Polycystic ovary but normal menstruation

Polycystic ovary is a disease that troubles girls. Polycystic ovary is generally caused by an abnormal endocrine system. Girls may experience excess androgen, which may manifest as menstrual irregularities or excessive hirsutism. Some patients still have normal menstruation during polycystic ovary period, which is related to individual differences, but timely treatment is still needed to avoid serious consequences. So, what is the matter with polycystic ovary but normal menstruation?

1. Clinical manifestations of hyperandrogenism

(1) Hairy

The amount and distribution of hair vary with gender and race. Hirsutism is one of the important manifestations of increased androgen. There are many methods for evaluating hirsutism clinically. Among them, the method recommended by the World Health Organization is the Ferriman-Gallway hair scoring standard. In my country, hirsutism is not serious in most PCOS patients. The results of a large-scale community epidemiological survey show that hirsutism can be diagnosed if the mFG score is >5 points. Excessive sexual hair is mainly distributed on the upper lip, lower abdomen and inner thighs.

(2) Hyperandrogenic acne PCOS patients are mostly adult female acne with rough skin and enlarged pores. Unlike adolescent acne, they are characterized by severe symptoms, long duration, stubbornness, and poor response to treatment.

(3) Female pattern hair loss (FPA): PCOS women begin to lose their hair around the age of 20. It mainly occurs on the top of the head, extending forward to the front of the head (but not invading the hairline) and backward to the back of the head (but not invading the back of the head). The hair on the top of the head becomes diffusely sparse and falls out. It neither invades the hairline nor causes baldness.

(4) Seborrhea PCOS produces excessive androgens, resulting in hyperandrogenism, which increases sebum secretion, causing excessive oil on the patient's head and face, enlarged pores, slightly red and greasy skin on both sides of the nasolabial groove, dandruff and itchy scalp, and increased oil secretion on the chest and back.

(5) Masculinity

The main manifestation is male-pattern pubic hair distribution, and generally no obvious masculinization manifestations such as clitoral hypertrophy, breast atrophy, deep voice and other abnormal development of external genitalia. In PCOS patients with typical masculinization manifestations, attention should be paid to distinguishing congenital adrenal hyperplasia, adrenal tumors, and tumors that secrete androgens.

2. Polycystic ovary (PCO)

Although a lot of research has been done on the ultrasound diagnostic criteria for PCO, there are still many different opinions. In addition, racial differences make it even more difficult to unify the diagnostic criteria. The 2003 Rotterdam PCO ultrasound standard was ≥12 follicles in one or both ovaries, with a diameter of 2 to 9 mm, and/or an ovarian volume (length × width × thickness/2) >10 ml. At the same time, it may show increased medullary echo.