小節的醫學筆記

Ref. Revised 2003 criteria (2 out of 3)

盛行率：4%-12% of reproductive-age women

症狀：

1. Hyperandromgenism - hirsutism (用Ferriman-Gallwey Scoring System ≧8分來評估)

2. Type II DM

3. Acanthosis nigricans

4. Irregular menses (經血過少、無月經、DUB)

5. Obesity (50%)

6. Infertility, Early pregnancy loss (30% in PCOS women)

診斷

1. 2/3 criteria

2. DHEAS high (Dehydroepiandrosterone sulfate)

治療:

1. Clomiphene (促排卵藥) + Metformin combination (oral) : 使用6個月約50%可以排卵、24%可以懷孕、8%生雙胞胎。

2. Gonadotropin + down regulation with GnRH-agonist (IV)

3. OC

4. Anti-androgens: Spironolactone or Cortisone 0.25mg-0.5mg every night (去拮抗DHEAS)

5. Surgery : Laparoscopic ovarian drilling

副作用

1. Clomiphene : 是Hypothalamus estrogen receptor blocker，所以會抑制HPO axis feedback，造成GnRH, FSH, LH上升。此外部分作用於Endometium，導致子宮內膜變薄。