What to do with polycystic amenorrhea

What to do about polycystic amenorrhea?

1. Regulate the menstrual cycle: It is very important to use medications regularly and reasonably to counter androgens and control the menstrual cycle.

① Oral contraceptives: estrogen and progesterone combined cyclic therapy. Progesterone can directly act on the endometrium through negative feedback to abnormally high pituitary LH secretion, reduce ovarian estrogen production, and regulate the menstrual cycle; estrogen can promote the liver to produce sex hormone binding globulin, resulting in a decrease in free testosterone. Commonly used oral short-acting contraceptives are taken regularly, and the course of treatment is generally 3-6 months, which can be used repeatedly. It can effectively inhibit hair growth and treat acne.

② Progesterone second half cycle therapy: It can regulate menstruation and protect the endometrium. It can also inhibit the high secretion of LH. It can also restore ovulation.

2. Reduce blood androgen levels.

3. Improve insulin resistance: Insulin sensitizers are often used in patients with obesity or insulin resistance. Metformin can inhibit the liver from synthesizing glucose and increase the sensitivity of peripheral tissues to insulin. By reducing the insulin learning level, it can correct the patient's high androgen state, improve ovarian ovulation function, and improve the effect of ovulation induction treatment. The usual dose is 500 mg orally each time, 2-3 times a day.

4. Inducing ovulation: After basic treatments such as adjusting lifestyle, anti-androgen, and improving insulin resistance, ovulation induction treatment is performed. Clomiphene is a first-line ovulation drug. Patients with clomiphene resistance can be given second-line ovulation drugs, such as gonadotropin. Inducing ovulation is prone to ovarian hyperstimulation syndrome, which requires strict monitoring and strengthening of preventive measures.