What are the symptoms of right ovarian polycystic disease?

Polycystic ovaries can occur on one side or on both sides at the same time. The biggest characteristics of right-sided polycystic ovaries are amenorrhea, hirsutism, obesity and infertility. It is necessary to pay attention to the symptoms of right-sided polycystic ovaries and treat them in time when abnormalities are found to avoid serious consequences.

1. Menstrual disorders. pCOS causes anovulation or infrequent ovulation in patients, and about 70% of them have menstrual disorders. The main clinical manifestations are amenorrhea, infrequent menstruation, and dysfunctional uterine bleeding, accounting for 70% to 80% of women with abnormal menstruation, 30% of secondary amenorrhea, and 85% of anovulatory dysfunctional uterine bleeding. Because pCOS patients have ovulatory dysfunction and lack cyclical progesterone secretion, the endometrium is under simple high estrogen stimulation for a long time, and the endometrium continues to proliferate, which is prone to simple endometrial hyperplasia, abnormal hyperplasia, and even atypical endometrial hyperplasia and endometrial cancer.

2. Clinical manifestations related to hyperandrogenism

(1) The amount and distribution of hirsutism varies with gender and race. Hirsutism is one of the important manifestations of increased androgen levels. There are many methods for clinically assessing hirsutism, among which the Ferriman-Gallway hair scoring standard is recommended by the World Health Organization. In my country, the hirsutism of pCOS patients is not serious. The results of a large-scale community population survey showed that an mFG score > 5 points can be diagnosed as hirsutism. 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, pCOS has the characteristics of severe symptoms, long duration, stubbornness and poor response to treatment.

(3) Female pattern hair loss (FPA) pCOS starts to lose hair at around the age of 20. It mainly occurs on the top of the head, extending forward to the front of the head (but not to the hairline), and extending backward to the back of the head (but not to the back of the head). The hair on the top of the head is 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) Masculinization is mainly manifested by male-pattern pubic hair distribution. Generally, there are no obvious masculinization manifestations, such as clitoral hypertrophy, breast atrophy, deep voice, and other abnormal development of external genitalia. If pCOS patients have typical masculinization manifestations, they should be distinguished from congenital adrenal hyperplasia, adrenal tumors, and tumors that secrete androgens.

3. 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 ultrasound criteria for pCO are ≥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 manifest as increased medullary echoes.

4. Others

(1) Obesity Obesity accounts for 30% to 60% of pCOS patients, and its incidence varies depending on race and dietary habits. In the United States, 50% of pCOS women are overweight or obese, while reports from other countries show that obese pCOS is relatively rare. Obesity in pCOS manifests as central obesity (also known as abdominal obesity), and even non-obese pCOS patients show an increased proportion of perivascular or omental fat distribution.

(2) Infertility: Due to ovulatory dysfunction, the pregnancy rate of pCOS patients is reduced and the miscarriage rate is increased. However, it is not clear whether the miscarriage rate of pCOS patients is increased or whether miscarriage is the result of being overweight.

(3) Obstructive sleep apnea is a common problem in pCOS patients and cannot be simply explained by obesity. Insulin resistance has a greater predictive effect on sleep apnea than age, BMI or circulating testosterone levels.

(4) Depression: The incidence of depression in pCOS patients is increased and is associated with a high body mass index and insulin resistance. The patients' quality of life and sexual satisfaction are significantly reduced.