-term anovulation and no progesterone secretion in the body, the endometrium of polycystic patients is under a state of estrogen stimulation for a long time, and the endometrium is very prone to lesions and even endometrial cancer. In addition, this disease will significantly increase the risk of breast cancer in women.

4. How should polycystic ovary syndrome be treated?

At present, the specific cause of "polycystic ovary syndrome" is still unclear, so it cannot be cured and requires lifelong management. Reproductive physicians mainly formulate comprehensive treatment plans based on clinical symptoms, the need for fertility, the severity of the disease, and the effectiveness of previous treatments.

The first-line treatment for polycystic ovary syndrome is exercise and dietary adjustment. By changing bad eating habits, eating a balanced diet and exercising regularly, patients can not only lose weight, but also improve the endocrine metabolic environment in the body. Some patients can even restore normal menstrual cycles and ovulation by losing 5% to 10% of their body weight.

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In addition, reproductive physicians will choose to prescribe oral contraceptives to regulate menstruation and metformin to increase insulin sensitivity and improve metabolism, etc., based on the patient's specific situation and demands; when the patient has fertility needs, drugs such as letrozole and clomiphene will be used to promote follicle growth to increase the patient's probability of pregnancy.

5. How should women with polycystic ovary syndrome prepare for pregnancy?

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(1) Seek medical attention promptly. If you find yourself experiencing symptoms such as irregular menstruation, excessive hair growth, acne, or obesity, you should seek medical attention promptly and receive relevant treatment under the guidance of a professional physician.

(2) Eat a balanced diet and exercise actively. Supplement nutrients such as protein, vitamins, and minerals appropriately, eat more low-sugar, low-fat, and high-fiber foods; and perform moderate-intensity exercise 3 to 5 times a week, each time for more than 40 minutes.

(3) Change bad living habits, such as quitting smoking, drinking, drinking coffee, eating raw or cold food, and avoiding staying up late.

(4) Get pregnant as soon as possible. If you have been diagnosed with polycystic ovary syndrome, you must actively cooperate with treatment and prepare for pregnancy as soon as possible to avoid getting pregnant more difficultly as your age increases and your endocrine and metabolic disorders become more serious. This can also increase the risk of fetal growth retardation and spontaneous abortion.

(5) Maintain a good mood and be positive and optimistic.

References

[1] Yin Jingwen, Yang Wan, Yu Duo, et al. Recommendations of international evidence-based guidelines for the evaluation and management of polycystic ovary syndrome (2023 edition)[J]. Chinese Journal of Reproduction and Contraception, 2023, 43(11): 1099-1113.