How to diagnose polycystic ovary syndrome

Polycystic ovary syndrome is a common disease among women of childbearing age, mainly caused by metabolic abnormalities and complex endocrine system. Suffering from this disease often manifests as irregular and disordered menstruation or loss of ovulation, affecting fertility. Severe cases may also cause other complications, such as cardiovascular disease, gestational hypertension, etc. So what should we do when facing polycystic ovary syndrome?

Causes

At present, there are two kinds of research on the etiology of PCOS: non-genetic theory and genetic theory.

1. Non-genetic theory of PCOS

Studies have shown that the hormonal environment in the uterus during pregnancy affects the endocrine state of the individual in adulthood. Exposure to high-concentration androgen environments during pregnancy, such as mothers with a history of PCOS or mothers with congenital adrenal hyperplasia and poorly controlled hyperandrogenism, can easily lead to ovulatory dysfunction after puberty.

2. PCOS Genetics Theory

The main basis of this theory is that PCOS tends to run in families. Familial ovulatory dysfunction and polycystic ovarian changes suggest that the disease has a genetic basis. Hyperandrogenism and/or hyperinsulinemia may be genetic characteristics that PCOS family members also suffer from. The effect of insulin on promoting ovarian androgen production is also affected by genetic factors or genetic susceptibility. Family members with oligoovulation, hyperandrogenism, and polycystic ovaries have an increased prevalence of hyperinsulinemia in women and premature hair loss in men. Cytogenetic studies have shown that PCOS may be inherited in an X-linked recessive, autosomal dominant or polygenic manner. Through whole genome scanning, the largest number of genetic genes related to PCOS were discovered, such as candidate genes for steroid hormone synthesis and related functions, androgen synthesis-related regulatory genes, insulin synthesis-related genes, carbohydrate metabolism and energy balance candidate genes, gonadotropin function and regulation candidate genes, adipose tissue-related genes, and chronic inflammation-related genes.

In short, the etiology research of PCOS cannot confirm that the disease is caused by a certain gene site or a certain gene mutation. Its onset may be related to the action of some genes under the influence of specific environmental factors, leading to the occurrence of the disease.

Classification

PCOS diagnosed according to the international diagnostic criteria for PCOS (see the diagnosis section for details) can be subtyped to facilitate individualized treatment selection:

Type 1: Classic PCOS, with polycystic ovarian changes on ultrasound and clinical manifestations of hyperandrogenism and/or hyperandrogenism;

Type 2: Ultrasound shows polycystic ovaries and rare or no ovulation;

Type 3: NIH criteria for PCOS, clinical manifestations of hyperandrogenism and/or hyperandrogenemia and infrequent ovulation or anovulation;

Type 4: Ultrasound polycystic ovarian changes, clinical manifestations of hyperandrogenism and/or hyperandrogenemia and infrequent ovulation or anovulation are also present. This type is also called classic PCOS.