Why do bilateral ovaries show polycystic changes?

Polycystic changes in bilateral ovaries are usually caused by endocrine disorders, genetic factors, insulin resistance, obesity, hyperandrogenism, etc., and can be improved by adjusting lifestyle, drug treatment, ovulation induction treatment, surgical intervention, and traditional Chinese medicine conditioning.

1. Endocrine disorders

Hypothalamic-pituitary-ovarian axis dysfunction may lead to obstruction of follicle development and accumulation of immature follicles to form polycystic changes. Patients are often accompanied by oligomenorrhea or amenorrhea and increased body hair. Ethinyl estradiol and cyproterone tablets are commonly used clinically to regulate hormone levels, or dydrogesterone tablets are used to promote menstrual recovery, and letrozole tablets are used to improve ovulation function when necessary. Ultrasound examination shows that the ovarian volume increases, and the number of follicles in one or both ovaries exceeds 12.

2. Genetic factors

People with a family history of polycystic ovary syndrome have a significantly higher risk of developing the disease, and specific genetic mutations may lead to abnormal function of theca cells. Such patients often develop acne, hair loss and other hyperandrogenic manifestations after puberty. It is recommended to carry out genetic testing to assist diagnosis. In treatment, spironolactone tablets can be used to reduce androgens, and metformin sustained-release tablets can be used to improve metabolic abnormalities.

3. Insulin resistance

Decreased peripheral tissue sensitivity to insulin can cause compensatory hyperinsulinemia and stimulate the ovaries to secrete excess androgens. Patients often have symptoms such as thickening of waist circumference and acanthosis nigricans. In addition to lifestyle intervention, gliclazide sustained-release tablets can be used to improve glucose metabolism, and inositol supplements can be used to regulate the follicular microenvironment. Monitoring fasting blood glucose and insulin release testing can help assess metabolic status.

4. Obesity

Excessive accumulation of adipose tissue can aggravate endocrine disorders, and abdominal fat can promote the conversion of androgens into estrogen. Those with a body mass index over 24 are recommended to lose weight through diet management and aerobic exercise, and to control fat absorption with Orlistat capsules. Research shows that losing 5-10% of your body weight can significantly improve ovulatory function and hormone levels.

5. Hyperandrogenemia

Hyperfunction of ovarian theca cells or excess adrenal-derived androgens can lead to this condition, which is manifested by elevated serum testosterone levels. In addition to the above-mentioned drugs, laparoscopic ovarian drilling can be used to reduce androgen secretion when necessary. Hormone levels need to be checked regularly after surgery, and some patients may need assisted reproductive technology to solve fertility problems.

People with polycystic changes in both ovaries should establish a long-term health management plan, maintain 150 minutes of moderate-intensity exercise every week, and give priority to low-glycemic index foods such as whole grains and deep-sea fish. Review ultrasound and six sex hormones every 3-6 months. Women of childbearing age are advised to monitor basal body temperature to assess ovulation. Those with obvious Kaohsiung symptoms need to continue treatment until their hormone levels stabilize. During pregnancy preparation, ovulation induction drugs should be used in a standardized manner under the guidance of a doctor.