月经不调,痤疮,多毛,多囊卵巢综合征的可能性

Dian Nur Apriliana, Refia Putri Restiana, Irene Yemima Dalope, Andhika A. Perdana, Arie Widiyasa
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摘要

背景:多囊卵巢综合征(PCOS)是一种常见的由雄激素过多引起的激素紊乱,卵巢肿大,有许多小卵泡,呈囊肿状。病因尚不清楚,但越来越多的证据表明,这可能是一种复杂的多基因疾病,具有强烈的表观遗传和环境影响。治疗方案包括联合口服避孕药、抗雄激素等。病例介绍:N女士,17岁,因闭经来到RSAL Mintohardjo综合诊所就诊。她的父母没有共病。患者14岁开始月经初潮,此后不久发生继发性闭经。检查时,她的身体质量指数为18.4kg/m²,脉搏92/min,血压115/80毫米汞柱。她的多毛评分(Ferriman-Gallway)为8分,无黑棘皮病。其他全身检查未见异常,实验室检查未见异常。病人服用联合激素药片。激素避孕可以帮助治疗多囊卵巢综合征,但它不是唯一的选择。生活方式的改变,比如减肥和多锻炼,可能会有所帮助。讨论:多囊卵巢综合征涉及下丘脑-垂体轴、胰岛素和卵巢功能的原发性缺陷。黄体生成素水平过高导致多囊卵巢综合征患者雄激素过多。结论:所有月经模式异常的女性都应评估潜在的多囊卵巢综合征,雄激素过多的迹象,激素谱和盆腔超声检查卵巢。早期诊断和治疗可以避免潜在的并发症。避孕药(联合激素)可以用于那些不想怀孕的妇女的长期治疗。避孕药可能有助于调节月经出血,减少毛发过度生长和痤疮,并降低患子宫内膜癌的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Irregular Menstruation, Acne, Hirsutism, and the Possibility with PCOS
Background: PCOS was a common hormonal disorder caused by hyperandrogenism so the ovaries enlarged with many small follicles appear like cysts. The aetiology still unknown, but mounting evidence suggests that can be complex multigenic disorder with strong epigenetic and environmental influences. Therapeutic options include combined oral contraception, antiandrogens, etc. Case Presentation: Ms. N, 17 years old, came to polyclinic of RSAL Mintohardjo evaluated for amenorrhea. Her parents didn’t have comorbid conditions. The patient started Menarche at the age of 14, soon thereafter developed a secondary amenorrhea. On examination her BMI was 18.4kg/m², pulse-92/min and BP-115/80 mm of hg. She had a hirsute score (Ferriman-Gallway) of 8 and had no acanthosis nigricans. No abnormality on the other systemic examination and no laboratory tests were carried out. Patient given with combination hormonal pills. Hormonal birth control can help with PCOS symptoms, but it is not the only option. Lifestyle changes, such as losing weight and exercising more, may help. Discussion: PCOS involves primary defects in hypothalamic–pituitary axis, insulin, and ovarian function. Excess LH levels lead to hyperandrogenism in PCOS. Conclusion: All women with abnormal menstrual patterns should be evaluated for underlying PCOS, signs of hyperandrogenism, hormone profile, and pelvic ultrasonography to visualize the ovaries. Early diagnosis and treatment can avoid potential complications. Birth control pills (combined hormonal) can used for long-term treatment in women who didn’t want to pregnant. The birth control pills may help regulate menstrual bleeding, reduce excessive hair growth and acne, and decrease the risk of endometrial cancer.
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