What should I do if I don't get my period due to polycystic ovary syndrome?

Written by Li Shun Hua
Obstetrics and Gynecology
Updated on January 08, 2025
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Polycystic Ovary Syndrome (PCOS) is a metabolic disease and a lifelong condition that cannot be cured. The main symptom is irregular menstruation, which can manifest as infrequent menstrual periods or absence of menstruation. If menstruation does not occur for more than two months, it is essential to take oral progestogens, such as progesterone or dydrogesterone, for 12 days. After stopping the medication, menstruation should resume. This is mainly to protect the endometrium, as not menstruating for an extended period prevents it from shedding. Under the influence of unopposed estrogen, there might be excessive proliferation, leading to precancerous changes in the endometrial lining and potentially developing into endometrial cancer over time. Therefore, it is crucial to have a menstrual period at least every two months to protect the endometrium. (Medication should be taken under the guidance of a physician.)

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Written by He Bing
Obstetrics and Gynecology
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What are the symptoms of polycystic ovary syndrome?

Polycystic ovary syndrome often begins in adolescence, with primary clinical manifestations including menstrual disorders, excess androgens, and obesity. First, menstrual disorders are the most prominent symptoms, often characterized by infrequent menstruation, with cycles ranging from 35 days to 6 months, or amenorrhea. Before amenorrhea, there may be scanty menses or infrequent menstruation. It can also present as irregular uterine bleeding with no regular pattern in menstrual cycle, period, or flow. Second, infertility. Women of childbearing age may experience infertility due to ovulatory disorders. Third, hirsutism is the most common manifestation of high androgen levels. It appears in varying degrees, primarily affecting sexual hair, with dense pubic hair showing a male pattern tendency, extending around the anus, groin, or midline of the abdomen. There may also be fine mustache hair on the upper lip or hair around the nipple. Oily skin is also common, related to the accumulation of androgens stimulating vigorous secretion from the sebaceous glands. Fourth, obesity. Over 50% of patients are obese, commonly exhibiting abdominal obesity. Fifth, acanthosis nigricans. Occurs in areas such as the labia, the back of the neck, armpits, under the breasts, and the groin, where skin folds are present. This is characterized by symmetric grey-brown pigmentation, thickened skin, and a soft texture.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Can polycystic ovary syndrome be cured?

Polycystic ovary syndrome is a lifelong disease and is incurable. The causes of this disease are not very clear at present, but are mostly related to environmental and genetic factors. Therefore, it is important to exercise regularly and maintain a normal weight. Generally, the problem is not very serious, but if there is a severe endocrine disorder, it must be addressed, especially in women of childbearing age who experience irregular menstruation or infertility. It is necessary to check the endocrine system and regulate menstruation and promote ovulation based on the endocrine results. If there is a desire to conceive, oral contraceptives can be taken followed by treatments to regulate menstruation and promote ovulation. If there is no desire to conceive, menstruation should occur at least once every two months to avoid endometrial abnormalities.

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Written by He Bing
Obstetrics and Gynecology
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Can polycystic ovary syndrome cure itself?

Strictly speaking, polycystic ovary syndrome is a chronic disease, just like hypertension, which does not have concepts of being cured or healing naturally. It's just that symptoms vary from person to person, and the degree of impact differs. For example, some people have ovulation disorders, often characterized by sparse menstruation or amenorrhea; some have high androgen levels in the blood, often characterized by excessive hair growth and acne; others may have metabolic abnormalities, commonly manifesting as obesity. If patients adjust their lifestyles well, the long-term impact can be relatively minor, but this should not be considered self-healing.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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How to diagnose polycystic ovary syndrome?

Polycystic Ovary Syndrome is a type of gynecological endocrine disorder. Clinically, it generally presents with symptoms such as menstrual irregularities, amenorrhea, obesity, infertility, acne, and hirsutism. If these symptoms appear, it is essential to visit a hospital for an ultrasound examination. The diagnosis of Polycystic Ovary Syndrome can be made if more than 12 follicles are observed on a single sectional view of the ovaries during the ultrasound. In such cases, it is also necessary to have a blood test at the hospital to analyze six key sex hormones, including the ratio of luteinizing hormone to follicle-stimulating hormone, and the levels of testosterone. If the blood test shows high levels of luteinizing hormone and testosterone, Polycystic Ovary Syndrome can also be considered. A diagnosis of Polycystic Ovary Syndrome can generally be confirmed through a combination of ultrasound and sex hormone tests, followed by targeted treatment based on the test results.

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Written by He Bing
Obstetrics and Gynecology
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How is polycystic ovary syndrome treated?

Polycystic ovary syndrome is mainly treated symptomatically, including lifestyle modifications, medication, and surgical treatment. Medication involves regulating menstrual cycles, reducing blood androgen levels, improving insulin resistance, and inducing ovulation; the main surgical treatment currently used is laparoscopic ovarian drilling.