What's the matter with polyovaries?

Polyovaries may be caused by genetic factors, endocrine disorders, insulin resistance, obesity, drug effects, etc. Polyovaries can be intervened by adjusting lifestyle, drug treatment, ovulation induction treatment, weight control, surgical treatment, etc.

1. Genetic factors

Some patients with polyovary have a family genetic tendency, which may be related to X-linked dominant inheritance or autosomal abnormalities. Such patients usually develop symptoms of oligomenorrhea or amenorrhea after puberty, accompanied by hyperandrogen symptoms such as hirsutism and acne. Treatment needs to be combined with genetic testing results to develop an individualized plan, including regular reproductive hormone monitoring and ultrasound assessment of ovarian morphology.

2. Endocrine disorders

Hypothalamic-pituitary-ovarian axis dysfunction is the core pathogenesis of polyovary, which is mainly manifested by an increase in the ratio of luteinizing hormone and follicle-stimulating hormone. Patients often have prolonged menstrual cycles and ovulation disorders, and laboratory tests can reveal abnormally elevated levels of anti-Müllerian hormone. Clinically, estrogen and progesterone compound preparations such as drospirenone and ethinylestradiol tablets are commonly used to regulate the menstrual cycle, or dydrogesterone tablets are used to improve the state of the endometrium.

3. Insulin resistance

About 70% of patients with polyovary have insulin resistance, resulting in compensatory hyperinsulinemia that stimulates ovarian stromal cells to excessively secrete androgens. Such patients are often accompanied by metabolic abnormalities such as acanthosis nigricans and abdominal obesity. Treatment needs to be combined with endocrinology for glucose tolerance screening, and metformin hydrochloride enteric-coated tablets can be used to improve insulin sensitivity.

4. Obesity

Obese women with a body fat rate of more than 30% have increased aromatase activity in adipose tissue, which promotes abnormal conversion of androgens into estrogen, forming a vicious cycle. Patients often present with central obesity with a waist-to-hip ratio greater than 0.85, and ultrasound shows that the ovarian volume exceeds 10 cubic centimeters. Lifestyle intervention includes daily calorie control at 1,200-1,500 calories, combined with aerobic exercise for more than 150 minutes per week.

5. Effects of drugs

Long-term use of anti-epileptic drugs such as sodium valproate tablets or glucocorticoids may induce iatrogenic polyovaries. Such patients usually develop menstrual disorders within 1 to 2 years of taking the drug, and the symptoms are reversible after stopping the drug. Treatment requires gradual adjustment of the medication regimen under the guidance of a specialist. If necessary, letrozole tablets may be used in combination to inhibit androgen synthesis.

It is recommended that patients with polyovary ovaries establish a regular work and rest habit, ensure 7-8 hours of sleep a day, and avoid staying up late and interfering with melatonin secretion. In terms of diet, choose low-glycemic index foods such as oats, brown rice and other whole grains, consume no less than 60 grams of high-quality protein per day, and reduce the intake of refined sugar and saturated fatty acids. Moderate-intensity exercise such as brisk walking, swimming, etc. 3-5 times a week for 30-45 minutes each time can help improve insulin sensitivity. Regularly review gynecological ultrasound and six sex hormones to monitor follicle development and changes in metabolic indicators. Patients preparing for pregnancy need to formulate an ovulation induction plan under the guidance of the Department of Reproductive Medicine.