PolyCystic Ovary Syndrome (PCOS) is a common reproductive endocrine metabolic disease, which seriously affects the quality of life, fertility and long -term health of patients. However, PCOS is highly heterogeneous in terms of clinical manifestations. There are still controversy in diagnosis and treatment. The choice of treatment methods is also different. Clinical diagnosis and treatment are more difficult.
In 2018, the Endocrinology Group of the Obstetrics and Gynecology Branch of the China Medical Association’s Obstetrics and Gynecological Sciences Branch, after referring to the relevant foreign guidelines and consensus, combined with the situation, clinical research and diagnosis and treatment experience in China, formulated the “Polycystic Ovarian Syndrome China Diagnosis and Treatment Guidelines “
Guidelines are suitable for diagnosis and treatment and management of patients with PCOS patients in adolescence, childbearing age, and menstrual period. This article will summarize the main points in the diagnosis in the form of a mind map.
PCOS diagnosis basis
It is precisely because the clinical manifestations of PCOS are highly heterogeneous, so in clinical diagnosis, medical history inquiry, physical examination, laboratory examination, and pelvic ultrasound examination are very important diagnosis basis.
Detailed history inquiries will help judge the cause, the further of the PCOS typing, and the design of individualized diagnosis and treatment.
Point of PCOS Medical History
The two major clinical syndrome of PCOS are endocrine abnormalities and / or metabolic abnormalities. For patients with metabolic abnormalities such as obesity, insulin resistance, high insulin ledmia, and sugar fat metabolic disorders, the patient’s weight changes and menstrual abnormalities, diet and lifestyle, family or past metabolic diseases should be asked in detail. Essence For patients with scarcity ovulation or ovulation -free, they can cause patients with menstrual disorders and ovulation disorders, and they should ask in detail whether to combine symptoms such as high and mosaic and polymorphos.
Menstrual disorders are often one of the main causes of domestic PCOS patients, including frequent menstruation, scarcity, amenorrhea, and irregular uterine bleeding. When asking the medical history Change of weight, the menstrual model of the direct family members; about 70%of the ovulation disorders infertile women are PCOS patients. If PCOS is abnormal with obesity and sugar fat metabolism, the impact on reproductive health cannot be ignored, which can cause menstrual disorders, no no Ovulation, infertility, miscarriage, increased risk of complications in the pregnancy period, increasing endless pregnancy ending, etc. Therefore, inquiries with meticulous medical history, distinguish the main manifestations of two types of different symptoms of PCOS patients, and provide a basis for diagnosis of PCOS’s precise diagnostic typing and individualized treatment.
The main clinical manifestations of Kenoscus are more hair, especially men’s black and rough hair, but racial differences need to be considered. The Han people are common in the upper lip, lower abdomen, and inside of the thighs. The rough hair can also be diagnosed with hair on the areola and the umbilical cord. Compared to adolescent acne, acne patients with PCOS are inflammatory skin lesions, which mainly affects the lower, neck, front chest and upper back of the cheeks.
Pelvic ultrasound examination
PolyCystic Ovarian Morphology (PCOM) ultrasound is defined as: 1 or bilateral or bilateral ovarian diameter of 2-9 mm of follicles ≥12, and (or) ovarian volume ≥10 ml (ovarian volume is 0.5 × Calculation of long diameter × horizontal diameter × front and rear diameter).
Before ultrasonic examination, sex hormone drugs should be discontinued for at least one month. If patients with scarcity ovulation have a diameter of follicles> 10 mm or luteal, they should be reviewed in the subsequent menstrual cycle. For those who are asexual, you can choose to pass the rectal ultrasound or abdominal ultrasound. Other patients should choose vaginal ultrasound examination.
PCOM is not unique to PCOS patients. 20%to 30%of women in normal childbearing age may have PCOM, which can also be seen when oral contraceptives and amenorrhea.
PCOS diagnostic standard
At present, the PCOS diagnostic standards proposed internationally focus on the development of three major clinical characteristics of Kenoscopy and/or clinical manifestations, ovulation disorders/menstrual disorders, and ovarian polycystic changes (PCO). In 2011, the Gynecological Endocrinology Group of the Obstetrics and Gynecology Branch of the China Medical Association formulated the domestic industry standards in the “Diagnosis of Mult capsules”. Uterine bleeding is a necessary condition for Chinese PCOS diagnosis.
In 2018, the diagnostic standards of China’s “Polycystic Ovarian Syndrome Consultation Guide” continued to use the 2011 diagnostic standards in 2011, and the diagnosis of China to diagnose China in two steps divided the diagnosis of PCOS into two different ages: childbearing age and siege Menstructed period, adolescence.
Excluding other similar diseases is a condition for diagnosis of PCOS.
1) Differential diagnosis of Agroges hemophilia or the symptoms of high androgen
2) Difference diagnosis of ovulation disorders
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